A school-based approach to the control of urinary schistosomiasis and intestinal helminth infections in children in Matuga, Kenya: impact of a two-year chemotherapy programme on prevalence and intensity of infections

Abstract

A school- and chemotherapy-based urinary schistosomiasis and intestinal helminth infection control programme was conducted in Matuga Division, Kwale District, Coast Province with teachers taking care of diagnosis, treatment and health education. More than 12,000 children in 36 primary schools were included in the 2-year programme. Results for 20 evaluation schools are presented. Children with haematuria were treated with praziquantel (40 mg/kg) once a year. Within 2 years, the prevalence of haematuria in the schools was reduced from 28% (range 8-68%) to 11.4% (range 3-23%). More than 80% of the schoolchildren were infected with one or more intestinal helminths at baseline. After one year with levamisole mass chemotherapy, single dose (2.5 mg/kg) three times a year (once per school term), the prevalence of Ascaris infection was reduced by 83% from 18% to 3%, but there was no change in pretreatment prevalences of hookworm (57%) and Trichuris (56%) infections. In the second year of the programme, albendazole 600 mg once every six months was administered to the children in 10 randomly selected schools. This resulted in 52% and 23% reductions in prevalences of hookworm and Trichuris infections, respectively, in these schools and a reduction in mean intensity of infection of 52.8% and 50.3%, respectively.