Abstract
BackgroundIt is widely advocated that integrated strategies for the control of neglected tropical diseases (NTDs) are cost-effective in comparison to vertical disease-specific programmes. A prerequisite for implementation of control interventions is the availability of baseline data of prevalence, including the population at risk and disease overlap. Despite extensive literature on the distribution of schistosomiasis on the mainland in Uganda, there has been a knowledge gap for the prevalence of co-infections with malaria, particularly for island communities in Lake Victoria. In this study, nine lakeshore and island districts were surveyed for the prevalence of NTDs and malaria, as well as educational and health infrastructure.ResultsA total of 203 communities were surveyed, including over 5000 school-age children. Varying levels of existing health infrastructure were observed between districts, with only Jinja District regularly treating people for NTDs. Community medicine distributors (CMD) were identified and trained in drug delivery to strengthen capacity. Prevalence levels of intestinal schistosomiasis and soil-transmitted helminthiasis were assessed via Kato-Katz thick smears of stool and malaria prevalence determined by microscopy of fingerprick blood samples. Prevalence levels were 40.8%, 26.04% and 46.4%, respectively, while the prevalence of co-infection by Schistosoma mansoni and Plasmodium spp. was 23.5%. Socio-economic status was strongly associated as a risk factor for positive infection status with one or more of these diseases.ConclusionsThese results emphasise the challenges of providing wide-scale coverage of health infrastructure and drug distribution in remote lakeshore communities. The data further indicate that co-infections with malaria and NTDs are common, implying that integrated interventions for NTDs and malaria are likely to maximize cost-effectiveness and sustainability of disease control efforts.
Highlights
It is widely advocated that integrated strategies for the control of neglected tropical diseases (NTDs) are cost-effective in comparison to vertical disease-specific programmes
Since 2000, an increasing number of countries have embarked on national control programmes against one or more of the NTDs and/or malaria, but rarely have these efforts been integrated to examine the overall burden of combined parasitic infections
In Uganda, a programme for the control of intestinal schistosomiasis has been in place since 2003, coordinated by the Vector Control Division (VCD) of the Uganda Ministry of Health, with support from the Schistosomiasis Control Initiative (SCI; http://www.sci-ntds.org)
Summary
It is widely advocated that integrated strategies for the control of neglected tropical diseases (NTDs) are cost-effective in comparison to vertical disease-specific programmes. There has been a recent renewed global interest to control neglected tropical diseases (NTDs), which include intestinal schistosomiasis and soil-transmitted helminthiasis (STH) [1,2]. This focus is timely given the mainly occurs around the large lakes and rivers, including Lake Victoria, affecting approximately 4 million people, while 16.7 million are estimated to be at risk from the infection [5]. The Global Network for Neglected Tropical Diseases (GNNTD: http://globalnetwork.org) has been instrumental in raising awareness and promoting advocacy relating to the NTDs. The initiative has provided funding to national health programmes, through partner collaborations, in order to examine existing control components and broaden them as necessary, to integrate treatment for more than one NTD. The National Control Programme included basic health education training and information on how behavioural change can reduce transmission, but no funding was available for improvement of sanitation facilities, water pumps or other health-related infrastructure
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