School-based mass distributions of mebendazole to control soil-transmitted helminthiasis in the Munshiganj and Lakshmipur districts of Bangladesh: an evaluation of the treatment monitoring process and knowledge, attitudes, and practices of the population

Acta Trop. 2015 Jan;141(Pt B):385-90. doi: 10.1016/j.actatropica.2013.12.010. Epub 2013 Dec 24.

Abstract

Bangladesh's national deworming program targets school-age children (SAC) through bi-annual school-based distributions of mebendazole. Qualitative and quantitative methods were applied to identify challenges related to treatment monitoring within the Munshiganj and Lakshmipur Districts of Bangladesh. Key stakeholder interviews identified several obstacles for successful treatment monitoring within these districts; ambiguity in defining the target population, variances in the methods used for compiling and reporting treatment data, and a general lack of financial and human resources. A treatment coverage cluster survey revealed that bi-annual primary school-based distributions proved to be an effective strategy in reaching school-attending SAC, with rates between 63.0% and 73.3%. However, the WHO target of regular treatment of at least 75% of SAC has yet to be reached. Particularly low coverage was seen amongst non-school attending children (11.4-14.3%), most likely due to the lack of national policy to effectively target this vulnerable group. Survey findings on water and sanitation coverage were impressive with the majority of households and schools having access to latrines (98.6-99.3%) and safe drinking water (98.2-100%). The challenge now for the Bangladesh control program is to achieve the WHO target of regular treatment of at least 75% of SAC at risk, irrespective of school-enrollment status.

Keywords: Bangladesh; Mass drug administration; Mebendazole; Process evaluation; STH; Treatment coverage survey.

Publication types

  • Clinical Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antinematodal Agents / therapeutic use*
  • Bangladesh
  • Child
  • Child, Preschool
  • Communicable Disease Control
  • Female
  • Hand Disinfection*
  • Health Knowledge, Attitudes, Practice*
  • Helminthiasis / drug therapy*
  • Helminthiasis / epidemiology
  • Humans
  • Infant
  • Male
  • Mebendazole / therapeutic use*
  • Sanitation
  • School Health Services*
  • Schools
  • Soil / parasitology

Substances

  • Antinematodal Agents
  • Soil
  • Mebendazole