Unmet Needs to Treat Schistosomiasis in Children Under Five Years Old in uMkhanyakude District of KwaZulu-Natal, South Africa

Moses J. Chimbari,Mhlengi V. Ncube,Innocent T. Mutero

doi:10.5539/gjhs.v12n4p127

Abstract

Preventive treatment for schistosomiasis control is a priority objective for the Department of Health (DoH) in South Africa. The uMkhanyakude district of KwaZulu-Natal is one of the districts in which schistosomiasis in a major public health concern. We mapped the unmet resource requirements for a schistosomiasis control mass drug administration (MDA) program targeting children aged five years old and below in the uMkhanyakude District. We interviewed 10 decision makers among the uMkhanyakude Health District staff in order to understand the resources that the district has and the resources that the district needs to implement a schistosomiasis control MDA program targeting children aged five years old and below in the uMkhanyakude district. We analyzed and reported on the resources based on the following categories: financing; coverage; program integration; monitoring and evaluation; infrastructure; materials; human resources and training. We identified the resources that the district has and the resources that the district needs to acquire to implement a schistosomiasis MDA program targeting children aged five years old and below. The resources that the district needs to acquire to implement a schistosomiasis control MDA program for children under five include but are not limited to financing, human resources and digital scales. The uMkhanyakude district has insufficient resources to implement a schistosomiasis control MDA program targeting children aged five years old and below. The cost of the resources that need to be acquired for the program could be reduced by integrating the schistosomiasis control MDA program with existing child health intervention programs for children aged five years old and below. Economic evaluations are necessary to determine the child health program to which the schistosomiasis control MDA program could be most cost-effectively integrated to.

Highlights

Recent evidence shows that infants living in schistosomiasis endemic areas may be infected by schistosomiasis in their first year of life, contrary to beliefs that children under five are not at risk of infection (Stothard, Sousa-Figueiredo et al, 2013)
A district health staff member told us that: “Epidemiological considerations must be taken into account when we decide on our budget.”
The district health staff members mentioned financial constraints in implementing some programs and found the intervention of some Non-Governmental Organizations (NGOs) helpful in the provision of adequate resources to ensure the success of treatment programs

Summary

Introduction

Recent evidence shows that infants living in schistosomiasis endemic areas may be infected by schistosomiasis in their first year of life, contrary to beliefs that children under five are not at risk of infection (Stothard, Sousa-Figueiredo et al, 2013). In the absence of a vaccine, mass drug administration (MDA) has been found to be a cost-effective strategy to prevent and control schistosomiasis in endemic regions(WHO, 2018). Five years old children and those below that have previously been excluded from schistosomiasis control MDA programs. In response to evidence showing that this age group is at risk of contracting schistosomiasis, WHO has recommended the inclusion of children aged below five in schistosomiasis control MDA programs in endemic areas (Stothard, Sousa-Figueiredo et al, 2013). Operational planning based on the resources that are available is important to ensure the success of MDA programs (Babu & Kar, 2004, Sturrock et al, 2011)

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Conclusion