Who misses out with school-based health programmes? A study of schistosomiasis control in Egypt

Abstract

There has been a recent revival of interest in school-based health programmes in developing countries as a means of reducing the morbidity observed in school-aged children, of improving their physical growth and cognitive development, and of controlling transmission of disease in the community at large. This study used data collected from a large epidemiological survey of schistosomiasis in Egypt to examine what proportion of infected children missed treatment from an established national school-based schistosomiasis control programme simply because they did not attend school. It showed that children who were not enrolled in school had a higher prevalence of infection and were more intensely infected than children who attended school. At the extreme, over 80% of infected girls in one part of Egypt could not be treated by the existing school programme because they did not attend school. If these trends are similar in other countries where school-based programmes are being developed, school-based delivery may exacerbate existing inequalities in society and ways of expanding services to children who do not attend school regularly need to be explored.

Schistosomiais and Soil-Transmitted Helminth Control in Niger: Cost Effectiveness of School Based and Community Distributed Mass Drug Administration

“…For many recipients, access to the more numerous schools is more convenient than attending more distant health facilities [19]. However, where school enrolment is low and particular groups (for example girls or the poorest children) are under-represented, there is a need for additional methods of reaching target populations [7]. Studies in Tanzania [20] and Uganda [21] have examined the effectiveness of Community Directed Treatment (ComDT) and school based treatment in terms of coverage for enrolled and non enrolled children.…”

Urine heme dipsticks are useful in monitoring the impact of Praziquantel treatment on Schistosoma haematobium in sentinel communities of Delta State, Nigeria

“…It has been suggested that CDDs, as a result of their community level records are better able than teachers to reach school aged children. However, we did not determine in this study if CDDs with their ivermectin records addressed the issues of who misses-out in school-based PZQ treatments (Husein et al, 1996), and ensured high coverage of targeted persons (90% coverage) (Table 1). …”

Observed Reductions in Schistosoma mansoni Transmission from Large-Scale Administration of Praziquantel in Uganda: A Mathematical Modelling Study

“…These approaches, incorporating longitudinal snail sampling to capture seasonal variations in transmission [63], will likely provide ultimate confirmation of reductions in FOI , and will provide useful validation of the results obtained in the present study. Combining these different approaches and incorporating the impact of non-random patters of compliance in relation to parasite burden as has been suggested [64], [65], [66], [67], would provide valuable information on the true effectiveness of MDA control programmes. This work will also help identify areas that are potentially open to local elimination of the disease and of the infection reservoir, and we advocate that the use of mathematical models could guide this process.…”