Prevalence of Urogenital Schistosomiasis and Associated Factors in the Lac Region: A Focus on Environmental and Socioeconomic Contexts

ABSTRACT Background Urogenital schistosomiasis caused by Schistosoma haematobium remains a major public health concern in the Lake Chad region. This study aimed to estimate the cumulative prevalence of S. haematobium infection and to identify factors associated with test positivity within an intervention zone of the Ngouri health district, Lac Province, Chad. Methods A cross-sectional analytical study was conducted using routinely collected data from the Dawa Mobile Health system between February 2024 and April 2025. A total of 4,504 individuals were included after data cleaning and biological consistency correction (22 haematuria cases recoded as positive). Bivariate analysis (Chi-square test) and multivariable logistic regression were performed. Results The overall prevalence was 19.5% (95% CI: 18.4%–20.7%). No statistically significant association was found for age (p=0.163), sex (p=0.939), marital status (p=0.858), occupation (p=0.704), or urine appearance in the binary model (p=0.116). Education level approached significance (p=0.078), with the highest prevalence observed at the primary level (23.0%). In multivariable analysis, only primary education was independently associated with positivity (adjusted OR=1.29, 95% CI: 1.06–1.57; p=0.011). Conclusion Nearly one in five participants tested positive, confirming the high endemicity of the Ngouri district. The homogeneous distribution across demographic subgroups suggests widespread community exposure, supporting mass drug administration beyond school-aged children, strengthened WASH interventions, and consolidation of mobile health surveillance.