Abstract

BackgroundSoil transmitted helminthes (STH) are significant health problems among school-age children. In Kenya’s coastal region, the prevalence among pre-school age children (PSAC) ranges from 27.8 to 66.7 %. Whereas some pre-schools are as far as 7 km from the nearest primary schools, the National School-Based Deworming Programme (NSBDP) requires the pre-school teachers to walk with the children to primary schools for deworming by trained primary school teachers. The long distances may contribute in making drug delivery ineffective and unsustainable.MethodsTo assess the pre-school teachers’ knowledge, experiences and perceptions of STH and the NSBDP, a cross-sectional study using qualitative methods was conducted in four sub-counties of the Coast Region. Through purposive sampling, 41 pre-schools which are 2 or more kilometers away from a primary school were selected and in-depth interviews administered to the teachers. Separate in-depth interviews were administered to 34 community health extension workers, 40 opinion leaders and 38 primary school teachers all purposively selected to assess their perceptions of the role of pre-school teachers in the NSBDP. Data was audio recorded, transcribed, coded and analyzed manually by study themes.ResultsA third of the pre-school teachers were aware of signs of STHs and a half indicated that poor hygiene and sanitation practices are major causes. A majority of the pre-school teachers reported that health education and environmental sanitation are key control methods. Majority (39) had received information on NSBDP from various sources and all took part in community sensitization and in treating the pre-school children. A large majority of all study participants indicated that treating the children at pre-schools is ideal for increased coverage. Majority of the pre-school teachers perceived the NSBDP as important in improving the health status of the children. All study participants felt that the parents needed to be given adequate information on STHs and training the pre-school teachers to assist in community sensitization and drug administration would be useful.ConclusionPre-school teachers are a potential resource to the NSBDP that should be utilized to instill proper water and sanitation practices to the young children and assist in community sensitization. They should be empowered and allowed to administer treatment for STH control. County Governments, their current employers should find ways of engaging them in worm control efforts.Trial registration KEMRI SSC 2547, Registered 22 July 2013.

Highlights

  • Soil transmitted helminthes (STH) are significant health problems among school-age children

  • The results presented in this paper are part of a larger study entitled “Evaluating Different Drug Delivery Approaches for Treatment of STHs among Pre-School Age Children during the National School-Based Deworming Programme of Kenya” which was conducted after the Mass Drug Administration of 2014

  • Background characteristics of the study participants A total of 34 Community Health Extension Workers (CHEWs), 41pre-school teachers, 38 primary school teachers, and 40 opinion leaders participated in the separate in-depth interviews

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Summary

Introduction

Soil transmitted helminthes (STH) are significant health problems among school-age children. In Kenya’s coastal region, the prevalence among pre-school age children (PSAC) ranges from 27.8 to 66.7 %. Soil-transmitted helminthes (STHs) spp Ascaris lumbricoides, Trichuris trichiura and hookworm, contribute the greatest disease burden among the NTDs [2]. Pre-school age children are among the priority groups identified by the World Health Organization that harbor chronic and intense infection [3] having compromised nutritional status and cognitive abilities [4]. In Kenya, the endemicity of STHs among pre-school age children is high with sub-counties in Coast region having prevalence ranging from 27.8 to 66.7 % and current estimates suggest that up to 3 million school-age children (SAC) live in areas that warrant mass treatment for STH infection [5]. Responding to the need of the 2010 target of treating 75 % of school-age children, a new consortium was established in Paris in 2014, to support countries in coming up with ways of addressing STH among preschool-age (PSAC) and SAC [6]

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