Trends and seasonal patterns in intestinal parasites diagnosed in primary health facilities in Northwest Ethiopia.

INTRODUCTION: Intestinal parasites have an insidious impact on human health. In response to high parasite frequencies in Northwest Ethiopia, mass drug administration (MDA) is provided for school children using albendazole/mebendazole (since 2007) and praziquantel (since 2015). The study objective was to assess trends and seasonal patterns of intestinal parasite infections in a context of MDA. METHODOLOGY: This was a descriptive study collecting routine data from laboratory registers in two health centres in Denbia district, Amhara region. Stool test results (wet-mount direct microscopy) from patients attending these centres between 2013 and 2018 were included. Frequencies of different parasite species were evaluated within and across the years and stratified by age and gender. RESULTS: From a total of 8002 stool test results, the overall parasite frequency was 53.3%; this proportion remained constant. The most frequently diagnosed soil-transmitted helminths (STH) were Ascaris lumbricoides (16.9%) and hookworm (3.9%). STH frequency varied over the years, but was similar at the beginning (20.0%) and the end (22.0%) of the six-year period. STH infections were more frequent in winter (December-February; 20.4%) than in other seasons (16.0%). The most frequently diagnosed protozoa were Entamoeba histolytica/dispar (18.5%) and Giardia lamblia (12.2%). The frequency of Giardia steadily increased from 9.6% in 2013 to 15.3% in 2018. E. histolytica/dispar peaked in summer and G. lamblia in autumn. CONCLUSIONS: Trends in routine laboratories may be a proxy for a status quo in the community. These findings suggest that higher MDA coverages and/or interventions beyond MDA are needed to reduce intestinal parasite-related morbidity.

Does mass drug administration affect Schistosoma mansoni infection trends in West Dembia district, Northwest Ethiopia?

INTRODUCTION: Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia. Since 2015, yearly school-based mass drug administration (MDA) using praziquantel has become the major control strategy. This study aimed to assess trends of Schistosoma mansoni infection in a high-endemic area in Northwest Ethiopia. METHODOLOGY: Data were extracted from routine laboratory logbooks at two health centers in West Dembia district, Amhara region, for the period 2013-2018. Wet-mount direct microscopy was used to diagnose intestinal parasites. Chi-square test was used to compare proportions of S. mansoni-positive results before and after the start of MDA with praziquantel, across sex, age groups, and seasons. RESULTS: Data of 8002 stool tests was extracted. The proportion of S. mansoni progressively decreased from 9.6% in 2013 to 4.1% in 2018 in the overall patient population and from 20.3% in 2013 to 8.8% in 2018 in school-aged children. However, a declining trend of S. mansoni was observed before the launch of MDA and remained constant after the start of the MDA. The positivity rate was significantly higher in males and in the 5-14 years age group. S .mansoni infection in school aged children showed significant seasonal variation. CONCLUSIONS: The declined trend of S. mansoni positivity rate is encouraging and may be related to the existence of intervention packages. Although the timing of MDA was related with low positivity rate of S. mansoni infection, it has not resulted in the expected beneficial effect. Therefore, the district health office should work on both MDA and other interventions.