@article{oai:nagasaki-u.repo.nii.ac.jp:00002616,
 author = {Chadeka, Evans Asena and Nagi, Sachiyo and Sunahara, Toshihiko and Cheruiyot, Ngetich Benard and Bahati, Felix and Ozeki, Yuriko and Inoue, Manabu and Osada-Oka, Mayuko and Okabe, Mayuko and Hirayama, Yukio and Changoma, Mwatasa and Adachi, Keishi and Mwende, Faith and Kikuchi, Mihoko and Nakamura, Risa and Kalenda, Yombo Dan Justin and Kaneko, Satoshi and Hirayama, Kenji and Shimada, Masaaki and Ichinose, Yoshio and Njenga, Sammy M. and Matsumoto, Sohkichi and Hamano, Shinjiro},
 issue = {9},
 journal = {PLOS Neglected Tropical Diseases},
 month = {Sep},
 note = {Background: Large-scale schistosomiasis control programs are implemented in regions with diverse social and economic environments. A key epidemiological feature of schistosomiasis is its small-scale heterogeneity. Locally profiling disease dynamics including risk factors associated with its transmission is essential for designing appropriate control programs. To determine spatial distribution of schistosomiasis and its drivers, we examined schoolchildren in Kwale, Kenya. 
Methodology/Principal findings: We conducted a cross-sectional study of 368 schoolchildren from six primary schools. Soil-transmitted helminths and Schistosoma mansoni eggs in stool were evaluated by the Kato-Katz method. We measured the intensity of Schistosoma haematobium infection by urine filtration. The geometrical mean intensity of S. haematobium was 3.1 eggs/10 ml urine (school range, 1.4?9.2). The hookworm geometric mean intensity was 3.2 eggs/g feces (school range, 0?17.4). Heterogeneity in the intensity of S. haematobium and hookworm infections was evident in the study area. To identify factors associated with the intensity of helminth infections, we utilized negative binomial generalized linear mixed models. The intensity of S. haematobium infection was associated with religion and socioeconomic status (SES), while that of hookworm infection was related to SES, sex, distance to river and history of anthelmintic treatment. Conclusions/Significance: Both S. haematobium and hookworm infections showed micro-geographical heterogeneities in this Kwale community. To confirm and explain our observation of high S. haematobium risk among Muslims, further extensive investigations are necessary. The observed small scale clustering of the S. haematobium and hookworm infections might imply less uniform strategies even at finer scale for efficient utilization of limited resources., PLOS Neglected Tropical Diseases, 11(9), e0005872; 2017},
 title = {Spatial distribution and risk factors of Schistosoma haematobium and hookworm infections among schoolchildren in Kwale, Kenya},
 volume = {11},
 year = {2017}
}