Factors that contribute to Helminth Prevalence in Communities even after Repeated Mass Drug Administrations in Anambra State, Nigeria

Abstract

Background Over the past decade, mass drug administration (MDA) has been a crucial strategy in controlling schistosomiasis and soil-transmitted helminthiasis in Anambra State, Nigeria. This longitudinal study from 2017 to 2019, evaluated the implementation of interventions introduced for the control of schistosomiasis (SCH) and soil-transmitted helminthiasis (STHs) in recipient communities and the gains. Methods One thousand and forty-six consenting pupils aged 5 to 16 years old were enrolled. Kato- Katz and urine filtration techniques were employed for the examination of fresh faecal and urine samples respectively. A structured questionnaire was administered to 243 people for the assessment of the contextual factors. Data were analyzed using Minitab 17. Results Equal numbers (50% females and 50% males) make up the 1046 pupils. A baseline prevalence of 8% (82/1046) was observed. Helminthes ova seen were A. lumbricoides (7.0%), T. trichiura (1.0%), Hookworm (0.1%) and S. haematobium (0.5%), while co-infection of 1% was observed between A. lumbricoides and Hookworm. Follow-up evaluation showed a prevalence of 6% (65/1046) made up of A. lumbricoides (2.0%), T. trichiuria (2.2%), S. haematobium (2%) with co-infection of 0.2% observed between A. lumbricoides and S. haematobium. Helminth infection with respect to location (p > 0.05) varied significantly at baseline and follow-up. Socio-economic status was significantly related to transmission. From the 243 respondents, 87% of the people earn less than $50 per month; also 39% practice open defecation, and 71% advocated for Mass Administration of Medicines to continue as 67% were happy as it was free of charge. On sustainability, 98% were happy that the government is providing funds. Conclusion It is advocated that emphasis should continue on health education, while concurrently working on enhancing basic social amenities. These combined efforts will significantly contribute to achieving long-lasting positive changes and maintaining the gains of the interventions.