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Abstract
Background: It has been estimated that 700 million people worldwide and 5.2 million people in South Africa are in need of annual treatment for schistosomiasis. In accordance with the current policy the Department of Health (DoH) in KwaZulu-Natal province, South Africa, aimed to reach 75% treatment coverage in a mass treatment campaign (MTC) of schools in a schistosomiasis-endemic area.
Methods: A cross-sectional study was designed to explore the implementation, coverage, challenges and limitations of a DoH MTC in a middle-income country. The study was conducted by exploring nurses’ and research team records, school enrolment lists and parental consent forms.
Results: Slightly more than 10 000 learners in 43 primary and high schools were treated, achieving treatment coverage of 44.3%. A median of two schools per day were visited over the course of 39 days. We found that older learners, being male and attending a large school were independent significant predictors for low treatment coverage.
Conclusion: Our results indicate a much lower coverage than recommended by the South African National Department of Health and World Health Organization (WHO). Coverage would likely increase through improved consent procedures and repeated schools visits. Further information is needed on how to increase compliance in older teenagers, males and learners in large schools.
Acknowledgements
Technical and professional assistance were provided by the school health nurses, research nurses of Child Development Research Unit, research assistants, security guards, logisticians, data enterers and laboratory staff. The authors are very grateful for the financial support from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement no. PIRSES-GA-2010-269245 and from the University of Copenhagen with the support from the Bill and Melinda Gates Foundation grant number OPPGH5344. We are indebted to the Ugu Department of Health, District Health Manager Mr Veeran Chetty, Dr. Olowookorum, Mrs Sokhulu, the Ugu Department of Education, teachers and headmasters of Ugu schools, teenagers, children and parents.