Girls in Sierra Leone enjoy lunch before taking praziquantel for schistosomiasis. Photo ©HKI/Mustapha Sonnie
Schistosomiasis is a parasitic disease that manifests with urinary and intestinal symptoms. It also can lead to anemia, stunting of growth, poor cognition, and decreased school attendance and performance among children. A child living in Sierra Leone’s northern, eastern, and southern districts face serious risks of contracting schistosomiasis simply from swimming or bathing in fresh, still water.
For the first time in 2009, with support from the U.S. Agency for International Development’s (USAID), the National Neglected Tropical Disease (NTD) Control Program in Sierra Leone distributed praziquantel to school-aged children in endemic areas to control infections caused by schistosomiasis. However, many children go to school each morning without having eaten breakfast—or even dinner the night before. If praziquantel is taken on an empty stomach, it can result in stomach aches, nausea, diarrhea, vomiting, tiredness, and extreme fatigue. These side effects are more likely to manifest in heavily parasitized children who are receiving treatment for the first time.
Attenuation of side effects is a very important aspect of any NTD control program since medicines that cause great discomfort will not be favored by the populations receiving them, which could lead to low coverage rates and jeopardize control and elimination efforts. To minimize these problems, USAID provided funds to enable schools to prepare a meal for every child prior to the administration of praziquantel on the day of treatment. The NTD Control Program—in collaboration with the local leaders—organized the preparation of school meals in over 2,000 primary schools, in six heavily endemic districts. The school feeding initiative was a success. Ninety-five percent of school authorities prepared meals on the day of the scheduled praziquantel distribution. In the 5% of schools where food was not available, evaluation teams halted the distribution of praziquantel until the situation was corrected.
Ensuring that side effects are minimal following drug distribution is not only essential for the well-being of the children, but also for the well-being of the community and future success of the program. The smooth execution of Sierra Leone’s first treatment distribution for schistosomiasis illustrated the importance of collaboratively planning with school authorities, community leaders, and health professionals. This success will help the country scale up treatment in 2010 to target the full 1.8 million people who are at risk.
USAID support for NTD control in Sierra Leone is provided through a grant to Helen Keller International as part of the NTD Control Program led by RTI International under Cooperative Agreement No. GHS-A-00-00006-00. The Program currently supports national NTD control programs in 12 countries—Bangladesh, Burkina Faso, Cameroon, Ghana, Haiti, Mali, Nepal, Niger, Sierra Leone, Southern Sudan, Togo, and Uganda. For more information, go to our website at http://ntd.rti.org.
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