Uptake of Preventive Treatment for Intestinal Schistosomiasis among School Children in Jinja District, Uganda: A Cross Sectional Study

Abstract

BackgroundIn Uganda, the current national health sector strategic and investment plan underscores schistosomiasis as one of the diseases targeted for elimination by the year 2015. However, uptake of treatment among school children is unknown but suspected to be low. We estimated the uptake and predictors of preventive treatment with praziquantel.MethodsIn a cross sectional study carried out in Jinja district of Uganda, a random sample of 1,010 children in 12 primary schools was questioned about their uptake of praziquantel, knowledge and perceptions about schistosomiasis, support for taking preventive treatment and the dangers of taking praziquantel. The prevalence and mean intensity of infection with Schistosoma mansoni were determined.ResultsSelf reported uptake of praziquantel at last mass treatment was 28.2% (95% confidence interval (CI): 22.9%–33.6%). Overall prevalence and mean intensity of S. mansoni infection was 35% (95% CI: 25.4%–37.9%) and 116.1 eggs per gram (epg) of stool (95% CI: 98.3–137.1) respectively. Uptake of praziquantel was more likely if a child was from a school with high prevalence of infection, had knowledge about schistosomiasis transmission and prevention, and reported teachers’ support to take praziquantel. Of the 285 children who took praziquantel, 142 (49.8%) developed side effects. Of the 725 children who did not take the drug, 522 (72.0%) reported fear of side effects as a major reason for non-uptake.ConclusionsUptake of praziquantel in this population is very low. Fear of side effects of praziquantel, lack of knowledge about schistosomiasis transmission and prevention and lack of teacher support are some of the major factors associated with low uptake.

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

“…The uptake of praziquantel for schistosomiasis control has also been reported to be low among school children in Jinja district in Uganda, where it was estimated at 28.2% during the 2011 MDA (Muhumuza et al, 2013b). Similarly, low levels of drug uptake among school children have been reported in Kenya (Miguel & Kremer, 2002).…”

“…In Jinja district, Schistosoma mansoni is highly endemic in areas along Lake Victoria, with 35% of the school-age children harbouring moderate infections of 116.1 eggs per gram (epg) of stool (Muhumuza et al, 2013b). The World Health Organization (WHO) recommends regular treatment programmes for schistosomiasis to target school-age children who could be reached through the primary school system (Engels et al, 2002).…”

Low Prevalence of Intestinal Schistosomiasis Among Fisherfolk Living Along the River Nile in North-Western Uganda: A Biosocial Investigation

“…The majority of research in Uganda has been carried out along Lake Victoria and Lake Albert where infection rates have remained high. Local-level research has found that among people along the lakeshores there is often low drug coverage and, in some cases, there has been resistance to the distribution (Parker et al, 2008;Muhumuza et al, 2013Muhumuza et al, , 2015. Despite multiple rounds of free distribution of praziquantel, high rates of reinfection in both adults and children have persisted, even up to 80-90% at some locations (Kabatereine et al, 2011;Seto et al, 2012;Allen & Parker, 2016).…”

Deworming Delusions? Mass Drug Administration in East African Schools

“…Nevertheless, it was possible to estimate drug uptake at many schools in Uganda. Overall, the uptake of praziquantel by children in schools was higher than the rate reported by Muhumuza et al (2013) from Jinja, although it was very variable, and still well below the WHO's 75% target. Examples are provided below.…”

“…Recently, consumption of praziquantel by children in Uganda has also been studied by another research team in the area around Jinja (Muhumuza et al, 2013). The findings have tended to confirm those presented above.…”