title: School-based mass distributions of mebendazole to control soil-transmitted helminthiasis in the Munshiganj and Lakshmipur districts of Bangladesh: an evaluation of the treatment monitoring process and knowledge, attitudes, and practices of the population.
abstract: Bangladesh's national deworming program targets school-age children (SAC) through bi-annual school-based distributions of mebendazole. Qualitative and quantitative methods were applied to identify challenges related to treatment monitoring within the Munshiganj and Lakshmipur Districts of Bangladesh. Key stakeholder interviews identified several obstacles for successful treatment monitoring within these districts; ambiguity in defining the target population, variances in the methods used for compiling and reporting treatment data, and a general lack of financial and human resources. A treatment coverage cluster survey revealed that bi-annual primary school-based distributions proved to be an effective strategy in reaching school-attending SAC, with rates between 63.0% and 73.3%. However, the WHO target of regular treatment of at least 75% of SAC has yet to be reached. Particularly low coverage was seen amongst non-school attending children (11.4-14.3%), most likely due to the lack of national policy to effectively target this vulnerable group. Survey findings on water and sanitation coverage were impressive with the majority of households and schools having access to latrines (98.6-99.3%) and safe drinking water (98.2-100%). The challenge now for the Bangladesh control program is to achieve the WHO target of regular treatment of at least 75% of SAC at risk, irrespective of school-enrollment status.
authors.affiliation: Ministry of Health and Family Welfare (MOH&FW), Bangladesh. Electronic address: dr.ihafiz2012@gmail.com.
authors.forename: Israt
authors.initials: I
authors.lastname: Hafiz
authors.affiliation: Children Without Worms, The Task Force for Global Health, Atlanta, GA, USA. Electronic address: mberhan@gmail.com.
authors.forename: Meklit
authors.initials: M
authors.lastname: Berhan
authors.affiliation: Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: angela.j.keller@gmail.com.
authors.forename: Angela
authors.initials: A
authors.lastname: Keller
authors.affiliation: Ministry of Health and Family Welfare (MOH&FW), Bangladesh. Electronic address: dr.rouselihaq@gmail.com.
authors.forename: Rouseli
authors.initials: R
authors.lastname: Haq
authors.affiliation: Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: nchesnaye@gmail.com.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Chesnaye
authors.affiliation: Children Without Worms, The Task Force for Global Health, Atlanta, GA, USA. Electronic address: kkoporc@taskforce.org.
authors.forename: Kim
authors.initials: K
authors.lastname: Koporc
authors.affiliation: Ministry of Health and Family Welfare (MOH&FW), Bangladesh. Electronic address: drmujib.rahman@gmail.com.
authors.forename: Mujibur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Ministry of Health and Family Welfare (MOH&FW), Bangladesh. Electronic address: mirsamsut@gmail.com.
authors.forename: Shamsur
authors.initials: S
authors.lastname: Rahman
authors.affiliation: Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: emm7@cdc.gov.
authors.forename: Els
authors.initials: E
authors.lastname: Mathieu
mesh_terms: D000293:Adolescent; D000969:Antinematodal Agents / Q000627:therapeutic use*; D001459:Bangladesh; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control; D005260:Female; D006235:Hand Disinfection; D007722:Health Knowledge, Attitudes, Practice; D006373:Helminthiasis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use*; D012499:Sanitation; D012572:School Health Services; D012574:Schools; D012987:Soil / Q000469:parasitology
chemical_list: D000969:Antinematodal Agents; D012987:Soil; D008463:Mebendazole
keywords: Bangladesh; Mass drug administration; Mebendazole; Process evaluation; STH; Treatment coverage survey