Impact of Mass Drug Administration on Prevalence of Schistosomiasis in Eight Riverine Communities in the Asuogyaman District of the Eastern Region, Ghana

Abstract

Background: The incidence of schistosomiasis in Ghana and more specifically in the Asuogyaman District had become a noticeable record following the creation of the Akosombo Dam in the early 1960s. This has inevitably since placed an enormous burden on the health service delivery systems in the geographical area. Mass Drug Administration (MDA) of Praziquantel has been used worldwide as a preventive and treatment intervention measure for the disease, and the study area is no exception. The study, therefore, aimed to assess the impact of MDA on the prevalence and associated risk factors of schistosomiasis in eight (8) selected riverine communities within the district.
 Methods: A descriptive retrospective cross-sectional study was conducted involving 896 respondents with ages ranging from 2 to 82 years and a mean age of 17±13.78 years. Data were obtained from the Volta River Authority (VRA) Public Health and Environmental Department. Pearson’s chi-square tests and logistic regression models were used to assess the association and predict the relationship between variables.
 Findings: Out of the 896 respondents, 93 (10.4 %) tested positive for Schistosoma haematobium. Proportionally, the Nyameben community had a high prevalence of 25.8% while Mami-Waterkope, and Mangoase both had a low prevalence of 3.2 %. The average uptake of Praziquantel was 41% across the study area. From the bivariate analysis, the respondents’ community of residence was noted as the only statistically significant variable contributing to infection. Respondents aged 13-39 were 1.68 times more likely to be infected compared to their younger counterparts after controlling for all other covariates in the predictive model.
 Conclusion: Mass Drug Administration had a tremendous effect on reducing the prevalence of urinary schistosomiasis to the present level of 10.4%. However, some “hotspots” like the Nyameben community will require special attention to reduce the high prevalence disease rate. Communities with low uptake of Praziquantel had a relatively high prevalence of schistosomiasis.

Mass drug administration campaigns: Comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected southern Malawi districts

“…These variations observed between intervention and control communities in follow-up when compared to those obtained in baseline mean that other district-specific organizational factors than those attributed to implementation of the study might have influenced the results. These high MDA coverage rates are similar to what other recent studies carried out in Philippines [27], Ghana [34], Cote d’Ivoire, Kenya, Mozambique, Niger and Tanzania [35, 36], Sierra Leone [37], Togo [38] and Zanzibar [39]. A spatiotemporal modelling review [40] have also reported that schistosomiasis prevalence in sub-Saharan Africa has decreased considerably, most likely explained by the scale-up of preventive chemotherapy.…”

Mass drug administration campaigns: Comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected southern Malawi districts

“…These variations observed between intervention and control communities in follow-up when compared to those obtained in baseline mean that other district-speci c organizational factors than those attributed to implementation of the study might have in uenced the results. These high MDA coverage rates are similar to what other recent studies carried out in Philippines [27], Ghana [34], Cote d'Ivoire, Kenya, Mozambique, Niger and Tanzania [35,36], Sierra Leone [37], Togo [38] and Zanzibar [39]. A spatiotemporal modelling review [40] has also reported that schistosomiasis prevalence in sub-Saharan Africa has decreased considerably, most likely explained by the scaleup of preventive chemotherapy.…”

Urogenital schistosomiasis transmission, malaria and anemia among school-age children in Northern Ghana

“…Therefore, a significant proportion of children in the study area are unlikely to have received the MDA treatment year in year out. Similar surveys in other parts of Ghana, have shown that average uptake of Praziquantel targeted at school age children (SAC) can go as low as 41% but varies to as high as 85% [ 16 ]. Therefore, others have argued for an expansion of the MDA for SAC to include adults, pre-school children and school-aged children who are out of school using community-based distribution, though this has been difficult to implement due to logistic challenges including inadequate supply of drugs.…”

“…Ghana has been implementing mass drug administration (MDA) campaigns for school age children (SAC) for schistosomiasis since 2008 [ 15 ]. Notwithstanding the paucity of data on a national evaluation of the program, previous assessments from various endemic communities across the countries show that the MDA for SAC had a significant impact on schistosome prevalence, particularly prevalence of S. haematobium, bringing prevalence rates down to <15% [ 16 ]. Notably, MDA for SAC with Praziquantel in the Asuogyaman District of Eastern Region of Ghana is reported to have contributed in reducing the prevalence of urinary schistosomiasis to about 10.4%.…”

“…Notably, MDA for SAC with Praziquantel in the Asuogyaman District of Eastern Region of Ghana is reported to have contributed in reducing the prevalence of urinary schistosomiasis to about 10.4%. However, uptake of Praziquantel is highly variable and important foci of high prevalence (>19%) remain [ 16 , 17 , 18 ], raising the question of expanding the program to include pre-school children, community-based treatment of out of school children and adults [ 15 ]. Also, previous evidence associates specific risk factors with the likelihood of increased schistosome infection.…”