Abstract Background Schistosomiasis remains a major neglected tropical disease in Ghana with substantial health and social consequences for women and girls. Long-standing mass drug administration (MDA) programmes with praziquantel have been implemented since 2008, yet the disease remains endemic in Ghana raising significant concerns about World Health Organization (WHO) efforts towards elimination by 2030. The study thus aimed to assess the spatio-temporal and hotspots for female schistosomiasis (FS) in Ghana and provide insight that informs gender-sensitive public health interventions. Methods We conducted an ecological, retrospective, spatio-temporal analysis using routine surveillance data on FS. Case counts from female population data were extracted from the District Health Information Management System 2 (DHIMS-2) for all 260 districts in Ghana between 2020 and 2024. Annual and period prevalence per 10,000 female populations were estimated. Global Moran’s I was used to assess spatial autocorrelation, and clustering and hotspots were assessed using Anselin Local Moran’s I and Getis-Ord Gi* statistics respectively, with False Discovery Rate (FDR) correction. Results A total of 4864 FS cases were reported over the five years, with a significant increase in prevalence from 71.9 cases per 10,000 female population in 2020 to 99 cases per 10,000 female population in 2024. Majority of the cases occurred in the second half of the year. There was an observed diffusion of prevalence of the cases from the east-southern to west-southern part of the country. Spatial autocorrelation was observed for FS (Moran I index = 0.060032, Z-Score = 2.650757 and a P < 0.008). Ten districts showed high-high clustering, with districts in middle and south-western zones of the country showing significant hotspots for female schistosomiasis in Ghana. Conclusions The occurrence of female schistosomiasis is not a coincidence. Female populations in approximately 6.5% hotspot districts are at significant risk of female schistosomiasis infection. Hence, gender sensitive schistosomiasis control, including targeted MDA, should be directed towards clustered hotspots, focusing on zones with low prevalence fenced off by high prevalence zones. Graphical Abstract
Efichie et al. (Wed,) studied this question.