Monitoring and evaluating the impact of national school-based deworming in Kenya: Study design and baseline results(Article)(Open Access)
- aEastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O Box 54840-00200, Nairobi, Kenya
- bFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
- cDivision of Vector-borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, P.O. Box 19982-00202, Nairobi, Kenya
- dDevelopment Research Group, World Bank, 1818 H Street NW, Washington, DC 20433, United States
- eChildren's Investment Fund Foundation, London, United Kingdom
- fKEMRI-Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya
Abstract
Background: An increasing number of countries in Africa and elsewhere are developing national plans for the control of neglected tropical diseases. A key component of such plans is school-based deworming (SBD) for the control of soil-transmitted helminths (STHs) and schistosomiasis. Monitoring and evaluation (M&E) of national programmes is essential to ensure they are achieving their stated aims and to evaluate when to reduce the frequency of treatment or when to halt it altogether. The article describes the M&E design of the Kenya national SBD programme and presents results from the baseline survey conducted in early 2012. Methods. The M&E design involves a stratified series of pre- and post-intervention, repeat cross-sectional surveys in a representative sample of 200 schools (over 20,000 children) across Kenya. Schools were sampled based on previous knowledge of STH endemicity and were proportional to population size. Stool (and where relevant urine) samples were obtained for microscopic examination and in a subset of schools; finger-prick blood samples were collected to estimate haemoglobin concentration. Descriptive and spatial analyses were conducted. The evaluation measured both prevalence and intensity of infection. Results: Overall, 32.4% of children were infected with at least one STH species, with Ascaris lumbricoides as the most common species detected. The overall prevalence of Schistosoma mansoni was 2.1%, while in the Coast Province the prevalence of S. haematobium was 14.8%. There was marked geographical variation in the prevalence of species infection at school, district and province levels. The prevalence of hookworm infection was highest in Western Province (25.1%), while A. lumbricoides and T. trichiura prevalence was highest in the Rift Valley (27.1% and 11.9%). The lowest prevalence was observed in the Rift Valley for hookworm (3.5%), in the Coast for A. lumbricoides (1.0%), and in Nyanza for T. trichiura (3.6%). The prevalence of S. mansoni was most common in Western Province (4.1%). Conclusions: The current findings are consistent with the known spatial ecology of STH and schistosome infections and provide an important empirical basis on which to evaluate the impact of regular mass treatment through the school system in Kenya. © 2013 Mwandawiro et al.; licensee BioMed Central Ltd.
Indexed keywords
| EMTREE drug terms: | hemoglobin |
|---|---|
| EMTREE medical terms: | adultarticleAscaris lumbricoidesblood samplingchilddewormingendemic diseasefemalehealth programhemoglobin blood levelhookwormhookworm infectionhumanKenyamajor clinical studymalemicroscopymonitoringnonhumanpopulation sizepreschool childprevalenceSchistosoma mansonischistosomiasisschool childskin tingling |
| MeSH: | AdolescentAnimalsBlood Chemical AnalysisChildChild, PreschoolCross-Sectional StudiesEpidemiological MonitoringFecesFemaleHemoglobinsHumansKenyaMaleMicroscopyNematodaNematode InfectionsPrevalenceSchistosomaSchistosomiasisSchoolsTopography, MedicalUrine |
| Species Index: | AncylostomatoideaAscaris lumbricoidesSchistosomaSchistosoma mansoniTrichuris trichiuraVermes |
Chemicals and CAS Registry Numbers:
hemoglobin, 9008-02-0;
Hemoglobins
Funding details
| Funding sponsor | Funding number | Acronym |
|---|---|---|
| 098045 | ||
| Bill and Melinda Gates Foundation See opportunities by BMGF | BMGF | |
| Wellcome Trust See opportunities by WT | WT | |
| Children's Investment Fund Foundation | CIFF | |
| Ministry of Education, Kenya | MOE |
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1
We acknowledge with appreciation the support from the Ministry of Education, Ministry of Public health and Sanitation and the local provincial and district administration in Coast, Western, Nyanza and Rift Valley Provinces. We thank the head teachers, teachers and students and parents in each of the schools that participated in this study and are grateful to the fieldworkers, project staff and laboratory technologists for their assistance in field operations that included sample collection and examination. This study received great support from the Division of Vector-Borne and Neglected Tropical Diseases’ (DVBNTD’s) district facilities and personnel for which we are highly grateful. The fieldwork was financially supported by the Children’s Investment Fund Foundation (CIFF). SJB is supported by a Wellcome Trust Senior Fellowship in Basic Biomedical Science (098045), which also supports RLP. BN is supported by a grant from the Bill & Melinda Gates Foundation. This paper is published with the permission of the Director of the Kenya Medical Research Institute (KEMRI). The findings, interpretations and conclusions expressed in this paper are entirely those of the authors, and do not necessarily represent the views of the World Bank, its Executive Directors, or the governments of the countries they represent.
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2
In Kenya, a national SBD programme was launched in 2009, with financial support from the Ministry of Education and technical support and drugs provided by Deworm the World and the Partnership for Child Development. The programme successfully treated over 3.6 million school-age children. This programme built on previous pilot programmes in Kenya [3-5], including a pilot school health programme in Mwea District in central Kenya supported by the Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC) at the Kenya Medical Research Institute (KEMRI) and the Japan International Cooperation Agency [6]. In addition to the operational experience in implementing SBD programmes in Kenya, there exists a clear policy context, with school health policy and guidelines developed jointly by the Ministry of Public Health and Sanitation and the Ministry of Education [7,8]. In 2011, the national government programme (with technical support from Deworm the World) received five years of funding from the Children Investment Fund Foundation and in 2012, an estimated 4.6 million school children received albendazole treatment for STH infection (Government of Kenya, pers. comm.).
- ISSN: 17563305
- Source Type: Journal
- Original language: English
- DOI: 10.1186/1756-3305-6-198
- PubMed ID: 23829767
- Document Type: Article
Mwandawiro, C.S.; Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O Box 54840-00200, Kenya;
© Copyright 2013 Elsevier B.V., All rights reserved.
© MEDLINE® is the source for the MeSH terms of this document.
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