Praziquantel treatment coverage among school age children against Schistosomiasis and associated factors in Ethiopia: a cross-sectional survey, 2019.

BACKGROUND: World Health Organization estimated that 779 million people are at risk of getting schistosomiasis (SCH) and 240 million people were infected worldwide. SCH due to Schistosoma mansoni (S. mansoni) is a wide public health problem in Ethiopia. The aim of the survey was to quantify national and district disaggregated treatment coverage status for SCH and compare validated coverage with the one reported. METHODS: Community based cross-sectional survey was conducted in April 2019 among households with school age children (SAC) 5-14 years in seven purposively selected districts of the country. Segments to be surveyed were randomly selected and households to be interviewed from each segment were determined using systematic sampling technique. A total of 3378 households visited and 5679 SAC (5-14 years) were interviewed. RESULTS: Overall reported treatment coverage of Praziquantel (PZQ) against SCH was 4286 (75.5%). Males were 27% more likely to swallow the drug (AOR = 1.27; 95% CI: 1.09, 1.47) than females. SAC with age 10-14 years were 45% more likely to swallow the drug compared with their counter parts (5-9 years), (AOR =1.45; 95% CI: 1.25, 1.69). There is statistically significant association between PZQ swallowing status with school enrollment. (AOR = 20.90, 95% CI: 17.41, 25.08). Swallowing status of PZQ against SCH significantly higher for SAC treated in districts applied integrated treatment approach (87.5%) compared with SAC treated in vertical treatment approach (72.5%); P-value < 0.001. SACs were asked for reasons for not taking the drug and the main reported reason for not swallowing PZQ in the present study was none attending of the school. CONCLUSIONS: Over all treatment coverage of PZQ against SCH in the present study was 75.5%. Although it is in accordance with WHO recommendation for Ethiopia, national programmatic improvements are necessary to achieve higher coverage in the future. To increase treatment coverage for PZQ against SCH in Ethiopia, school based training should target all schools. Moreover, mobilization, sensitization and implementation of the community wide treatment need to be improved.

Development of resistance by Plasmodium falciparum to sulfadoxine/pyrimethamine in Amhara Region, Northwestern Ethiopia.

Following the high rate of chloroquine-resistant Plasmodium falciparum, Ethiopia changed the national drug policy in 1999 from chloroquine to sulfadoxine/pyrimethamine (SP) as first line. However, the useful therapeutic lifespan of SP may be limited by the rapid emergence of resistance. We conducted a study between October and November 2001 to examine the current extent of SP resistance to P. falciparum in Amhara Region, Northern Ethiopia. A total of 93 patients with uncomplicated P. faliciparum malaria were studied from Habru (n=50) and Weizazirt (n=43) localities. Drug resistance was evaluated using the 14-day WHO in vivo test protocol. Parasitological resistance to SP was found to be 32.0% (16/50) and 4.7% (2/43) in Harbu and Weizazirt localities, respectively. The corresponding clinical failure rates were 20.0% (10/50) and 4.7% (2/43). Of the parasitological failure at Harbu, 9 patients were classified as RI, 6 as RII and one as RIII type response. Among the clinical failures, 7 were LTF while the remaining 3 were ETF. Nevertheless, there was hardly any patient with RII/RIII or ETF response, and only two patients each with RI and LTF response were seen from Weizazirt locality. Therefore, the study underscores the presence of varying level of SP resistance to P. falicparum in the areas studied. Whereas SP remains quite effective in the treatment of uncomplicated P. falciparum in Weizazirt locality, the observed high rate of resistance from Harbu is alarming and an area of concern.