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

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  • 1 The Carter Center, Atlanta, Georgia;
  • | 2 The Carter Center, Jos, Nigeria;
  • | 3 Plateau State Ministry of Health, Jos, Nigeria;
  • | 4 Nasarawa State Ministry of Health, Lafia, Nigeria;
  • | 5 Federal Ministry of Health, Abuja, Nigeria;
  • | 6 Emory University, Atlanta, Georgia

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.

Author Notes

Address correspondence to Emily Griswold, The Carter Center, One Copenhill, 453 John Lewis Freedom Parkway, Atlanta, GA 30307. E-mail: emily.griswold@cartercenter.org

Financial support: This work was funded by the American People through the United States Agency for International Development (USAID). The contents are the responsibility of Act to End NTDs | East, led by RTI International in partnership with The Carter Center, Fred Hollows Foundation, IMA World Health, Light for the World, Sightsavers, Results for Development, Save the Children, and WI-HER under cooperative agreement No. 7200AA18CA00040 and do not necessarily reflect the views of USAID or the United States Government.

Authors’ addresses: Emily Griswold, The Carter Center, Atlanta, GA, E-mail: emily.griswold@cartercenter.org. Abel Eigege, Solomon Adelamo, Bulus Mancha, Nwodu Kenrick, and Yohana Sambo, The Carter Center, Jos, Nigeria, E-mails: abel.eigege@cartercenter.org, solomon.adelamo@cartercenter.org, bulus.mancha@cartercenter.org, kenrick.anorue@cartercenter.org, and yohana.sambo@cartercenter.org. Joseph Ajiji, Plateau State Ministry of Health, Jos, Nigeria, E-mail: ajijijoseph@yahoo.com. Gideon Zam, Nasarawa State Ministry of Health, Lafia, Nigeria, E-mail: gideonzam@gmail.com. Jacob Solomon and Rita Urude, Federal Ministry of Health, Abuja, Nigeria, E-mails: owukpa2000@yahoo.com and ritaurude.health@yahoo.com. Jonathan Kadimbo, Plateau State Ministry of Health, Jos, Nigeria, E-mail: joekadims@yahoo.com. Jacob Danboyi, Nasarawa State Ministry of Health, Lafia, Nigeria, E-mail: danboyijacob@gmail.com. Emmanuel Miri, The Carter Center, Jos, Nigeria, E-mail: emmanuel.miri@cartercenter.org. Andrew W. Nute and Lindsay Rakers, The Carter Center, Atlanta, GA, E-mails: andrew.nute@cartercenter.org and lindsay.rakers@cartercenter.org. Obiageli Nebe and Chukwuma Anyaike, Federal Ministry of Health, Abuja, Nigeria, E-mails: nebeoj@yahoo.com and chuxxanyaike@yahoo.com. Paul Weiss, Emory University, Atlanta, GA, E-mail: pweiss2@sph.emory.edu. Gregory Noland and Frank Richards, The Carter Center, Atlanta, GA, E-mails: greg.noland@cartercenter.org and frank.richards@cartercenter.org.

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