Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren

TY - JOUR

T1 - Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren

AU - Kabatereine, Narcis B

AU - Brooker, Simon

AU - Koukounari, Artemis

AU - Kazibwe, Francis

AU - Tukahebwa, Edridah M

AU - Fleming, Fiona M

AU - Zhang, Yaobi

AU - Webster, Joanne P

AU - Stothard, J Russell

AU - Fenwick, Alan

PY - 2007/2

Y1 - 2007/2

N2 - OBJECTIVE: To evaluate the impact on schistosomiasis of biennial treatment with praziquantel (PZQ) among school-age children in Burkina Faso, the first country that achieved full national coverage with treatment of more than 90% of the school-age population. METHODS: A cohort of 1727 schoolchildren (6-14 years old) was monitored at yearly intervals through a longitudinal survey. Additional groups of schoolchildren were monitored in cross-sectional surveys. Parasitological examinations for Schistosoma haematobium and Schistosoma mansoni were performed, and prevalence and intensity of infection before and after treatment were analysed. FINDINGS: Data from the longitudinal cohort show that a single round of PZQ treatment significantly reduced prevalence of S. haematobium infection by 87% (from 59.6% to 7.7%) and intensity of infection by 92.8% (from 94.2 to 6.8 eggs/10 ml of urine) 2 years post-treatment. The impact on infection was also confirmed by a cross-sectional survey 2 years post-treatment. Importantly, the proportion of school-age children with heavy S. haematobium infection decreased from around 25% before treatment to around 2-3% 2 years post-treatment. Cross-sectional comparison of S. haematobium infection in 7-year-old children in their first year at school, who received treatment through community-based drug delivery, also showed significant reduction in both prevalence (65.9%) and intensity of S. haematobium infection (78.4%) 2 years after single treatment. A significant reduction in S. mansoni infection was also achieved. CONCLUSION: Significant and sustained reduction in S. haematobium infection was achieved by biennial treatment in school-age children in Burkina Faso. This may provide a cost-effective treatment strategy for similar national schistosomiasis control programmes in sub-Saharan Africa.

AB - OBJECTIVE: To evaluate the impact on schistosomiasis of biennial treatment with praziquantel (PZQ) among school-age children in Burkina Faso, the first country that achieved full national coverage with treatment of more than 90% of the school-age population. METHODS: A cohort of 1727 schoolchildren (6-14 years old) was monitored at yearly intervals through a longitudinal survey. Additional groups of schoolchildren were monitored in cross-sectional surveys. Parasitological examinations for Schistosoma haematobium and Schistosoma mansoni were performed, and prevalence and intensity of infection before and after treatment were analysed. FINDINGS: Data from the longitudinal cohort show that a single round of PZQ treatment significantly reduced prevalence of S. haematobium infection by 87% (from 59.6% to 7.7%) and intensity of infection by 92.8% (from 94.2 to 6.8 eggs/10 ml of urine) 2 years post-treatment. The impact on infection was also confirmed by a cross-sectional survey 2 years post-treatment. Importantly, the proportion of school-age children with heavy S. haematobium infection decreased from around 25% before treatment to around 2-3% 2 years post-treatment. Cross-sectional comparison of S. haematobium infection in 7-year-old children in their first year at school, who received treatment through community-based drug delivery, also showed significant reduction in both prevalence (65.9%) and intensity of S. haematobium infection (78.4%) 2 years after single treatment. A significant reduction in S. mansoni infection was also achieved. CONCLUSION: Significant and sustained reduction in S. haematobium infection was achieved by biennial treatment in school-age children in Burkina Faso. This may provide a cost-effective treatment strategy for similar national schistosomiasis control programmes in sub-Saharan Africa.

KW - Adolescent

KW - Albendazole

KW - Ancylostoma

KW - Animals

KW - Anthelmintics

KW - Child

KW - Female

KW - Health Promotion

KW - Helminthiasis

KW - Hookworm Infections

KW - Humans

KW - Male

KW - National Health Programs

KW - Praziquantel

KW - Program Evaluation

KW - Prospective Studies

KW - Schistosoma mansoni

KW - Schistosomiasis

KW - School Health Services

KW - Uganda

U2 - 10.2471/BLT.06.030353

DO - 10.2471/BLT.06.030353

M3 - Article

C2 - 17308729

SN - 0042-9686

VL - 85

SP - 91

EP - 99

JO - Bulletin of the World Health Organization

JF - Bulletin of the World Health Organization

IS - 2

M1 - N/A

ER -