Impact of community piped water coverage on re-infection with urogenital schistosomiasis in rural South Africa

Previously, we demonstrated that high coverage of piped water in the seven years preceding a parasitological survey was strongly predictive of Schistosomiasis haematobium infection in a nested cohort of 1,976 primary school children [1]. Here, we report on the prospective follow up of infected members of this nested cohort (N=333) for two successive rounds following treatment. Using a negative binomial regression fitted to egg count data, we found that every percentage point increase in piped water coverage was associated with 4.4% decline in intensity of re-infection (incidence rate ratio = 0.96, 95%CI: 0.93-0.98, P= 0.002) among the treated children. We therefore provide further compelling evidence in support of the scaleup of piped water as an effective control strategy against Schistosomiasis haematobium transmission.