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Impact of praziquantel mass drug administration campaign
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Impact of praziquantel mass drug administration campaign on prevalence and intensity of Schistosoma haemamtobium among schoolchildren in Bahi district, Tanzania
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Tanzania Journal of Health Research Doi: http://dx.doi.org/10.4314/thrb.v16i1.1
Volume 16, Number 1, January 2014
1
Impact of praziquantel mass drug administration campaign on prevalence and intensity of
Schistosoma haemamtobium among schoolchildren in Bahi district, Tanzania
SIMON A. CHAULA
1
and DONATH S. TARIMO
2*
1
Department of Biomedical Sciences, School of Medicine, University of Dodoma, Tanzania
2
School of Public Health and Social Sciences, Muhimbili University of Health & Allied Sciences, Dar es Salaam,
Tanzania
_______________________________________________________________________________ ___________
Abstract: As part of the Tanzania National Schistosomiasis Control Programme, Bahi district in central Tanzania,
received two annual rounds of praziquantel mass drug administration (MDA) to control urinary schistosomiasis
in schoolchildren. The objectives of this study were to assess the impact of the two rounds of MDA on
prevalence and intensity of Schistosoma haemamtobium and the impact of MDA campaigns on knowledge of
urinary schistosomiasis, safe water use and contact with potentially unsafe water bodies. A quantitative cross-
sectional study was carried out among schoolchildren in March and April, 2013. A structured questionnaire was
used to collect information on MDA uptake, knowledge of schistosomiasis, sources of water for domestic and
other uses. Urine samples were collected from each pupil to examine prevalence and intensity of S.
haematobium. Transmission of schistosomiasis was assessed by sampling Bulinus spp snails for cercarial
shedding. Uptake of MDA was 39.5% in 2011 and 43.6% in 2012. Prevalence of S. haematobium significantly
dropped by 50.0% from 26% in 2011 to 15% in 2012 (p = 0.000). Prevalence of S. haematobium was significantly
low in MDA participating (3.1%) than non-participating (28.5%) schoolchildren (p = 0.000). MDA campaigns had
significant impact on knowledge of the disease (p = 0.02) and borderline impact on safe water use (p = 0.04)
but had no impact on avoidance of contact with unsafe water bodies (p = 0.06). Bulinus spp. snails were found
shedding schistosome cercariae indicating environmental contamination with viable S. haematobium eggs. In
conclusion, though MDA significantly reduced prevalence of S. haematobium, uptake was below 50.0% and
below the World Health Assembly resolution 54.19 target of 75.0% for 2010. Non-participation in MDA was the
likely source of S. haematobium eggs in the environment hence the observed 15.0% prevalence of S.
haematobium infection; and cercarial shedding Bulinus spp. snails indicating continuity of transmission hence
the need for further health promotion campaigns.
______________________________________________________________________________ ____________
Keywords: urinary schistosomiasis, schoolchildren, mass drug administration, praziquantel, Tanzania
Introduction
Urinary schistosomiasis is a chronic disease caused by infection with the parasitic trematode known
as Schistosoma haematobium. Common early signs of S. haematobium infection include microscopic
and visible haematuria that precede the development of urological abnormalities such as urinary
bladder calcification, deformed ureters and hydroneprosis; significantly more common in
schoolchildren with higher infection intensities (WHO, 2002). It is estimated that 70 million
individuals out of 682 million experience haematuria and 32 million people dysuria associated with S.
haematobium infection in Sub-Saharan Africa; 18 million suffer bladder wall pathology and 10 million
hydronephrosis (WHO, 2012). On a nationwide scale, available data show that all administrative
regions of Tanzania mainland have some level of schistosomiasis infection, ranging from 12.7% to
87.6%; however, it is most prevalent along the coast of the Indian Ocean and shores of Lake Victoria
(MoHSW, 2012). The levels of infection are known to be highest in children of school age (WHO
2002), thus, the national goal of urinary schistosomiasis control has been to reduce prevalence and
intensity of infection among schoolchildren by Praziquantel MDA. In so doing assuming
parasitological cure, the children will stop shedding S. haematobium eggs in the environment
*
Correspondence: Donath S. Tarimo; E-mail: dontarimo@gmail.com
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