A prospective risk assessment of the implementation of a schistosomiasis preventive mass drug administration for children aged five years and below in the uMkhanyakude district of KwaZulu-Natal

Abstract

Background Schistosomiasis is endemic in the uMkhanyakude district of KwaZulu-Natal, South Africa. The South Africa Department of Health (DoH) has decided to implement a schistosomiasis preventive mass drug administration program in all affected parts of the country. Quality management is part of the strategic objectives of the treatment program. We conducted a risk assessment and developed guidelines for the quality management of a schistosomiasis preventive treatment program for children aged 5 years and below in the uMkhanyakude District of KwaZulu-Natal. Methods We conducted a scenario planning exercise by interviewing 10 child health experts from the uMkhanyakude Health District to establish potential risks associated with a planned schistosomiasis preventive control treatment program for children aged 5 years old and below. The risks were analyzed using a modified Failure Mode and Effect Analysis (FMEA). An FMEA table was produced to guide the quality management of the planned schistosomiasis preventive control treatment program for children aged 5 years and below in the uMkhanyakude Health District. Results We identified potential risks, failure modes and possible failure corrective/preventive measures in the following activities that would be part of the mass treatment of children aged 5 years and below infected with schistosomiasis in the uMkhanyakude District. These included enrolment of children into the treatment program; general health checks; weight and height measurements; administration of drugs; reporting of side effects and monitoring and evaluation. Conclusion We were able to use FMEA guide quality management and identify potential risks associated with the planned schistosomiasis preventive treatment program for children aged 5 years old and below in the uMkhanyakude District of KwaZulu-Natal. The FMEA for this program will be useful to the quality management of schistosomiasis preventive treatment programs for this age group in other similar settings.