Towards nationwide control of schistosomiasis in Yemen
Oshish, A., AlKohlani, A., Hamed, A., Kamel, N., AlSoofi, A., Farouk, H., ... French, M. D. (2011). Towards nationwide control of schistosomiasis in Yemen: A pilot project to expand treatment to the whole community. Transactions of the Royal Society of Tropical Medicine and Hygiene, 105(11), 617-27. DOI: 10.1016/j.trstmh.2011.07.013
Both the urinary and intestinal forms of schistosomiasis are thought to be widespread in the Republic of Yemen, with estimates of 3 million people infected and 600 000 suffering clinical morbidity. Sub-national control has been ongoing since 2006 via the distribution of praziquantel (PZQ) against schistosomiasis and albendazole (ALB) against soil-transmitted helminths using school-based treatment. In preparation for a 6-year nationwide control programme with the aim of expanding treatment to the wider community, a new programmatic approach of complementing school-based distribution with community-based treatment was trialled in 10 highly endemic districts in three governorates in December 2009. The new approach achieved coverage of 90.1% of non-enrolled children: a 40% increase compared with the same districts in 2008, and coverage of 97.9% of enrolled children: a 2% increase compared to 2008. Coverage of females (children and adults) was 81.8%, and of adults in general was 73.9%. The total cost per person treated was US$0.66 (US$0.79 in 2008), which includes training, health education, social mobilization, distribution and drugs. These results provide hope that a combined school and community-based approach can be successfully implemented on a wider scale during the main control programme in 2010-2015, with approximately 10 million people targeted in the first year alone.