title: Impact of community-directed treatment on soil transmitted helminth infections in children aged 12 to 59 months in Mazabuka District, Zambia.
abstract: This study assessed the impact of adding community-directed treatment (ComDT) to the routine health facility (HF)-based treatment on prevalence and intensity of soil transmitted helminth (STH) infections among children aged 12 to 59 months. Repeated cross-sectional surveys were conducted among randomly selected children of this age group from the intervention area (HF+ComDT area) and the comparison area (HF area) at baseline (n=986), 12 months (n=796) and 18 months (n=788) follow-up. The prevalence of Ascaris lumbricoides was significantly higher in the HF+ComDT as compared to the HF area at baseline (P=0·048), but not at 12 and 18 months follow-up. At baseline the HF+ComDT area had significantly higher intensities of A. lumbricoides compared to the HF area (P<0·001), but not at 12 and 18 months follow-ups. Prevalence and intensity of hookworm did not differ significantly between treatment arms at any time. Analysis of trends showed a significant decrease in prevalence of A. lumbricoides and hookworm in the HF+ComDT area (P<0·001), of hookworm in the HF area (P<0·05), but not of A. lumbricoides in the HF area. It is concluded that the ComDT approach generally enhanced the treatment effect among under-five year children and that this alternative approach may also have advantages in other geographical settings.
authors.affiliation: Department of Biological Sciences, School of Natural Sciences, University of Zambia, Box 32379 Lusaka, Zambia. hikabasa@yahoo.com
authors.forename: Hikabasa
authors.initials: H
authors.lastname: Halwindi
authors.forename: Pascal
authors.initials: P
authors.lastname: Magnussen
authors.forename: Seter
authors.initials: S
authors.lastname: Siziya
authors.forename: Ray
authors.initials: R
authors.lastname: Handema
authors.forename: Dan W
authors.initials: DW
authors.lastname: Meyrowitsch
authors.forename: Annette
authors.initials: A
authors.lastname: Olsen
mesh_terms: D017677:Age Distribution; D000723:Ancylostomatoidea / Q000302:isolation & purification*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D001196:Ascariasis / Q000188:drug therapy* / Q000453:epidemiology; D017164:Ascaris lumbricoides / Q000302:isolation & purification*; D002669:Child Welfare; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005500:Follow-Up Studies; D006725:Hookworm Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008463:Mebendazole / Q000627:therapeutic use; D010270:Parasite Egg Count; D015995:Prevalence; D012987:Soil / Q000469:parasitology; D015024:Zambia / Q000453:epidemiology
chemical_list: D000871:Anthelmintics; D012987:Soil; D008463:Mebendazole