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Impact of community-directed treatment on soil transmitted helminth infections in children aged 12 to 59 months in Mazabuka District, Zambia

Published online by Cambridge University Press:  15 February 2011

HIKABASA HALWINDI*
Affiliation:
Department of Biological Sciences, School of Natural Sciences, University of Zambia, Box 32379 Lusaka, Zambia
PASCAL MAGNUSSEN
Affiliation:
DBL-Centre for Health Research and Development, Department of Veterinary Disease Biology, Faculty of Life Sciences, Thorvaldsensvej 57, DK-1871 Frederiksberg C
SETER SIZIYA
Affiliation:
Department of Community Medicine, School of Medicine, University of Zambia, Box 50110 Lusaka, Zambia
RAY HANDEMA
Affiliation:
Department of Biological Sciences, School of Natural Sciences, University of Zambia, Box 32379 Lusaka, Zambia
DAN W. MEYROWITSCH
Affiliation:
Section of Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
ANNETTE OLSEN
Affiliation:
DBL-Centre for Health Research and Development, Department of Veterinary Disease Biology, Faculty of Life Sciences, Thorvaldsensvej 57, DK-1871 Frederiksberg C
*
*Corresponding author: Hikabasa Halwindi, Department of Biological Sciences, University of Zambia, Box 32379 Lusaka, Zambia. Tel.: +260 955 754 563. E-mail: [email protected]

Summary

This study assessed the impact of adding community-directed treatment (ComDT) to the routine health facility (HF)-based treatment on prevalence and intensity of soil transmitted helminth (STH) infections among children aged 12 to 59 months. Repeated cross-sectional surveys were conducted among randomly selected children of this age group from the intervention area (HF+ComDT area) and the comparison area (HF area) at baseline (n=986), 12 months (n=796) and 18 months (n=788) follow-up. The prevalence of Ascaris lumbricoides was significantly higher in the HF+ComDT as compared to the HF area at baseline (P=0·048), but not at 12 and 18 months follow-up. At baseline the HF+ComDT area had significantly higher intensities of A. lumbricoides compared to the HF area (P<0·001), but not at 12 and 18 months follow-ups. Prevalence and intensity of hookworm did not differ significantly between treatment arms at any time. Analysis of trends showed a significant decrease in prevalence of A. lumbricoides and hookworm in the HF+ComDT area (P<0·001), of hookworm in the HF area (P<0·05), but not of A. lumbricoides in the HF area. It is concluded that the ComDT approach generally enhanced the treatment effect among under-five year children and that this alternative approach may also have advantages in other geographical settings.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

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