Browsing by Author "Swai, Cosmas Wilhelm"

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    Effectiveness of primary school teachers in mass chemotherapy of intestinal helminthiasis in rural primary school children in Handeni district.
    (University of Dar es Salaam, 2001) Swai, Cosmas Wilhelm
    A cross-sectional study was carried out in July 2000 in rural Handeni District. The aim was to determine the effectiveness of primary school teachers in administering mass chemotherapy for the control of intestinal helminths. A simple random sampling method was used to select one primary school among the peri-urban schools whereby all school children in that school participated in this study. Out of the 500 school children in the school, a sample of 100 children was selected (one pupil out of five [1:5)) for baseline and evaluation of effectiveness. Two primary school teachers from the selected school (Msasa primary school) were trained for two days on how to administer mass chemotherapy for intestinal helminthic infection to their school children. Stool examination by Kato-Katz technique was carried out on the sample population of 100 children to determine the baseline prevalence and intensity of intestinal worms. After determination of the baseline prevalence and worm load by egg count per gm of faeces, the two trained primary school teachers conducted the mass chemotherapy for the whole school using mebendazole oral tablets of 500 mg single dose. Three weeks after the mass chemotherapy had been conducted, re-check stool examination was done for only those children who were infected with intestinal helminthiasis among the 100 children from whom the baseline prevalence and intensity of infection was determined. Immediately after the re-check stool examination followed a period of evaluation of the teachers by questionnaire check list to the school children to see if all children were given the anthelmintic tablets by their teachers. The data were then analysed by Epi Info Version 6 Statistical software for baseline prevalence and intensity, effectiveness of teachers in mass chemotherapy and coverage of mass chemotherapy. Results showed that intestinal helminthic infections were a health problem to rural primary school children in Handeni. The overall baseline prevalence was 81% with mean egg count of 284.2 eggs per gm of faeces. The overall prevalence of hookworm was 79% with mean egg count of 241.6 eggs per gm of faeces. The overall prevalence of Trichuris trichiura mixed with hookworm was 3% and that of E'nterobius vermicularis mixed with hookworm was 2%. The overall prevalence of intestinal helminths, dropped from 81% to 24% after mass chemotherapy. The effectiveness of mass chemotherapy was statistically significant (p = 0.00001). The cure rate was 70.4%. The mass worm load after chemotherapy was reduced by 87.5%. The mean egg count dropped from 384.2 eggs per gm to 35.6 per gm of faeces. The hookworm prevalence dropped from 79% to 23% before and after mass chemotherapy. The cure rate for hookworm vvas 70.9% and it was statistically significant (p=0.00001). The arithmetic mean eggs per gm for hookworm dropped from 241.6 to 36.1 before and after mass chemotherapy respectively. Worm load reduction rate was 85.3% and egg sum dropped from 29930 to 3580 before and after mass chemotherapy. The cure rate for cases of T. trichiura was 100%, while cases of T. trichiura mixed with hookworm had 0% cure rate. The cure rate for E vermicularis mixed with hookworm was 100%. With regard to prevalence of intestinal worms there was no statistically significant difference between the two age groups 6-9 and 10-13 years. The coverage of mass chemotherapy conducted by primary school teachers was 100%. Hand washing behaviour and wearing of shoes had no association with the worm infection. It was concluded that although each school child knew at least one mode of transmission of intestinal helminths and prevention, the problem still remained in school children because they were living with risk factors for intestinal helminthic infection. Therefore it is recommended that the relevant authorities have to find some mechanisms of reducing intestinal helminthic infection. It is also recommended to adopt mass chemotherapy (deworming) conducted by primary school teachers to primary school children using a single dose of mebendazole 500 mg at four monthly intervals yearly and that promotion of footwear is necessary for primary school children.