Browsing by Author "Whawell, Sarah"
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Item Morbidity due to Schistosoma mansoni: an epidemiological assessment of distended abdomen syndrome in Ugandan school children with observations before and 1-year after anthelminthic chemotherapy(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2006-06) Balena, Julie; Stotharda, J. Russell; Kabatereine, Narcis B.; Tukahebwa, Edridah M.; Kazibwee, Francis; Whawell, Sarah; Webster, Joanne P.; Utzinger, J¨urg; Fenwick, AlanSummary: The objectives of this study were to determine the prevalence and distribution of distended abdomens among Ugandan school children across a range of eco-epidemiological settings and to investigate the relationship between distended abdomens and helminth infections, in particular Schistosoma mansoni, before and 1-year after anthelminthic treatment. A cross-sectional survey was conducted on 4354 school children across eight districts, with a longitudinal 1-year follow-up of 2644 children (60.7%). On both occasions, parasitological,biometrical and clinical data were collected for each child. Baseline prevalence of S. mansoni and hookworms was 44.3% and 51.8%, respectively. Distended abdomens, defined as an abdominal circumference ratio (ACR) >1.05, were observed in 2.5% of the sampled children,several of whom presented with particularly severe distensions necessitating hospital referral.ACR scores were highly overdispersed between districts and schools. Multivariate regression analysis revealed that S. mansoni infection accounted for only a small fraction of ACR variation,suggesting that either single point prevalence and intensity measures failed to reflectthis more chronically evolved morbidity and/or that other interacting factors were involved,Item 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, AlanSchistosomiasis 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.