Schistosomiasis Control in Uganda


Uganda was the first African country to distribute Praziquantel en masse through the Schistosomiasis Control Initiative. In Uganda itself, an estimated 4 million are infected with schistosomiasis, and another 17 million are at high risk of developing the disease. Although schistosomiasis morbidity is comparable to that of the "big three"-- HIV/AIDS, malaria, and tuberculosis-- it did not receive the attention it deserved. The disease primarily affected people in poor agricultural communities who already suffered from poor health and co-infections with soil-transmitted helminths. These people did not know what afflicted them and did not know what cure, if ny, was available (7).
Luckily, the Ugandan government showed a commitment to eliminating schistosomiasis, the international community rallied around to help. The Danish Bilharziasis Laboratory and the WHO developed a strategy that used the existing infrastructure to tackle the problem, training health workers to integrate deworming into their health programs. After this momentum, a number of other international groups joined the effort, including the Italian Ministry of Foreign Affairs and a variety of NGOs and religious organizations.

The break came when the Bill and Melinda Gates Foundation issued a $30 million pledge to deworm at least 15 million African people over 5 years (7). The Ugandan government's commitment to deworming allowed it to secure the first funds from the Foundation, and already over 1.5 million individuals have been treated through the program.

The Strategy:
Health education and administration is carried out using the existing infrastructures-- "schoolteachers, community health workers, nurses, district health staff, and community development officers." The program identifies districts where the disease burden is particularly high, and often delivers the medications through a day-long health awareness session at a school. Teachers are given a "Question and Answer" booklet that informs them of all the basics of the disease and its common misconceptions. Children are educated on the symptoms and effects of the disease, and each child is examined. The children are then given a treatment card, a bun or other small food item, and a dose of praziquantel and either mebendazole or albendazole. The combination therapy is intended to de-worm the child of both schistosomes and other soil-transmitted helminths.


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