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Changing Patterns of Soil-Transmitted Helminthiases in Zanzibar in the Context of National Helminth Control Programs

Helminth control programs have been implemented in Zanzibar for over a decade. In June/July 2007, ~6 months after the last school-based anthelmintic treatment, a cross-sectional survey was carried out in two schools, and results were compared with data obtained in the same schools in 1994. Multiple stool samples collected from 368 school children were subjected to the Kato-Katz, Koga agar plate, and Baermann methods. The prevalence of Trichuris trichiura, hookworm, Ascaris lumbricoides, and Strongyloides stercoralis was 46.6%, 21.6%, 16.9%, and 10.2%, respectively. Infection intensities were generally low. Compared with 1994, the prevalence of S. stercoralis, hookworm, A. lumbricoides, and T. trichiura decreased by 81.0%, 80.5%, 70.6%, and 48.6%, respectively. Infection intensities decreased by > 95% for all helminth species studied. Our study confirms that preventive chemotherapy successfully reduces the level and intensity of helminth infections. To consolidate achievements made, additional control measures such as health education and environmental sanitation are needed.

Received July 2, 2009. Accepted for publication August 11, 2009.

Acknowledgments: This study is dedicated to Ali Foum Mgeni, who tragically died in December 2007 but contributed decisively to this study. The authors thank the children from Chaani and Kinyasini primary schools and are grateful to the headmasters, teachers, and local authorities for their support during the study. In addition, we thank the staff of HCLU, especially Alisa Mohd, Haji Ameri, Ali Kichocho, and Alipo N. Khamis, for their great help in the field and at the bench.

Financial support: This study received funding from the Swiss National Science Foundation (projects PPOOB–102883 and PPOOB–119129), the Natural History Museum (supported through The Health Foundation, United Kingdom), the World Health Organization (OD/TS-07-00331), the European Union (FP6 STREP CONTRAST project, contract 032203), and the Schistosomiasis Control Initiative. S.K. is the recipient of a personal stipend from the Emanuel Burckhardt Foundation.

^* Address correspondence to Hanspeter Marti, Department of Medical and Diagnostic Services, Swiss Tropical Institute, PO Box, CH–4002 Basel, Switzerland. E-mail: hanspeter.marti{at}unibas.ch

Authors’ addresses: Stefanie Knopp and Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland, Tel: 41-61-284-8226 and 41-61-284-8129). Khalfan A. Mohammed and I. Simba Khamis, Helminth Control Laboratory Unguja, Ministry of Health and Social Welfare, PO Box 236, Mianzini, Zanzibar, Tanzania, Tel: 255-24-23-4512 and 255-24-23-4512. J. Russell Stothard and David Rollinson, Wolfson Wellcome Biomedical Laboratories, Biomedical Parasitology Division, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK, Tel: 44-207-942-5490 and 44-207-942-5181. Hanspeter Marti, Department of Medical and Diagnostic Services, Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland, Tel: 41-61-284-8256.

Reprint requests: Hanspeter Marti, Department of Medical and Diagnostic Services, Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland, E-mail: hanspeter.marti{at}unibas.ch.