Mass drug administration significantly reduces infection of Schistosoma mansoni and hookworm in school children in the national control program in Sierra Leone

Abstract

BackgroundThe first-ever round of school-based mass drug administration (MDA) with praziquantel together with mebendazole targeting school-aged children in endemic districts was conducted in 2009 by the National Neglected Tropical Diseases Control Program. To evaluate the impact of the treatment regimen, a cross-sectional sentinel site survey was conducted 6 months post-MDA.MethodsFifteen sentinel schools from six highly endemic districts (according to data from national and pre-MDA surveys) with Schistosoma mansoni affecting over 50% of the population, and moderate to high prevalence of hookworms (> 20%). Approximately 30 children aged 9-14 years were selected from each school and stool samples (one per student) were examined by the Kato-Katz method.ResultsThe overall prevalence (and intensity) in these sentinel sites pre-MDA of S. mansoni was 69.0% (170.8 epg), hookworm: 41.7% (71.7 epg), Ascaris lumbricoides: 1.8% and Trichuris trichiura: 3.8%. Six months post MDA, the findings were S. mansoni: 38.2% (47.3 epg) and hookworm: 14.5% (8.7 epg), representing a reduction from pre-MDA levels of 44.6% (65.2%) and 72.3% (87.9%) respectively. The proportion of children who were moderately or heavily infected with S. mansoni fell from 35.6% pre MDA to 9.9% post MDA.ConclusionsSignificant reduction in S. mansoni and hookworm infection was achieved by this first round MDA in school-going children in Sierra Leone. This reduction in infection burden can potentially contribute to a reduction of morbidity, such as anaemia, in these children.

Analysis of Schistosomiasis haematobium Infection Prevalence and Intensity in Chikhwawa, Malawi: An Application of a Two Part Model

“…Studies have shown that MDA significantly reduces Schistosomiasis infection [31], [32]. Evidence has shown that, following chemotherapeutic cure of S. mansoni or S. haematobium infection, older individuals display a resistance to re-infection in comparison to younger children [33].…”

Understanding Low Uptake of Mass Treatment for Intestinal Schistosomiasis Among School Children: A Qualitative Study in Jinja District, Uganda

“…Providing food for children prior to MDA, as well as treatment to alleviate and manage the side-effects attributable to praziquantel treatment, could be considered. High coverage and better compliance to treatment for schistosomiasis among school children was achieved by the national control programme in Sierra Leone when a special feeding programme for the children and supplies such as antihistamines and paracetamol to mitigate the side-effects were provided (Hodges et al, 2012).…”

“…Teachers confessed that they withheld the drugs from such children because they feared they would cause serious side-effects if the children swallowed them on empty stomachs. In Swaziland, the mass treatment exercise by the national schistosomiasis control programme was suspended following hospitalization of over 800 pupils after receiving praziquantel treatment (Hodges et al, 2012). In Tanzania, treatment for schistosomiasis in schools was suspended following riots in 2008 after parents became convinced that the tablets had been sent to poison their children ).…”

A qualitative study to assess community barriers to malaria mass drug administration trials in the Gambia

“…MDA is the control strategy of choice in other parasitic diseases, such as lymphatic filariasis, schistosomiasis, and onchocerciasis [5-7]. However, current studies of MDA for malaria have shown mixed results, with some evidence of success yet no long lasting effects in either sub-Saharan Africa or the Asia Pacific [8-12].…”