Prevalence, Geographical Distribution and Risk Factors of Urinary Schistosomiasis, Bacteriuria and their Co-Infection among School-Aged Children, Kano, Nigeria

Urinary schistosomiasis and bacterial urinary tract infection frequently coexist in children, yet community-based data from northern Nigeria are scarce. This cross-sectional study determined the prevalence, geographical distribution and risk factors of Schistosoma haematobium infection, bacteriuria and their co-infection among school-aged children in Kura, Dambatta and Wudil Local Government Areas (LGAs) of Kano State. Using multistage sampling, 3,030 pupils (1,010 per LGA) from public primary, Islamiyya and Almajiri schools were enrolled between June 2024 and September 2025—a questionnaire captured socio-demographic, environmental and behavioural data. We examined terminal urine microscopically for S. haematobium eggs and cultured it for bacteria. Associations were tested using Chi-square tests and crude odds ratios. Of the 3,030 pupils, 670 (22.1%) had S. haematobium infection alone, 484 (16.0%) had bacteriuria alone, 183 (6.0%) had both infections and 1,693 (55.9%) had neither. Children from Kura recorded the highest prevalence of S. haematobium (26.3%) and bacteriuria (18.8%), followed by Dambatta and Wudil (both p < 0.001), whereas co-infection did not differ significantly between LGAs (5.2–6.9%; p = 0.243). Use of river or stream water, open defecation, frequent water contact, Almajiri school attendance and inadequate handwashing were all significantly associated with infection (p < 0.001), and frequent water contact showed the steepest gradient (22.1% of uninfected pupils compared with 100% of co-infected pupils). Urinary schistosomiasis and bacteriuria are common among pupils in Kano State with shared environmental and behavioural drivers. Integrated control that combines Praziquantel treatment, improved water, sanitation and hygiene, health education and urine culture-based surveillance is recommended.