Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

use of height versus weight in determining praziquantel dose for treatment of schistosomiasis in children

Praziquantel [PZQ] is currently the drug of choice in treatment of Schistosomiasis because of its high efficacy, few and transient side effects, simple administration and competitive cost. In community-based management and during mass chemotherapy of Schistosomiasis, WHO recommended a dose pole where height is taken as a single parameter to select the required dose. To compare PZQ dose according to WHO dose pole with the calculated weight-dependent dose and test their consistency. We used a growth percentile ruler [MOSWAR] that includes weight, height, head circumference and body surface area according to age and sex. Data were then compiled into a table-form that included PZQ dose according to the dose pole and the calculated mean weight-dependent dose. The results showed that PZQ dose according to the dose pole is not consistent with the weight-dependent dose. During mass chemotherapy and community-based management of Schistosomiasis in children, we recommend the use of a similar table or a device similar to [MOSWAR] to determine PZQ dose according to whichever of the growth parameters is available