Completion of 3rd Round of Treatment in Uganda
The year 2005 in Uganda has seen the third round of mass drug administration
take place in the original 18 districts and expansion to an additional 9
districts. Although reporting from the districts is still to be completed,
at this stage it is estimated that approximately 3.6 million children and
adults have been treated by the Ministry of Health’s Ugandan Bilharzia and
Worm Control Programme during the current year. Of those treated around 2.2
million were being treated for the first time with the remainder receiving
either their second or third treatment.
In early 2006 a rapid mapping exercise using the Lot Quality Assurance
Technique (LQAS) will be carried out in all the 27 districts with known
schistosomiasis prevalence by a team from the Vector Control Division of the
Ministry of Health. This team will be headed by Dr Narcis Kabatereine who
has previously investigated the LQAS technique (Brooker et al., 2005) and
it’s applicability as a rapid, valid and cost-effective method of
identifying areas which are still at high risk of infection and thus require
further rounds of treatment. After the mapping exercise a decision will be
taken about the strategy for treatment in 2006.
The second follow-up of data collection has been completed in 2005 and the
third follow up data collection has already commenced. Thus far data
analysis has indicated that there has been a satisfactory reduction in
anaemia in individuals treated by the programme and that the first target of
the treatment program, to reduce morbidity, may have been achieved. The
percentage of children with moderate and heavy infections has been reduced
from 26.1% to 6.5%, which in an area with very heavy transmission is
satisfactory. This result does suggest however, that in this area of Uganda,
several more annual treatments may be required to bring down prevalence and
intensity of infection to levels below which there is no public health
problem. Indeed continued regular treatment of school aged children may be a
long term necessity to prevent morbidity in later life.
In April 2006, the 7th annual workshop on the National Programme for the
Control of Bilharzia and Intestinal Helminths will be convened in Kampala to
bring together stakeholders from the district level to present the successes
and difficulties encountered whilst implementing the treatment programme. In
2006 many will be asked to provide their experiences of integrating
schistosomiasis and STH treatment within the Child Health Days, so that the
meeting can determine how this integration can be strengthened during the
health day scheduled for May 2006.
Reference:
Brooker S, Kabatereine NB, Myatt M, Stothard JR & Fenwick A. Rapid
assessment of Schistosoma mansoni: the validity, applicability and
cost-effectiveness of the Lot Quality Assurance Sampling method in Uganda.
Tropical Medicine and International Health 2005;10(7):647-658.
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