By ANDREW PHIRI
ZAMBIA, like many other tropical settings is currently grappling the elimination of Neglected Tropical Diseases like Schistosomiasis.
Schistosomiasis, also known as bilharziasis or snail fever, is a primarily tropical parasitic disease caused by the larvae of one or more of five types of flatworms or blood flukes known as schistosomes.
It is prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and adequate sanitation; it is endemic in almost all the 108 districts of Zambia.
According to the Zambia Bilharzia Control Program (ZBCP), 2007, close to 3.8 million people in Zambia have bilharzias. The high burden provinces being; Lusaka 49.57%, Eastern 16.66%, Western 15%, Southern 13.62%, and Copperbelt 2.5%.
The infection is more prevalent in rural districts especially those close to water bodies such as lakes, rivers, streams and dams.
It also affects people in agricultural and fishing areas.
Women doing domestic chores in infested water, such as washing clothes, are also at risk and can develop female genital schistosomiasis. Inadequate hygiene and contact with infected water make children especially vulnerable to infection.
Government through the Ministry of Health has placed premium on interventions to eliminate the burden of Schistosomiasis through a collaborative approach with other line ministries and stakeholders.
Ministry of Health, Chief Communicable and Neglected Tropical Diseases Officer, Grace Hameja says the Ministry working together with Ministry of Education has since put up measures to control and reduce the burden of schistosomiasis in Zambia.
Ms Hameja said that awareness programs have been heightened at Provincial, District, facility and community levels which focus on improved sanitation, good hygiene practices, safe drinking water and many more.
“Mass Drug Administration using praziquantel is done via schools primarily as the target population is school aged children (SAC) 5-14” she said “In areas above 50% prevalence, high risk adults are also treated in a community-based treatment approach of administering drugs going door to door.”
Both school based and community-based treatments are directly observed by the teacher, health worker or community drug distributor.
In high-transmission areas, treatment is repeated every year for a number of years.
A follow up of impact and coverage surveys are conducted to assess the impact and coverage of mass drug administration.
“Baseline surveys were carried out in 2013, 2015 and 2018 prior to mass drug administration and showed a significant decline in prevalence since the mapping took place” revealed Ms. Hameja
A 2015 coverage survey showed above WHO recommendation of 75% for SAC but less than 75% in adults (62.2%) across the majority of districts treated.
According to the National Health Strategic Plan 2017-2021, the Ministry of Health has the goal of having a Zambia free of all Neglected Tropical Diseases by enhancing surveillance and improving management so that all cases are promptly treated.
“Formulate health (sanitation and hygiene) promotion programmes that are aimed at preventing and reducing NTDs” reads part of the strategic plan.