Control of intestinal parasitic infections in Seychelles: a comprehensive and sustainable approach

Abstract

Intestinal parasitic infections have been perceived as a public health problem in Seychelles for decades. A comprehensive strategy to reduce morbidity and, in the long term, transmission of intestinal parasites has been implemented successfully since 1993. Management of the programme is integrated into the well established primary health care system, with control activities being undertaken through existing health facilities. The strategy is based on periodic chemotherapy of schoolchildren, intense health education and improvement of sanitation and safe water supply. The initial objectives of the control programme were met after 2 years of activities, with an overall reduction in prevalence of intestinal parasitic infections of 44%. The intensity of infection with Trichuris trichiura, the commonest parasite, was halved (from 780 to 370 eggs per g of faeces). The programme's integrated approach, in concert with political commitment and limited operational costs, is a warranty for the future sustainability of control activities. The programme can be seen as a model for other developing countries, even where health and socioeconomic conditions are different and the control of parasitic infections will need a much longer-term commitment.

PIP: Intestinal parasitic infections have been considered a major public health problem in Seychelles since 1925 and were the main reason for the first public health program in the country. The Seychelles Intestinal Parasite Control Program was launched in 1993 by the Ministry of Health, in cooperation with the Ministry of Education, and with technical support from the World Health Organization. Integrated into the well-established primary health care system, the program employs a successful, comprehensive strategy to reduce morbidity and the transmission of intestinal parasites. Program control activities are handled through existing health facilities. The strategy is based upon the periodic chemotherapy of school children, intense health education, and improvement of sanitation and safe water supply. An overall 44% reduction in the prevalence of intestinal parasitic infections was realized after 2 years of program activities, while the intensity of infection with the most common parasite, Trichuris trichiura, was halved from 780 to 370 eggs per gram of feces. The future sustainability of control activities is encouraged by the program's integrated approach, existing political commitment, and limited operational costs. Seychelles' program can be seen as a model for other developing countries.