Coverage evaluation surveys following soil-transmitted helminthiasis and schistosomiasis mass drug administration in Wolaita Zone of Ethiopia-The Geshiyaro project

PLoS One. 2021 Dec 21;16(12):e0260722. doi: 10.1371/journal.pone.0260722. eCollection 2021.

Abstract

Introduction: The Geshiyaro project aims to break transmission of soil-transmitted helminths and schistosomiasis in the Wolaita Zone of Ethiopia through a combination of two interventions: behavior change communication (BCC) for increased water, sanitation and hygiene (WaSH) infrastructure use alongside preventive chemotherapy (PC) using albendazole (ALB) and praziquantel (PZQ), targeted to reach 90% treatment coverage. Coverage evaluation surveys (CES) were conducted post-treatment, and the resultant survey coverage was compared to reported administrative coverage. This provided a secondary confirmation of the Geshiyaro project coverages, and is used to monitor the success of each Mass Drug Administration (MDA) round.

Methods: A community-based cross-sectional study was conducted in 13 woredas (districts) of the Wolaita Zone. All eligible individuals from the selected households were invited for an interview. The study design, sample size, analysis and report writing were conducted according to the World Health Organization (WHO) CES guidelines for PC.

Results: The study interviewed a total of 3,568 households and 18,875 individuals across 13 woredas in the Wolaita Zone. Overall, the survey coverage across all studied woredas was 81.5% (95% CI; 80.9-82.0%) for both ALB and PZQ. Reported administrative coverage across all studied woredas was higher than survey coverage, 92.7% and 91.2% for ALB and PZQ, respectively. A significant portion of individuals (17.6%) were not offered PC. The predominant reason for not achieving the target coverage of 90% was beneficiary absenteeism during MDA (6.6% ALB, 6.8% PZQ), followed by drug distributors failing to reach all households (4.7% ALB, 4.8% PZQ), and beneficiaries not informed of the program (1.3% ALB, 1.7% PZQ).

Conclusion: Programmatic actions will need to be taken during the next MDA campaign to achieve the targeted Geshiyaro project coverage threshold across data collection and program engagement. Adequate training and supervision on recording and reporting administrative coverage should be provided, alongside improved social mobilization of treated communities to increase participation, and strengthened institutional partnerships and communication.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Albendazole / administration & dosage*
  • Animals
  • Anthelmintics / administration & dosage*
  • Chemoprevention / methods*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Family Characteristics
  • Female
  • Helminthiasis / epidemiology
  • Helminthiasis / parasitology
  • Helminthiasis / prevention & control*
  • Helminthiasis / transmission
  • Humans
  • Hygiene / education
  • Infant
  • Male
  • Mass Drug Administration / statistics & numerical data
  • Middle Aged
  • Praziquantel / administration & dosage*
  • Prevalence
  • Sanitation / methods
  • Schistosomiasis / epidemiology
  • Schistosomiasis / parasitology
  • Schistosomiasis / prevention & control*
  • Schistosomiasis / transmission
  • Soil / parasitology
  • Surveys and Questionnaires

Substances

  • Anthelmintics
  • Soil
  • Praziquantel
  • Albendazole

Grants and funding

This research was funded by the Children’s Investment Fund Foundation (CIFF), UK through a grant to Ethiopian Public Health Institute, Ethiopia under grant number R-1805-02741. The funders had no role in the design of the study, collection, analysis and interpretation of the data. The finding and conclusion of the study reflect the view of the Authors only.