No abstract

Background Soil-transmitted helminth (STH) infections remain the most common neglected tropical diseases among children living mainly in low-resource settings. Preventive chemotherapy (PC) has been implemented as one of the main public health interventions to control and eliminate STH infections. Although data on routine coverage of PC against STH are available at different level of the health system; these data are unreliable as they are subject to errors and manipulation and evidence is lacking on validated treatment coverage. Thus, this study aimed to determine anthelminthic coverage among school age children (SAC) to inform decision made in PC program implementation. Methods We conducted a community-based cross-sectional coverage survey in ten districts of Ethiopia; in April 2019. Sample size was computed automatically using Coverage Survey Builder (CSB) tool in Microsoft excel. Thirty segments were randomly selected per each selected districts. Collected data were cleaned and analysed using SPSS software (IBM, version 25).

Background: Soil-transmitted helminth (STH) infections are prevalent in most developing countries, including Ethiopia, with school-age children (SAC) at high risk of infection. In Ethiopia, despite substantial progress being made on mass drug administration (MDA) coverage for STH infections, its implementation is facing challenges in hard-to-reach areas. This study thus aimed at assessing equity and coverage in MDA and identifying factors associated with drug coverage for STH infections among SAC in the hard-to-reach setting of southern Ethiopia. Methods: A community-based cross-sectional survey was conducted in the North Ari district, South Omo Zone in July 2019. Sample size was estimated following WHO drugcoverage evaluation guidelines. Factors associated with drug uptake for STH infections were identified using multivariate logistic regression. Results: Of 956 SAC participating in this study, the overall MDA coverage for STH was found to be 27.5% (95% CI 24.7%-30.5%). The odds of having taken drugs were highest among school-enrolled children and in those who knew the purpose of MDA: about about double their counterparts. In contrast, the odds of drug uptake were lower by 69% among those who had got informed only when the drugs delivered and by 92% among those who needed to travel >30 minutes to reach drug-distribution points than their counterparts. Conclusion: Achieving effective and equitable MDA coverage is facing serious challenges in the hard-to-reach setting of southern Ethiopia. The very low (27.5%) and inequitable MDA coverage found in this study are associated with school nonenrollment, inaccessibility, and lack of information, awareness, and mobilization. Social mobilization should be scaled up to inform and create awareness in the community ahead of MDA. Further, school-based deworming in settings with low school enrollment needs a modified strategy to reach those in need of drugs.

Background: Soil-transmitted helminths (STH) (Ascaris lumbricoides, Trichuris trichiura and hookworm) are among the most prevalent neglected tropical diseases (NTDs) in Ethiopia. Pre-school age children (PSAC) pay high morbidity toll associated with STH infections. Site specific operational evidence is lacking on prevalence, intensity and control strategies of STH among PSAC in Ethiopia. This study is, therefore, aimed to fill that missing knowledge gap. Methods: We did a community-based cross-sectional study in five districts of Gamo Gofa zone; from December 2018 to January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites egg in stool. Then data were edited, coded and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis. Results: A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462). Ascaris lumbricoides was the most prevalent, 18.6% (457/2462), followed by Trichuris trichiura, 9.2% (226/2462), and hookworm, 3.1% (76/2462). The prevalence of STH in Chencha, Dita, Deremalo, Bonke and Demba Gofa districts were 33.8% (210/622), 26.4% (109/413), 21.3% (88/414), 20.6% (128/621), and 11% (43/392), respectively. Of the total, 7.4% (181/2462) PSAC were infected with two STH species. Ascaris lumbricodes infections had moderate intensity (15%), and the rest had low infections intensity. It is found that 68.7% of PSAC were treated with Albendazole. This study also revealed households level data as, 39.4% used water from hand-dug well, 52.5% of need to move ≥30minutes to collect water, 77.5% did not treat water, and 48.9% not had hand washing facility. Conclusion: This study showed that a significant proportion of pre-school age children are suffering from STH infections across districts in the study area despite preventive chemotherapy distribution for more than 10 years. Further, gaps in control strategies of STH were highlighted, which calls for action.

Background: Onchocerciasis is the second leading cause of blindness globally next to trachoma, thus eliminating the infection is an important health priority. It is estimated that 15.7 million people are at risk of infection in different parts of Ethiopia. Mass drug administration with ivermectin at community and school level is the basis for control and elimination of onchocerciasis. This study was aimed at validating onchocerciasis treatment coverage in the selected districts of Ethiopia. Methods: A community-based cross-sectional study was employed in Itang special and Wombera districts of Ethiopia, from April 1 to 30, 2019 G.C. We used a coverage validation survey builder tool to compute sample size. Individuals aged five years old and above were eligible population. Data were entered into Microsoft Excel and exported to STATA 14 for cleaning and analyses. A chi-square test was used to note statistical association of the outcome variables with independent variables. Main Findings: A total of 3765 individuals were interviewed. Of these, 3244 were offered onchocerciasis treatment. The overall treatment coverage of onchocerciasis in the two selected districts of Ethiopia was 85.9% of the eligible population (3235/3765) (95% CI, 84.8%, 87%). There was significant difference between the two districts in terms of ivermectin offering (X 2 =70.467, P<0.001). School attendance was also significantly associated with treatment offering and swallowing status (X 2 =77.29, P<0.001; and X 2 =30.581, P<0.001). The main reported reasons for not being offered ivermectin were "being absent" (40.86%) and "not knowing about the mass drug administration" (MDA) (25.29%). Conclusion:In conclusion, the treatment coverage of onchocerciasis in this survey was higher than minimum national desired therapeutic coverage. Treatment coverage in Wombera was higher than Itang special district. In addition, children who attended school had a higher chance of swallowing the drug.