Impact of praziquantel on Schistosoma mansoni infection rates and associated factors among primary school children in Teda, Koladiba, and Maksegnit Towns, Northwest Ethiopia

Schistosoma mansoni is a significant public health concern worldwide, particularly affecting schoolchildren. The Ethiopian Ministry of Health promotes school-based single-dose praziquantel. However, this extensive implementation of mass drug administration might lead to selective drug resistance. Therefore, periodic assessment of the therapeutic efficacy of praziquantel is vital. Thus, we aimed to evaluate the impact of praziquantel on S. mansoni infection rates and associated factors among Primary School Children in the towns of Teda, Koladiba, and Maksegnit, Northwest Ethiopia. A Multicenter cross-sectional study design was conducted in Teda, Koladiba, and Maksegnit Primary Schools from May to July 2024. A total of 657 children were enrolled. Approximately 2 g of stool samples were collected and examined using the Kato-Katz technique. Children positive for S. mansoni received a single dose of praziquantel, and cure and egg-reduction rates were assessed within 21 days of treatment. The data were analyzed using SPSS. Out of 657 screened children, 10.5% (69/657) were infected with S. mansoni, with a higher prevalence among males and older children (56.5%). Of the infected children, 63 were followed to assess the therapeutic efficacy of praziquantel, showing a cure rate of 92.1% and an egg reduction rate of 90.1%, with most infections being of light intensity. S. mansoni infection was significantly associated with a history of swimming in rivers (adjusted odds ratio (AOR) = 1.85; 95% CI: 1.03–3.31; P = 0.039) and washing clothes in rivers (AOR = 1.82; 95% CI: 1.02 3.26; P = 0.044). The prevalence of S. mansoni infection among schoolchildren in Teda, Koladiba, and Maksegnit was at a moderate endemic level. The impact of a single dose of praziquantel was satisfactory for treating S. mansoni. However, sustained control efforts, including strengthened health education programs, are recommended to reduce exposure to contaminated freshwater sources, particularly through swimming and washing in open water bodies.