Browsing by Author "Brooker, Simon"

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    Epidemiology and geography of Schistosoma mansoni in Uganda: implications for planning control
    (Blackwell Publishing Ltd, 2004-03) Kabatereine, Narcis B; Brooker, Simon; Tukahebwa, Edridah M; Kazibwe, Francis; Onapa, Ambrose W
    Intestinal schistosomiasis caused by infection with Schistosoma mansoni is a widespread public health problem in Uganda. Although long known to be endemic, its current distribution within the country equires updating of parasitological data to help guide planned control. We report such data collected between 1998 and 2002 from 201 schools and 68 communities across Uganda. In accordance with epidemiological expectation, prevalence and intensity increased with age, peaking at 10–20 years and thereafter declined moderately with age, whereas intensity declined more rapidly with age, and the prevalence of infection in a school was non-linearly related to the mean intensity of infection. We used geographical information systems to map the distribution of infection and to overlay parasitological data with interpolated environmental surfaces. The derived maps indicate both a widespread occurrence of infection and a marked variability in infection prevalence, with prevalence typically highest near the lakeshore and along large rivers. No transmission occurred at altitudes >1400 m or where total annual rainfall was <900 mm; limits which can help estimate the population at risk of schistosomiasis. The results are discussed in reference to the ecology of infection and provide an epidemiological framework for the design and implementation of control efforts underway in Uganda.
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    Progress towards countrywide control of schistosomiasis and soil-transmitted helminthiasis in Uganda
    (Elsevier Ltd., 2005-03-09) Kabatereinea, Narcis B.; Tukahebwaa, Edridah; Kazibwea, Francis; Namwangyea, Harriett; Zarambab, Sam; Brooker, Simon; Russell Stothardd; Kamenka, Cara; Whawell, Sarah; Webster, Joanne P.; Fenwick, Alan
    Schistosomiasis caused by infection with Schistosoma mansoni is a serious public health burden in 38 of the 56 districts of Uganda. This article reviews the initial experience of the national control programme. Launched in 2003, this started with a pilot phase with the main aim of utilizing the experience to formulate feasible and appropriate methods of drug delivery. Overall, 432 746 people were treated and coverage was 91.4% in schools and 64.7% in communities. The issues raised by independent evaluators included that most communities did not participate in the selection of community drug distributors (CDD) and that teachers and CDDs needed refresher training mainly on health education and the management of side effects.As a way forward, it is suggested that the Ministry of Health should integrate deworming into the existing health infrastructure so that every time a child is reached for any health service, the child is also dewormed.