Sex-specific correlates of Schistosoma haematobium infection in a rural Zambian setting: A pilot study focusing on immune and hematological factors

This study aimed to identify and compare the sex-specific immune, hematological, and environmental factors associated with Schistosoma haematobium infection in a rural Zambian setting. This community-based cross-sectional study enrolled participants from rural Zambia. Schistosoma haematobium infection was diagnosed microscopically from urine. Blood samples were analyzed for complete blood counts and cytokines via ELISA. Data were analyzed using sex-stratified logistic regression models in StatCrunch, with multivariable models restricted to a limited number of predictors based on events-per-variable considerations to improve stability. The analysis included 51 male and 92 female participants. In the multivariable model, for males, only access to clean water remained independently associated with schistosomiasis infection (aOR = 0.03, 95% CI: 0.00–0.34, p = 0.0040). For females, the final model identified access to clean water (aOR = 0.11, 95% CI: 0.01–0.93, p = 0.0440), reporting any symptoms (aOR = 19.2, 95% CI: 3.17–116.4, p = 0.0010), elevated IL-4 (aOR = 1.01, 95% CI: 1.00–1.02, p < 0.0001), and lower hemoglobin (aOR = 0.48, 95% CI: 0.28–0.83, p = 0.0080) as independent correlates of infection. The correlates of schistosomiasis infection appear to differ by sex. While environmental exposure is a key driver for males, the female profile reflects a combination of environmental, immunological, and hematological factors. These findings highlight the importance of considering sex-specific patterns in schistosomiasis research; however, given the cross-sectional design and limited sample size, the results should be interpreted with caution and confirmed in larger, longitudinal studies.