There has been a recent revival of interest in school-based health programmes in developing countries as a means of reducing the morbidity observed in school-aged children, of improving their physical growth and cognitive development, and of controlling transmission of disease in the community at large. This study used data collected from a large epidemiological survey of schistosomiasis in Egypt to examine what proportion of infected children missed treatment from an established national school-based schistosomiasis control programme simply because they did not attend school. It showed that children who were not enrolled in school had a higher prevalence of infection and were more intensely infected than children who attended school. At the extreme, over 80% of infected girls in one part of Egypt could not be treated by the existing school programme because they did not attend school. If these trends are similar in other countries where school-based programmes are being developed, school-based delivery may exacerbate existing inequalities in society and ways of expanding services to children who do not attend school regularly need to be explored.

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Ghana has made significant progress in expanding water services, but microbial contamination of water is still a major public health problem. The objectives of the study were to: 1) Examine sociodemographic and water access related predictors for the point of use or drinking water quality among rural and urban households, and; 2) Determine the association between the point of use water quality and prevalence of diarrhea among young children in rural and urban households. A secondary data analysis was carried out using the Ghana UNICEF-MICS6 survey taking into account the complex survey design. Logistic regression models were used to carry out the objectives. Among the 2317 households included for water quality testing, majority reported using improved source of drinking water. However, use of unimproved source of water was more common among rural households. In examining water quality at the point of use, it was found that more than 60% of the samples had mid to high levels of E. coli count, with significantly more common among rural compared to urban households (p < .0001). The prevalence of diarrhea among under 5 children was 16.9%. In estimating the risk, E. coli count was not associated with higher diarrhea prevalence. However in urban areas, water storage was associated with increased risk of caregiver-reported diarrhea in children. Also, other factors such as child’s age, maternal education, region and household wealth index predicted diarrhea prevalence. In Ghana, contaminated point of use drinking water is more common in rural household, and in urban areas, water storage is associated with increased risk of caregiver-reported diarrhea in children. In the future, investigation of living condition and environmental hygiene is warranted to further understand different pathways through which risk of diarrhea increases among children.