Health System Challenges in Managing Schistosomiasis Among Pregnant Women: A Qualitative Study from an Endemic Indonesian Highland
Abstract
Introduction: Schistosomiasis infection in pregnant women can lead to poor newborn health and reduced birth weight. The present study was conducted on an endemic area, while the risk of pregnant women being exposed to Schistosomiasis in the Napu Highlands is quite high. This study aims to describe the health care system related to Schistosomiasis in pregnant women within the Puskesmas Wuasa working area.
Method: This study used a qualitative descriptive approach in the Puskesmas Wuasa working area in Poso Regency. The sample consisted of 11 key informants, including four pregnant women, three health workers, two Schistosomiasis laboratory workers, one head of the Puskesmas, and one official from a related agency. Data were collected through guided interviews.
Results: Mass screening for Schistosomiasis occurs annually, but specific screening for pregnant women has not been implemented, despite their support for it. Pregnant women cannot take Praziquantel due to potential fetal risks and regulatory concerns. Positive tests lead to referrals by village midwives to Puskesmas. Additionally, Schistosomiasis insurance for pregnant women is readily accessible, often covered by government insurance, ensuring support for affected individuals.
Conclusion: Current health services inadequately support pregnant women in Schistosomiasis -endemic areas, particularly in the Puskesmas Wuasa. The present study highlights the implementation gap in integrating schistosomiasis screening and treatment into antenatal care services within a specific endemic area. Ensuring the safety and regulation of praziquantel as the primary treatment is essential to optimize health services for this vulnerable group.
Keywords: Delivery of health care, mass screening, praziquantel, pregnancy, schistosomiasis
Full Text:
PDFReferences
World Health Organization. Schistosomiasis. Schistosomiasis. August 5, 2018. https://www.who.int/news-room/fact-sheets/detail/schistosomiasis
Friedman JF, Mital P, Kanzaria HK, Olds GR, Kurtis JD. Schistosomiasis and pregnancy. Trends Parasitol. 2007;23(4):159-164.
Widjaja J, Anastasia H, Nurwidayati A, Nurjana MA, Mujiyanto, Maksud M. Current Situation of Focus Areas of Intermediate Host Snails in Schistosomiasis Endemic Areas in Central Sulawesi (Situasi Terkini Daerah Fokus Keong Hospes Perantara di Daerah Endemis Schistosomiasis di Sulawesi Tengah, Indonesia). Bul Penelit Kesehat. 2017;45(4):215-222.
Satrija F, Ridwan Y, Jastal, Samarang, Rauf A. Current status of schistosomiasis in Indonesia. Acta Trop. 2015;141(Part B):349-353.
Media Litbang Kesehatan. Penularan schistosomiasis didesa dodolo dan mekarsaridataran tingginapu sulawesi tengah. Transm SCHISTOSOMIASIS DODOLO MEKARSARI VILLAGES NAPU Highl Cent SULAWESI. 2010;XX:113-117.
Erlan A, Junaidi M, Veridiana NN, Puryadi, Octaviani. Schistosomiasis Control Policy Study in Poso and Sigi Districts, Central Sulawesi Province in 2012 (Studi Kebijakan Pengendalian Schistosomiasis di Kabupaten Poso dan Kabupaten Sigi Propinsi Sulawesi Tengah tahun 2012, Indonesia). Media Litbangkes 2014; 24(1): 42-49.
Collins C, Xu J, Tang S. Schistosomiasis control and the health system in P.R. China. Infect Dis Poverty. 2012;1(1):1-8.
Ministry of Health Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia Number 21 of 2021 concerning the Provision of Health Care during the Pre-Pregnancy Period, Pregnancy Period, Childbirth, and Post-Childbirth Period, Contraceptive Services, and Sexual Health Services (Peraturan Menteri Kesehatan Republik Indonesia Nomor 21 Tahun 2021 Tentang Penyelenggaraan Kesehatan Masa Sebelum Hamil, Maasa Hamil, Persalinan, dan Masa Sesudah Melahirkan, Pelayanan Kontrasepsi, dan Pelayanan Kesehatan Seksual, Indonesia). Published online 2021. Accessed August 30, 2025. https://peraturan.bpk.go.id/Download/375491/permenkes-no-21-tahun-2021.pdf
Friedman JF, Mital P, Kanzaria HK, Olds GR, Kurtis JD. Schistosomiasis and pregnancy. Trends Parasitol. 2007;23(4):159-164.
