Integration of schistosomiasis-control activities into the primary-health-care system in the Gizan region, Saudi Arabia

Abstract

A few decades ago, the prevalence of Schistosoma haematobium infection in the human inhabitants of the Gizan region of Saudi Arabia was very high (43%-91%). A vertical programme for the control of the disease, by case finding, treatment of infected individuals and by chemical snail control, was begun in 1974 and led to significant reductions in prevalence in most areas. In 1989 the control activities were gradually integrated into the primary-health-care (PHC) system. Several schools in the area recently participated in the detection of ova (among schoolchildren and neighbouring communities) and organized health-education sessions. The records taken during the vertical and PHC programmes indicate that there were more diagnoses and higher chemotherapy coverage in the latter. The PHC programme has maintained the overall prevalence of infection at an extremely low level (< 1%) and the infection has been completely eradicated in several areas. The participation of schools proved to be particularly useful in terms of population coverage and health education.

PIP: A few decades ago, 43-91% of people living in the Gizan region of Saudi Arabia were infected with Schistosoma haematobium, the dominant schistosome in the region and one which is endemic in several provinces. However, a vertical disease control program comprised of case finding, the treatment of infected individuals, and chemical snail control launched in 1974 led to significant reductions in prevalence in most areas. By 1988, the overall prevalence of S. haematobium infection in Gizan had fallen to 1.6%. As the infection rate dropped to about 1% in many areas, the use of the vertical approach became less economically justifiable, and in 1989, control activities were gradually integrated into the primary health care (PHC) system. Several schools in the area recently participated in the detection of ova among schoolchildren and in neighboring communities, as well as in health education sessions. Records taken during the vertical and PHC programs indicate that there were more diagnoses and a higher degree of chemotherapy coverage in the PHC programs. The PHC program has maintained the overall prevalence of infection at under 1% and infection has been completely eradicated in several areas. The schools' participation was particularly helpful in terms of population coverage and health education.