Community perceptions of mass drug administration for soil-transmitted helminthiasis and schistosomiasis in selected schools in the Philippines.

BACKGROUND: Soil-transmitted helminthiasis (STH) and schistosomiasis are parasitic infections prevalent in tropical and subtropical countries, such as the Philippines. The prevalence of these infections remain high in certain Philippine provinces, despite established mass drug administration (MDA) programs in endemic communities. This study aimed to understand community knowledge and perceptions of these infections to determine their implications on the current control and elimination strategies, including possible barriers to MDA compliance. METHODS: The study was conducted in Northern Samar and Sorsogon, two provinces with the highest STH and schistosomiasis prevalence in the country. Focus group discussions with separate parent and children groups were utilized to gather knowledge and perceptions on STH and schistosomiasis causes, symptoms, treatment, and prevention; and on the deworming drugs and overall program implementation. Data collection in Northern Samar were done in August 2017, while the sessions in Sorsogon took place in May 2018. A cultural construction of disease framework will show how several factors affect MDA participation. RESULTS: Results showed that participants held mostly correct biomedical notions of the infections and expressed willingness to participate in MDA program. However, reservations remained due to a reported lack of information dissemination, lack of confidence in the drugs used, and widespread fear of adverse side effects. CONCLUSION: Addressing these concerns - improving the conduct of the deworming program, incorporating suggestions from the community, and managing potential adverse events - may help raise MDA participation and encourage better personal preventive practices, reducing STH and schistosomiasis prevalence. TRIAL REGISTRATION: N/A.

Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study.

OBJECTIVE: To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. DESIGN: Double blind, placebo controlled randomised factorial trial of iron supplementation and anthelmintic treatment. SETTING: Community in Pemba Island, Zanzibar. PARTICIPANTS: 614 preschool children aged 6-59 months. MAIN OUTCOME MEASURES: Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups. RESULTS: Before intervention, anaemia was prevalent and severe, and geohelminth infections were prevalent and light-Plasmodium falciparum infection was nearly universal. Iron supplementation significantly improved iron status, but not haemoglobin status. Iron supplementation improved language development by 0.8 (95% confidence interval 0.2 to 1.4) points on the 20 point scale. Iron supplementation also improved motor development, but this effect was modified by baseline haemoglobin concentrations (P=0.015 for interaction term) and was apparent only in children with baseline haemoglobin concentrations <90 g/l. In children with a baseline haemoglobin concentration of 68 g/l (one standard deviation below the mean value), iron treatment increased scores by 1.1 (0.1 to 2.1) points on the 18 point motor scale. Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura, but not by hookworms. Mebendazole increased development scores by 0.4 (-0.3 to 1.1) points on the motor scale and 0.3 (-0.3 to 0.9) points on the language scale. CONCLUSIONS: Iron supplementation improved motor and language development of preschool children in rural Africa. The effects of iron on motor development were limited to children with more severe anaemia (baseline haemoglobin concentration <90 g/l). Mebendazole had a positive effect on motor and language development, but this was not statistically significant.