Risk Factors and control strategies of soil transmitted Helminthiases in Kamuli District, Eastern Uganda.

Abstract

Driven by global targets to the elimination of Soil Transmitted helminths (STHs) as public health problem, governments have rapidly rolled out several control programmes under school-based platforms. The assessment on how the control has been implemented towards targets and strategic plans that stipulate the core interventions is important. In Uganda preventive anthelminthic treatment has been provided to school-age children annually, under a school-based chemotherapy programme since 2003. This program is inspired by Ministry of Health and implemented by decentralized District Local Governments. However, the effectiveness of the core interventions as in Health Sector Strategic Plan II (HSSPII); social mobilization, multi-drug administration to school age children and community and advocacy for improved water supply and sanitation and potential challenges at district level have not been critically evaluated. The study was undertaken in Kamuli District, Eastern Uganda, to determine the prevalence, risk factors amongst school age children (5-14 years old) and the factors influencing the core interventions against STHs in the district’ work plans. Stool samples were collected from 398 school age children and analyzed using Kato-Katz technique. Data regarding the sociodemographic and risk factors influencing the prevalence were collected using structured questionnaires and interviews. Data on the level of implementation of the control were collected from health personnel and district archives. Chi-square and Logistic regression statistics were used for data analysis using statistical software SPSS version 26.0. The overall prevalence of STHs was 52.26%. Parents’ education and occupations were found to significantly contribute to the STHs prevalence with p = 0.04 and 0.045, respectively. This study reaffirmed that there still exists a high prevalence of STHs in Kamuli District. On average, the district’s budgets for health, water and sanitation have been progressively increasing for the past three financial years 2017/18-2019/20. The activities of Village Health Teams and multi-drug administration have received less priority in the district’s budgets through the years. Poor priorities in budgeting and procurement have been ascertained to ensure the integration of core interventions against STHs in the district budget. Chemotherapy to the community and school age children should be implemented alongside water, sanitation and hygiene for effective and sustainable STHs control. Peasants have to wear boots and hand gloves where possible to avoid infection by hookworm larvae. Community sensitization is important and the well-motivated VHTs should well be involved. Keywords; Soil Transmitted Helminths, Prevalence, Ascaris lumbricoides, Trichuris trichura, Hookworm, Kamuli