Gray DJ, Ross AG, Li YS, McManus DP. Diagnosis and management of schistosomiasis. Br Med J. 2011;342(7807):1-12.
Lumeno ISP. Comparison of Various Methods in Detecting Schistosoma Japonicum Worm Eggs in Pregnant Women (Perbandingan Beragam Metode Dalam Mendeteksi Telur Cacing Schistosoma Japonicum Pada Ibu Hamil, Indonesia). Thesis. Hasanuddin University; 2019.
Erko B, Degarege A, Tadesse K, Mathiwos A, Legesse M. Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia. Asian Pac J Trop Biomed. 2012;2(3):235-239.
Adzrago D, Williams DR, Williams F. Multiple chronic diseases and psychological distress among adults in the United States: the intersectionality of chronic diseases, race/ethnicity, immigration, sex, and insurance coverage. Soc Psychiatry Psychiatr Epidemiol. 2025;60(1):181-199.
Van Wilder L, Devleesschauwer B, Clays E, Pype P, Vandepitte S, De Smedt D. Polypharmacy and Health-Related Quality of Life/Psychological Distress Among Patients With Chronic Disease. Prev Chronic Dis. 2022;19:E50.
Hailegebriel T, Nibret E, Munshea A. Efficacy of Praziquantel for the Treatment of Human Schistosomiasis in Ethiopia: A Systematic Review and Meta-Analysis. J Trop Med. 2021;2021:2625255.
Schleenvoigt BT, Holtfreter M, Bohnes T, Okwu DG, Amoako YA, Mischlinger J. Safety and efficacy of praziquantel in pregnant women infected with Schistosoma haematobium. Int J Infect Dis. 2025;153.
Gerstenberg J, Honkpehedji YJ, Dejon-Agobe JC, et al. Safety and efficacy of praziquantel in pregnant women infected with Schistosoma haematobium in Lambaréné, Gabon – Clinical results from the randomized, single-blinded, controlled freeBILy-Gabon trial. Int J Infect Dis. 2024;149:107253.
Tandi J. Treatment Pattern for Schistosomiasis (Snail Fever) Sufferers in Kaduwaa Village, North Lore District, Poso Regency, Central Sulawesi Province (Pola Pengobatan Penderita Schistosomiasis (penyakit Demam Keong) di Desa Kaduwaa Kecamatan Lore Utara Kabupaten Poso Provinsi Sulawesi Tengah, Indonesia). J Sains Dan Kesehat. 2024;1(9):456-464.
Ministry of Health Republic of Indonesia. Minister of Health Regulation Number 19 of 2018 concerning the Implementation of Snail Fever Eradication (Peraturan Menteri Kesehatan Nomor 19 Tahun 2018 tentang Penyelenggaraan Eradikasi Demam Keong, Indonesia). Published online 2018. Accessed August 30, 2025. https://peraturan.bpk.go.id/Details/139655/permenkes-no-19-tahun-2018
Adisa J, Egbujo EM, Yahaya BA, Echejoh G. Primary infertility associated with schitosoma mansoni: a case report from the Jos plateau, north central Nigeria. Afr Health Sci. 2012;12(4):563-565.
DOI: https://doi.org/10.37905/jmhsj.v4i2.34023
Refbacks
- There are currently no refbacks.
Jambura Medical and Health Science Journal (JMHSJ) has been indexed by:
 |  |  |  |
|
| Editorial Office |
Medical Faculty Building, 1st Floor Jl. Jend. Sudirman No.6, Kota Gorontalo, Gorontalo, 96128, Indonesia.Whatsapp: +6285233215280 Email: [email protected] |
 |