Geographic, water usage, and sanitation influences on effectiveness of mass drug administration for schistosomiasis control around Lake Victoria
By YuYen Chan
Background: Schistosomiasis is an important neglected tropical disease that requires public health intervention. According to the WHO, there are almost 800 million individuals at risk of infection globally. Lake Victoria in western Kenya is the largest tropical lake in the world and also serves as a habitat for Biomphalaria snails, which are the intermediate host of S. mansoni. Because the lake is used for various activities within the daily lives of the residents around the lake, there is high transmission of Schistosoma mansoni in the region, resulting in a large public health burden.
Purpose: An aim of the Schistosomiasis Consortium for Operation Research and Evaluation (SCORE) is finding the most effective interventions to gain control of schistosomiasis. The focus of this paper evaluated what geographical and village-level water and sanitation factors may influence how well the interventions worked.
Methods: This project compared six treatment plans of school based treatment and community-wide treatment over a five year period. One hundred and fifty villages with a primary school participated. Prevalence and intensity of S. mansoni infections was monitored in 9-12 year old children using the Kato-Katz thick smear method on stool specimens. Key informants from each village provided survey date of village level behavior.
Results: We found certain geographic areas to be statistically different when looking at the odds of infection for S. mansoni. Closer examination identified a primary cluster of high prevalence in Bondo and Rarieda areas with immunization interventions and drinking from bore holes associated with lower impact of the intervention.
Conclusion: Geographic location could have a potential effect on the success of intervention. Village-level event such as experiencing droughts and the presence of immunization interventions or individual habits in these areas may also be associated with treatment results. Further examination of other factors that affect the impact of mass drug administration for S. mansoni control is warranted.
Table of Contents
Table of Contents
LITERATURE REVIEW 3
METHODS: Score Project 11
TABLES AND FIGURES 30
APPENDIX 1 : SCORE Project Year 2 survey 36
APPENDIX 2: SAS Codes 38
About this Master's Thesis
|Committee Chair / Thesis Advisor|
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