Successful Mass Drug Administration across Tanzania

The last quarter of 2007 was brought to a successful close with the second treatment campaign of the National Schistosomiasis and Soil-transmitted helminth Control Programme.

The last quarter of 2007 brought to a successful close the second treatment campaign of the National Schistosomiasis and Soil-transmitted helminth Control Programme (NSSCP) which targeted school-aged children and, for the first time, communities residing in the highest prevalence districts in Tanzania.

On 5th September 2007, the NSSCP conducted mass drug administration across 11 regions (67 districts) of Tanzania; namely Tanga, Pwani, Dar es Salaam, Lindi, Mtwara, Kigoma, Kagera, Shinyanga, Tabora, Mwanza and Mara, which had all been previously treated at the end of 2005. During this campaign, an estimated 3.1 million school-aged children were reached with praziquantel. Treatment continued through September and October, with the exception of Ramadan, to ensure high coverage.

The NSSCP used the WHO guidelines to develop a strategy whereby every school received tablets but children within different classes or 'standards' were selectively treated. In high prevalence wards (the smallest administrative unit in the country), all school-aged children received drugs. However, in moderate prevalence wards children in standards 1, 3, 5 and 7 and in low prevalence wards, children in standards 1 and 7 only were given tablets. This strategy will continue in the future, thereby treating children every other year in moderate prevalence areas and treating children on school entry and exit in the lowest risk areas according to the guidelines.

For the first time, the NSSCP in collaboration with the National Institute for Medical Research, also conducted a treatment campaign targeting communities residing in the high prevalence district of Ukerewe. Within Mwanza region, Ukerewe district comprises several islands within Lake Victoria, where intestinal schistosomiasis is one of the major public health problems due to the reliance on the Lake for occupational and domestic activities.

The programme was officially launched on the 15th October 2007 by the District Commissioner, Mr Kichimba, and District Medical Officer, Dr Nkinga, at Butiriti Primary School in the presence of pupils and the local community. Drugs were delivered in all schools and administered to school-aged children (both enroled and non-enroled) by teachers, and to adults by village health workers, targeting a total population of 300,000 individuals. Although everyone was advised to eat prior to receiving treatment, many participating schools prepared food on location in anticipation of the treatment activities to ensure that any side effects were limited. The treatment continued through October and November to ensure that all individuals had an opportunity to attend a primary school to receive drugs, particularly fishermen who spend the majority of their time on the lake.

Throughout the treatment from September until early December, no serious adverse events were reported in any district and preliminary reports indicate high coverage and acceptance of the programme at every level.