Uptake of Preventive Treatment for Intestinal Schistosomiasis among School Children in Jinja District, Uganda: A Cross Sectional Study
Uptake of Preventive Treatment for Intestinal Schistosomiasis among School Children in Jinja District, Uganda: A Cross Sectional Study
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DOI：
10.1371/journal.pone.0063438
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发表时间：
2013-05-07
期刊：
影响因子：
3.7
通讯作者：
Nuwaha, Fred
中科院分区：
文献类型：
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作者：
Muhumuza, Simon;Olsen, Annette;Nuwaha, Fred
背景：在乌干达，目前的国家卫生部门战略和投资计划强调血吸虫病是到2015年消灭的疾病之一。然而，学龄儿童接受治疗的情况尚不清楚，但怀疑很低。我们估计了吡喹酮预防治疗的吸收和预测因素。方法：在乌干达Jinja地区开展的一项横断面研究中，随机抽样了12所小学的1010名儿童，询问了他们服用吡喹酮的情况、对血吸虫病的知识和看法、对采取预防性治疗的支持以及服用吡喹酮的危险。测定曼氏血吸虫的流行率和平均感染强度。结果：最后一次集体治疗时吡喹酮的自报吸收率为28.2%（95%可信区间（CI）： 22.9% ~ 33.6%）。总体感染率为35% (95% CI: 25.4% ~ 37.9%)，平均感染强度为116.1个/克粪便（95% CI: 98.3 ~ 137.1）。如果儿童来自感染高发学校，了解血吸虫病传播和预防知识，并报告教师支持服用吡喹酮，则更有可能服用吡喹酮。在服用吡喹酮的285名儿童中，142名（49.8%）出现了副作用。在725名未服用该药的儿童中，522名（72.0%）报告担心副作用是不服用该药的主要原因。结论：该人群吡喹酮的摄取非常低。对吡喹酮副作用的恐惧、对血吸虫病传播和预防知识的缺乏以及缺乏教师支持是与低吸取量相关的一些主要因素。
Background: In Uganda, the current national health sector strategic and investment plan underscores schistosomiasis as one of the diseases targeted for elimination by the year 2015. However, uptake of treatment among school children is unknown but suspected to be low. We estimated the uptake and predictors of preventive treatment with praziquantel.Methods: In a cross sectional study carried out in Jinja district of Uganda, a random sample of 1,010 children in 12 primary schools was questioned about their uptake of praziquantel, knowledge and perceptions about schistosomiasis, support for taking preventive treatment and the dangers of taking praziquantel. The prevalence and mean intensity of infection with Schistosoma mansoni were determined.Results: Self reported uptake of praziquantel at last mass treatment was 28.2% (95% confidence interval (CI): 22.9%-33.6%). Overall prevalence and mean intensity of S. mansoni infection was 35% (95% CI: 25.4%-37.9%) and 116.1 eggs per gram (epg) of stool (95% CI: 98.3-137.1) respectively. Uptake of praziquantel was more likely if a child was from a school with high prevalence of infection, had knowledge about schistosomiasis transmission and prevention, and reported teachers' support to take praziquantel. Of the 285 children who took praziquantel, 142 (49.8%) developed side effects. Of the 725 children who did not take the drug, 522 (72.0%) reported fear of side effects as a major reason for non-uptake.Conclusions: Uptake of praziquantel in this population is very low. Fear of side effects of praziquantel, lack of knowledge about schistosomiasis transmission and prevention and lack of teacher support are some of the major factors associated with low uptake.