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Schistosoma mansoni  infection is common among school-age children (SAC) in western Côte d'Ivoire. Little is known on the infection rate of preschool-aged children (PSAC) due to epidemiological data deficiency and nonappropriate formulation of the drug. Thus, mass drug administration for schistosomiasis control mainly targets SAC. This study aims to identify the risk factors and spatial distribution of  S. mansoni  infection among PSAC in Blapleu, endemic foci of  S. mansoni . We carried out a cross-sectional study in households with PSAC aged 1–6 years. A structured questionnaire was administered to mothers/guardians to obtain data on sociodemographics and water contact behaviour of children. Point-of-care circulating cathodic antigen (POC-CCA) immunodiagnostic test in urine and Kato-Katz (K-K) method with stool were used for  S. mansoni  infection diagnosis. Multiple logistic regression analysis was performed to determine the relationship between  S. mansoni  infection and sociodemographic data. Coordinates recorded by a Global Positioning System of households, water source points, and infected PSAC were used to map the spatial distribution of  S. mansoni  infection cases. This study was conducted with 350 PSAC aged 1–6 years. The overall infection prevalence of  S. mansoni  varies from 31.43% with the K-K method to 62.86% with the POC-CCA. PSAC aged 2–6 years were highly infected with  S. mansoni  than those aged 1-2 years (OR = 14.24, 95% CI: 5.85–34.64). PSAC who did not have access and who do not live close to the infected water source were at a significant lower risk of  S. mansoni  infection (OR = 0.13, 95% CI: 0.057–0.30). The main purpose of water contact of PSAC was to help their mother for laundry that occurs weekly. In Blapleu, a high risk of  S. mansoni  infection was observed among PSAC. Schistosomiasis control effort in such localities should include information, education, and communication, water, sanitation, and hygiene, and particularly chemotherapy targeting PSAC, reinforcing the need of the paediatric praziquantel formulation.

journal of tropical medicine

Risk Factors and Spatial Distribution of Schistosoma mansoni Infection among Preschool-Aged Children in Blapleu, Biankouma District, Western Côte d’Ivoire