Abstract
BackgroundTogo has conducted annual, integrated, community-based mass drug administration (MDA) for soil-transmitted helminths (STH) and schistosomiasis since 2010. Treatment frequency and target populations are determined by disease prevalence, as measured by baseline surveys in 2007 and 2009, and WHO guidelines. Reported programmatic treatment coverage has averaged over 94%. Togo conducted a cross-sectional survey in 2015 to assess the impact of four to five years of MDA on these diseases.Methodology/Principal findingsIn every sub-district in the country outside the capital, the same schools were visited as at baseline and a sample of fifteen children age 6 to 9 years old was drawn. Each child submitted urine and a stool sample. Urine samples were tested by dipstick for the presence of blood as a proxy measure of Schistosoma haematobium infection. Stool samples were analyzed by the Kato-Katz method for STH and Schistosoma mansoni. At baseline, 17,100 children were enrolled at 1,129 schools in 562 sub-districts; in 2015, 16,890 children were enrolled at the same schools. The overall prevalence of both STH and schistosomiasis declined significantly, from 31.5% to 11.6% for STH and from 23.5% to 5.0% for schistosomiasis (p<0.001 in both instances). Egg counts from both years were available only for hookworm and S. mansoni; intensity of infection decreased significantly for both infections from 2009 to 2015 (p<0.001 for both infections). In areas with high baseline prevalence, rebound of hookworm infection was noted in children who had not received albendazole in the past 6 months.Conclusions/SignificanceAfter four to five years of MDA in Togo, the prevalence and intensity of STH and schistosomiasis infection were significantly reduced compared to baseline. Data on STH indicate that stopping MDA in areas with high baseline prevalence may result in significant rebound of infection. Togo’s findings may help refine treatment recommendations for these diseases.
Highlights
Schistosomiasis and soil-transmitted helminths (STH) are parasitic diseases that cause significant morbidity worldwide, in sub-Saharan Africa
Mass drug administration (MDA) is a key component of programs aimed at controlling soil-transmitted helminths (STH) and schistosomiasis, diseases that disproportionately impact individuals in developing countries and adversely affect physical and cognitive development
The World Health Organization recommends evaluating the impact of mass drug administration on the prevalence of these infections after five years of MDA
Summary
Schistosomiasis and soil-transmitted helminths (STH) are parasitic diseases that cause significant morbidity worldwide, in sub-Saharan Africa. STH infections are among the most prevalent infections in the world, with approximately 1.5 billion people infected worldwide [1, 2]. These infections can cause weakness, malaise, anemia, and impaired physical and cognitive development [1]. In. Togo has conducted annual, integrated, community-based mass drug administration (MDA) for soil-transmitted helminths (STH) and schistosomiasis since 2010. Togo conducted a cross-sectional survey in 2015 to assess the impact of four to five years of MDA on these diseases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
