Following mapping of Schistosomiasis - STH in Sierra Leone in 2008‐2009 the prevalence of schistosomiasis into high, moderate and low endemic districts was defined.
In June 2009 mass drug administration of praziquantel and mebendazole to all school‐going children in 6 moderate and highly schisto-endemic districts was performed by 544 Primary Health Unit staff in a 5 day campaign. Much emphasis was placed on social mobilization as heavily parasitized children were expected to experience significant side effects, most notably abdominal pain, nausea and faintness when taking praziquantel for the first time. To mitigate these adverse effects all 2,397 primary school head ‐ teachers were provided with a budget to ensure all children were fed BEFORE being treated. As a result although these effects were significant they were well tolerated by the communities and the MDA was much appreciated: 562,980 children received Praziquantel, donated by USAID though HKI and 549,701 received mebendazole donated by MRC ‐ SL and STACC ‐ SL: 2 local NGOs
In 2010 the school‐based deworming program expanded to treat all school‐aged children in highly endemic chiefdoms in 7 districts and to provide deworming with either mebendazole or albendazole or SCHOOL AGED CHILDREN nation‐wide in 3 phases of activity:
- The Preventative Chemotherapy and Transmission Control Program for LF in the Urban and Rural Western Area, June 4 ‐ 9 th : 298,190 school aged children received albendazole in 595 primary schools, donated by GlaxoSmithKline and St Andrews Clinics for Children ‐ SL (local NGO): 86% coverage using Independent Monitors and a school aged population estimated as 27% of total population. Using population projections from the 2004 Census this was 128% coverage due to the inaccurate denominator due mostly to war ‐ time urban migration. This activity was funded by USAID through HKI ‐ SL.
- A head ‐ teacher ‐ implemented campaign planned and supervised by HKI ‐ MOH&S on 28 th June in the “low‐schisto” endemic chiefdoms: Kambia, Port Loko, Moyamba, Bonthe, Pujehun and Bombali (West), This was supervised by the National School and Adolescent Health Program: 460,839 school ‐ aged children received mebendazole donated by UNCEF and MRC ‐ SL or albendazole donated by World Vision International, in 2,044 primary schools with an enrollment of 449,404. Non school going children were also treated so final coverage s 102% was obtained based upon Deputy Directors, MEYS enrollment figures for 2010. This activity was funded by WFP through HKI ‐ SL.
- The PHU ‐ implemented campaign in the remaining “schisto” endemic districts: Koinadugu, Kono, Kailahun, Kenema, Bo, Tonkolili and Bombali (East) during the week 5 ‐ 12 th July: 540,103 children received Praziquantel, donated by USAID though HKI and 540,103 received mebendazole donated by Dewormtheworld or albendazole donated by World Vision International. Schools: 1,644. Coverage 86%: target population 626,845 using the enrollment figures supplied by Deputy Directors, MEYS. Children were fed before treatment again to mitigate side effects. This activity was funded by WFP and USAID through HKI ‐ SL.
Overall 1,299,132 children of school age were treated, which based upon target figures represents 99% coverage: target 1,308,691. Total primary schools participated: 4,283. Using the projections of school aged population from the 2004 National Census that target population for children 5<15 years was also 1.3 million: a very successful
Sincerely,
Dr. Mary Hodges, MBBS, MRCP, DScHKI