Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning

Uganda started implementing mass drug administration against schistosomiasis in 2003, with district used as an implementation unit. This resulted into misclassification of communities into wrong risk levels, under-or-over treatment and over request of praziquantel (PZQ) drugs. The objective of the c...

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Main Authors: Moses Adriko, Benjamin Tinkitina, Moses Arinaitwe, Edridah M. Tukahebwa, Alfred Mubangizi, Jorge Cano Ortega, Honorat Zoure, Pauline N. Mwinzi, Boniface Kinvi, Amadou Garba Djirmay, Sammy Njenga, Humphrey D. Mazigo
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Parasite Epidemiology and Control
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405673124000588
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author Moses Adriko
Benjamin Tinkitina
Moses Arinaitwe
Edridah M. Tukahebwa
Alfred Mubangizi
Jorge Cano Ortega
Honorat Zoure
Pauline N. Mwinzi
Boniface Kinvi
Amadou Garba Djirmay
Sammy Njenga
Humphrey D. Mazigo
author_facet Moses Adriko
Benjamin Tinkitina
Moses Arinaitwe
Edridah M. Tukahebwa
Alfred Mubangizi
Jorge Cano Ortega
Honorat Zoure
Pauline N. Mwinzi
Boniface Kinvi
Amadou Garba Djirmay
Sammy Njenga
Humphrey D. Mazigo
author_sort Moses Adriko
collection DOAJ
description Uganda started implementing mass drug administration against schistosomiasis in 2003, with district used as an implementation unit. This resulted into misclassification of communities into wrong risk levels, under-or-over treatment and over request of praziquantel (PZQ) drugs. The objective of the current study was to reviewing the community data available at World Health Organization/ESPEN database to understand the status of schistosomiasis and identify pockets with infection. The decision tree assessment tool was used to analyzed schistosomiasis epidemiological data of 7501 communities. Before validation, the schistosomiasis endemicity status of 79 % of communities was not known. After validation, 58.6 %, 22.6 % and 16.3 % of communities were not endemic, had low and moderate endemicity status. Of 2362 communities classified having high endemicity using a district as implementation unit, 41.6 %, 12.7 % and 17.3 % of them were not endemic, had low and moderate endemicity, while only 22.7 % had high endemicity. Using the new treatment guidelines, 2,875,006 school aged children were adequately treated, 18,235 were under-treated and 2,250,013 were over treated. The results show a considerable change in endemicity status when communities were used as an implementation unit compared to district. Thus, the country control programme is recommended to use communities as implementation unit.
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spelling doaj-art-744eb085c08a4864a3f7b9c0a738f5662024-12-18T08:49:42ZengElsevierParasite Epidemiology and Control2405-67312024-11-0127e00394Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planningMoses Adriko0Benjamin Tinkitina1Moses Arinaitwe2Edridah M. Tukahebwa3Alfred Mubangizi4Jorge Cano Ortega5Honorat Zoure6Pauline N. Mwinzi7Boniface Kinvi8Amadou Garba Djirmay9Sammy Njenga10Humphrey D. Mazigo11National Malaria Control Division, Ministry of Health, Plot 6 Laudel Road, P.O Box 7272, Kampala, Uganda; Vector Borne and NTD Control Division, Ministry of Health, Plot 15 Bombo road, P.O Box 1661, Kampala, Uganda; Corresponding author at: National Malaria Control Division, Ministry of Health, Plot 6 Laudel Road, P.O Box 7272, Kampala, Uganda.Vector Borne and NTD Control Division, Ministry of Health, Plot 15 Bombo road, P.O Box 1661, Kampala, UgandaVector Borne and NTD Control Division, Ministry of Health, Plot 15 Bombo road, P.O Box 1661, Kampala, UgandaVector Borne and NTD Control Division, Ministry of Health, Plot 15 Bombo road, P.O Box 1661, Kampala, UgandaVector Borne and NTD Control Division, Ministry of Health, Plot 15 Bombo road, P.O Box 1661, Kampala, UgandaExpanded Support Special Programme Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO African Regional Office, Congo Brazzaville, CongoExpanded Support Special Programme Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO African Regional Office, Congo Brazzaville, CongoExpanded Support Special Programme Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO African Regional Office, Congo Brazzaville, CongoExpanded Support Special Programme Project for Elimination of Neglected Tropical Diseases (ESPEN), WHO African Regional Office, Congo Brazzaville, CongoWHO Department of Control of Neglected Tropical Diseases, Geneva, SwitzerlandKenya Medical Research Institute, P.O. Box 54840 00200 Off Raila Odinga Way, Nairobi, KenyaKenya Medical Research Institute, P.O. Box 54840 00200 Off Raila Odinga Way, Nairobi, Kenya; The Catholic University of Health and Allied Sciences, School of Medicine, Department of Medical Parasitology and Entomology, P.O. Box 1464, Mwanza, Tanzania; Corresponding author at: School of Medicine, Department of Medical Parasitology, The Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.Uganda started implementing mass drug administration against schistosomiasis in 2003, with district used as an implementation unit. This resulted into misclassification of communities into wrong risk levels, under-or-over treatment and over request of praziquantel (PZQ) drugs. The objective of the current study was to reviewing the community data available at World Health Organization/ESPEN database to understand the status of schistosomiasis and identify pockets with infection. The decision tree assessment tool was used to analyzed schistosomiasis epidemiological data of 7501 communities. Before validation, the schistosomiasis endemicity status of 79 % of communities was not known. After validation, 58.6 %, 22.6 % and 16.3 % of communities were not endemic, had low and moderate endemicity status. Of 2362 communities classified having high endemicity using a district as implementation unit, 41.6 %, 12.7 % and 17.3 % of them were not endemic, had low and moderate endemicity, while only 22.7 % had high endemicity. Using the new treatment guidelines, 2,875,006 school aged children were adequately treated, 18,235 were under-treated and 2,250,013 were over treated. The results show a considerable change in endemicity status when communities were used as an implementation unit compared to district. Thus, the country control programme is recommended to use communities as implementation unit.http://www.sciencedirect.com/science/article/pii/S2405673124000588SchistosomiasisDistrictCommunitiesImplementation unitValidationUganda
spellingShingle Moses Adriko
Benjamin Tinkitina
Moses Arinaitwe
Edridah M. Tukahebwa
Alfred Mubangizi
Jorge Cano Ortega
Honorat Zoure
Pauline N. Mwinzi
Boniface Kinvi
Amadou Garba Djirmay
Sammy Njenga
Humphrey D. Mazigo
Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning
Parasite Epidemiology and Control
Schistosomiasis
District
Communities
Implementation unit
Validation
Uganda
title Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning
title_full Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning
title_fullStr Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning
title_full_unstemmed Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning
title_short Time to change implementation units for mass drug administration against schistosomiasis in Uganda: Evidence from Communities levels data validation and its implication in planning
title_sort time to change implementation units for mass drug administration against schistosomiasis in uganda evidence from communities levels data validation and its implication in planning
topic Schistosomiasis
District
Communities
Implementation unit
Validation
Uganda
url http://www.sciencedirect.com/science/article/pii/S2405673124000588
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