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LOW HERITABLE COMPONENT OF RISK FOR INFECTION INTENSITY AND INFECTION-ASSOCIATED DISEASE IN URINARY SCHISTOSOMIASIS AMONG WADIGO VILLAGE POPULATIONS IN COAST PROVINCE, KENYA

To estimate their heritable component of risk for Schistosoma haematobium infection intensity and disease, we performed a community-based family study among an endemic population in coastal Kenya. Demography and family linkages were defined by house-to-house interviews, and infection prevalence and disease severity were assessed by standard parasitologic testing and by ultrasound. The total population was 4,408 among 912 households, with 241 identified pedigree-household groups. Although age- and sex-adjusted risk for greater infection intensity was clustered within households (odds ratio = 2.7), analysis of extended pedigree-household groups indicated a relatively low heritability score for this trait (h² = 0.199), particularly after adjustment for common household exposure effects (adjusted h² = 0.086). Statistical evidence was slightly stronger (h² = 0.353) for familial clustering of bladder morbidity, with an adjusted h² = 0.142 after accounting for household exposure factors. We conclude that among long-established populations of coastal Kenya, heritable variation in host susceptibility is low, and likely plays a minimal role in determining individual risk for infection or disease.

Received August 7, 2003. Accepted for publication September 24, 2003.

Acknowledgments: We thank the people of Mabatani, Milalani, Marigiza, Nganja, and Vindungeni villages for their ready participation with this project. We also thank Joyce Bongo, Anthony Chome, Moses Machibo, Iddi Masemo, Grace Mathenge, Jackson Muinde, Malick Ndzovu, Saidi Tosha, Mwanaha Chuo, and Massese Naftali for their extensive efforts in the fieldwork that contributed to the success of this project. Our thanks are also extended to Dr. Patrick Muthoka (Ministry of Health for Kwale District) for his support. This work is published with the kind permission of the Director of Medical Services, Ministry of Health, Kenya.

Financial support: This research was supported by the National Institutes of Health (NIH) through grants AI-45473 (National Institute of Allergy and Infectious Diseases) and TW/ES01543 (Fogarty International Center). The development and support of SOLAR software has been supported by NIH grant MH59490.

Authors’ addresses: Charles H. King and Ronald E. Blanton, Center for Global Health and Diseases, W137, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-4983, Telephone: 216-368-4818, Fax: 216-368-4825, E-mail: chk{at}po.cwru.edu. Eric M. Muchiri and H. Curtis Kariuki, Division of Vector Borne Diseases, Ministry of Health, PO Box 20750, Nairobi, Kenya, Telephone: 254-20-725-833, Fax: 254-20-720-030. John H. Ouma, Edmund Ireri, and Davy K. Koech, Kenya Medical Research Institute, Mbagathi Road, Nairobi, Kenya, Telephone: 254-20-722-541, Fax: 254-20-720-030. Peter Mungai, c/o CWRU/DVBD/KEMRI Filariasis-Schistosomiasis Research Unit, PO Box 8, Msambweni, Kenya, Telephone: 254-40-52267. Philip Magak, City X-Ray Services, PO Box 20930, Nairobi, Kenya, Telephone: 254-2-241-105, Fax: 254-2-725624. Hilda Kadzo, Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya, Telephone: 254-2-711-888.

Reprint requests: Charles H. King, Center for Global Health and Diseases, W137, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-4983.

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