The impact of control measures on urinary schistosomiasis in primary school children in northern Cameroon: a unique opportunity for controlled observations.
As part of a program to integrate schistosomiasis control into the primary health care system in northern Cameroon, an unexpected opportunity to undertake a controlled evaluation of the impact of interventions was recognized. Inadvertently, a large part of Mindjil, one of four assessment villages, had been essentially excluded from the program, creating a unique natural control. The prevalence of infection with Schistosoma hematobium in school-aged children was 7% in the areas where the control program was implemented, and 71% in the excluded areas (P < 0.0002). High intensity infection was 1% and 26% in the two areas, respectively (P < 0.0002). Children in the school where the control interventions were implemented had a significantly lower prevalence of infection with Schistosoma hematobium (P < 0.005). Subjects in intervention areas demonstrated greater knowledge about the transmission of schistosomiasis than those in the control area. This study documented and quantified program impact in a controlled manner not usually possible in field studies and also illustrated how unrecognized intracultural diversity (within culture differences) in target populations may effect disease control programs in communities.
Bausch
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Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
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D000293:Adolescent; D000818:Animals; D000980:Antiplatyhelmintic Agents / Q000627:therapeutic use; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003466:Cultural Characteristics; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010270:Parasite Egg Count; D010865:Pilot Projects; D011223:Praziquantel / Q000627:therapeutic use; D015995:Prevalence; D012548:Schistosoma haematobium / Q000302:isolation & purification*; D012553:Schistosomiasis haematobia / Q000453:epidemiology* / Q000517:prevention & control*; D012574:Schools; D014556:Urine / Q000469:parasitology
D000980:Antiplatyhelmintic Agents; D011223:Praziquantel