title: Mass drug administration significantly reduces infection of Schistosoma mansoni and hookworm in school children in the national control program in Sierra Leone.
abstract: BACKGROUND
  The first-ever round of school-based mass drug administration (MDA) with praziquantel together with mebendazole targeting school-aged children in endemic districts was conducted in 2009 by the National Neglected Tropical Diseases Control Program. To evaluate the impact of the treatment regimen, a cross-sectional sentinel site survey was conducted 6 months post-MDA.
  
  
  METHODS
  Fifteen sentinel schools from six highly endemic districts (according to data from national and pre-MDA surveys) with Schistosoma mansoni affecting over 50% of the population, and moderate to high prevalence of hookworms (> 20%). Approximately 30 children aged 9-14 years were selected from each school and stool samples (one per student) were examined by the Kato-Katz method.
  
  
  RESULTS
  The overall prevalence (and intensity) in these sentinel sites pre-MDA of S. mansoni was 69.0% (170.8 epg), hookworm: 41.7% (71.7 epg), Ascaris lumbricoides: 1.8% and Trichuris trichiura: 3.8%. Six months post MDA, the findings were S. mansoni: 38.2% (47.3 epg) and hookworm: 14.5% (8.7 epg), representing a reduction from pre-MDA levels of 44.6% (65.2%) and 72.3% (87.9%) respectively. The proportion of children who were moderately or heavily infected with S. mansoni fell from 35.6% pre MDA to 9.9% post MDA.
  
  
  CONCLUSIONS
  Significant reduction in S. mansoni and hookworm infection was achieved by this first round MDA in school-going children in Sierra Leone. This reduction in infection burden can potentially contribute to a reduction of morbidity, such as anaemia, in these children.
authors.affiliation: Helen Keller International, PO Box 369, Freetown, Sierra Leone. mhodges@hki.org
authors.forename: Mary H
authors.initials: MH
authors.lastname: Hodges
authors.forename: Nsa
authors.initials: N
authors.lastname: Dada
authors.forename: Anna
authors.initials: A
authors.lastname: Warmsley
authors.forename: Jusufu
authors.initials: J
authors.lastname: Paye
authors.forename: Momodu M
authors.initials: MM
authors.lastname: Bangura
authors.forename: Emanuel
authors.initials: E
authors.lastname: Nyorkor
authors.forename: Mustapha
authors.initials: M
authors.lastname: Sonnie
authors.forename: Yaobi
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000723:Ancylostomatoidea / Q000302:isolation & purification*; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage*; D002648:Child; D004358:Drug Therapy / Q000379:methods; D005243:Feces / Q000469:parasitology; D005260:Female; D006725:Hookworm Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008463:Mebendazole / Q000008:administration & dosage; D011223:Praziquantel / Q000008:administration & dosage; D015995:Prevalence; D012550:Schistosoma mansoni / Q000302:isolation & purification*; D012555:Schistosomiasis mansoni / Q000188:drug therapy* / Q000453:epidemiology*; D012807:Sierra Leone / Q000453:epidemiology
chemical_list: D000871:Anthelmintics; D011223:Praziquantel; D008463:Mebendazole