Impact of Three to Five Rounds of Mass Drug Administration on Schistosomiasis and Soil-Transmitted Helminths in School-Aged Children in North-Central Nigeria

• Authors: Emily Griswold, The Carter Center, Atlanta; Abel Eigege, The Carter Center, Jos, Nigeria; Solomon Adelamo, The Carter Center, Jos, Nigeria; Bulus Mancha, The Carter Center, Jos, Nigeria; Nwodu Kenrick, The Carter Center, Jos, Nigeria; Yohana Sambo, The Carter Center, Jos, Nigeria; Joseph Ajiji, Plateau State Ministry of Health, Jos, Nigeria; Gideon Zam, Nasarawa State Ministry of Health, Lafia; Jacob Solomon, Federal Ministry of Health, Abuja, Nigeria; Rita O Urude, Federal Ministry of Health, Abuja, Nigeria; Jonathan Kadimbo, Plateau State Ministry of Health, Jos, Nigeria; Jacob Danboyi, Nasarawa State Ministry of Health, Lafia, Nigeria; Emmanuel Miri, The Carter Center, Jos, Nigeria; Andrew W Nute, The Carter Center, Atlanta; Lindsay Rakers, The Carter Center, Atlanta, Georgia; Obiageli Nebe, Federal Ministry of Health, Abuja, Nigeria; Chukwuma Anyaike, Federal Ministry of Health, Abuja, Nigeria; Paul Weiss, Emory University; Gregory Noland, Emory University; Frank Richards, Federal Ministry of Health, Abuja, Nigeria
• Journal Title: AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
• Volume: Volume 107, Number 1
• Publisher: American Society of Tropical Medicine and Hygiene | 2022-07-01, Pages 132-142
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.4269/ajtmh.21-1207

Abstract

Nasarawa and Plateau states of north-central Nigeria have implemented programs to control schistosomiasis (SCH) and soil-transmitted helminths (STH) in children since the 1990s. Statewide mapping surveys were conducted in 2013, when 11,332 school-aged children were sampled from 226 schools. The local government areas (LGAs) then received varying combinations of mass drug administration (MDA) for the next 5 years. We revisited 196 (87%) schools in 2018 plus an additional six (202 schools in total), sampling 9,660 children. We calculated overall prevalence and intensity of infection and evaluated associations with gender; age; behaviors; water, sanitation, and hygiene (WASH); and treatment regimen. Urine heme detection dipsticks were used for Schistosoma hematobium in both surveys, with egg counts added in 2018. Stool samples were examined by Kato-Katz for Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, and hookworm. Schistosomiasis prevalence among sampled students dropped from 12.9% (95% confidence interval [CI]: 11.1–14.9%) to 9.0% (95% CI: 7.5–10.9%), a statistically significant change (P < 0.05). In 2018, eight LGAs still had > 1% of children with heavy-intensity schistosome infections. Prevalence of STH infection did not significantly change, with 10.8% (95% CI: 9.36–12.5%) of children positive in 2013 and 9.4% (95% CI: 8.0–10.9%) in 2018 (P = 0.182). Heavy-intensity STH infections were found in < 1% of children with hookworm, and none in children with A. lumbricoides or T. trichiura in either study. The WASH data were collected in 2018, indicating 43.6% of schools had a latrine and 14.4% had handwashing facilities. Although progress is evident, SCH remains a public health problem in Nasarawa and Plateau states.