Abstract
BackgroundIn Uganda, the current national health sector strategic and investment plan underscores schistosomiasis as one of the diseases targeted for elimination by the year 2015. However, uptake of treatment among school children is unknown but suspected to be low. We estimated the uptake and predictors of preventive treatment with praziquantel.MethodsIn a cross sectional study carried out in Jinja district of Uganda, a random sample of 1,010 children in 12 primary schools was questioned about their uptake of praziquantel, knowledge and perceptions about schistosomiasis, support for taking preventive treatment and the dangers of taking praziquantel. The prevalence and mean intensity of infection with Schistosoma mansoni were determined.ResultsSelf reported uptake of praziquantel at last mass treatment was 28.2% (95% confidence interval (CI): 22.9%–33.6%). Overall prevalence and mean intensity of S. mansoni infection was 35% (95% CI: 25.4%–37.9%) and 116.1 eggs per gram (epg) of stool (95% CI: 98.3–137.1) respectively. Uptake of praziquantel was more likely if a child was from a school with high prevalence of infection, had knowledge about schistosomiasis transmission and prevention, and reported teachers’ support to take praziquantel. Of the 285 children who took praziquantel, 142 (49.8%) developed side effects. Of the 725 children who did not take the drug, 522 (72.0%) reported fear of side effects as a major reason for non-uptake.ConclusionsUptake of praziquantel in this population is very low. Fear of side effects of praziquantel, lack of knowledge about schistosomiasis transmission and prevention and lack of teacher support are some of the major factors associated with low uptake.
Highlights
Fear of side effects of praziquantel, lack of knowledge about schistosomiasis transmission and prevention and lack of teacher support are some of the major factors associated with low uptake
An estimated 207 million people are infected with schistosomiasis and more than 700 million people are at risk of infection in 76 countries [1,2,3]. 90% of the global schistosomiasis burden is shouldered by low income countries of sub-Saharan Africa [1,3,4] with Uganda described as the cradle of Schistosoma mansoni in the region [5]
The objective of the current study is to report on levels of and predictors of uptake of preventive treatment for intestinal schistosomiasis among primary school children
Summary
An estimated 207 million people are infected with schistosomiasis and more than 700 million people are at risk of infection in 76 countries [1,2,3]. 90% of the global schistosomiasis burden is shouldered by low income countries of sub-Saharan Africa [1,3,4] with Uganda described as the cradle of Schistosoma mansoni in the region [5]. An estimated 207 million people are infected with schistosomiasis and more than 700 million people are at risk of infection in 76 countries [1,2,3]. 90% of the global schistosomiasis burden is shouldered by low income countries of sub-Saharan Africa [1,3,4] with Uganda described as the cradle of Schistosoma mansoni in the region [5]. The major control strategy for schistosomiasis is preventive treatment with praziquantel [9,10,11,12]. Since 2001, when WHO recommended that regular praziquantel treatment against schistosomiasis should be provided to 75% of school-age children in high burden regions by 2010, there has been increased efforts and financing for schistosomiasis control [13]. We estimated the uptake and predictors of preventive treatment with praziquantel
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