Schistosomiasis, one of the Neglected Tropical Diseases (NTDs), is a parasitic disease caused by parasitic worms that can cause acute and chronic infection while Soil Transmitted Helminthiasis (STH) is caused by infection with a group of intestinal nematode worms.
Schistosomiasis, which is prevalent in rural communities can be contracted through contaminated food and water while STH is transmitted by the fecal oral route and by skin penetration.
According to available statistics, over 200 million people globally are infected with Schistosomiasis with over 700 million people living at risk of infection and over 90 per cent of infected people live in sub-Saharan Africa. Approximately 1.5 billion people are infected with soil-transmitted helminths worldwide with infections widely distributed in tropical and sub-tropical areas, and greatest number occurring in Africa (WHO, 2017).
Speaking during a media dialogue on Neglected Tropical Diseases (NTDs) Control in Nigeria, organised by the United Nations Children’s Fund (UNICEF) in collaboration with the Child Rights Information Bureau (CRIB) of the Federal Ministry of Information & Culture, recently in Ibadan, Oyo State, deputy director/programme manager, Schistosomiasis and Soil Transmitted Helminthiasis Elimination Programme, Dr. Obiageli Nebe, said though neglected, Schistosomiasis and STH cause chronic infections and infants and children are prone to the infections due to their less developed immune system, experts revealed.
In her presentation, Nebe said symptoms of these worm infections include: diarrhoea, bloody stool, anaemia, stunted growth, enlarged liver and spleen, severe damage to the liver leading to liver fibrosis, portal hypertension.
The risk factors include walking barefoot (hookworm), ingestion of eggs in contaminated food or from contaminated hands, poor sanitary infrastructure, and inadequate water supply, she said.
According to the Nigeria’s National baseline mapping report (2017), a total of 139,645,032 people live in schistosomiasis at-risk areas. 41,033,925 SAC & 1,396,203 Adults require mass treatment (WHO & FMOH treatment guidelines)
582 local government areas (LGAs) are endemic. 279 LGAs require once in years treatment and 294 LGAs requiring once a year treatment while 10 high risk LGAs require treatment for school age children and adults, said Nebe.
On prevention, she said this can achieved by wearing shoes, washing hands thoroughly with soap and water after using the latrine and before eating, proper food preparation and storage, filtering or treating contaminated drinking water, and keeping schools and households feces free
“These parasites are known to have detrimental impact on child health as they deplete nutrients in children and adversely affect physical and cognitive development, causing symptoms such as abdominal pain, anaemia, bladder, liver diseases and other health problems which impair growth, reduced school attendance with poor learning outcome,” she explained.
With Nigeria having the highest burden of tropical diseases in Africa, Nebe said massive deworming exercise has been initiated in the country.
Stressing the importance of the exercise, she said worms are harmful to children’s health, education, growth, and development, stating that deworming can improve children’s school participation, growth, and nutritional intake.
“Deworming tablets improve health, appetite, and energy levels, reduce school absenteeism, and improve the learning ability of children,” she said.
She said government have made a lot of efforts toward elimination of the disease. These efforts, she said include establishment of coordinating mechanisms such as NTD SC, WASH WG and National De-worming Multi-sectoral TWG 2017, Partnership with the NHGSF Programme and Flag off of Mass Deworming, Finalization of National Schistosomiasis & STH strategic plan and Implementation guidelines 2021-2025, Revision of NTDs data collection tools (NTDs community treatment register, summary forms and supervisory checklist) for improve data reporting 23rd-25th September 2019, among others.
In the Federal Capital Territory (FCT), for instance, massive deworming exercise was carried out recently, targeting 75 per cent of school age children.
FCT NTDs coordinator, Mrs Ogundife Eunice Bosede, noted that all six Area Councils of FCT were endangered of Filarial worms, which causes river blindness as well as elephantiasis.
Bosede stated that the deworming exercise, which started November 26, 2020 and to end on December 11, 2020 aimed to treat at least 75 per cent of school- age children for 5 consecutive years after which an eveluation will be conducted to determine if there is need to continue with treatment or not.
Children between the ages of 5 and 14 are at the highest risk of infection and suffer the most impact from worm burdens. To reach this age group who is found mostly in schools, teachers are trained to safely administer deworming tablets during a normal school day.” She added.
“Teachers are already trained from 2000 schools across the 3 area councils of the FCT to deworm children during normal school hours,” her statement reads,” she said
She called for more participation in the deworming exercise while urging parents to ensure that all children between the ages of 5 and 14 year receive the deworming medicine even if they are not currently infected.
The medicine are safe and free of charge. Out-of-school children should visit any nearby school for deworming,” said Bosede.
She, however, warned that children who are ill on the day of deworming should not receive the tablet but wait until mop-up-day.
Meanwhile, she stated that due to high prevalence of Schistosomiasis (bilhaziasis) in Gwagwalada Area Council, adults will also be treated.
“Children will be treated with either Mebendazole or Praziquantel in AMAC, while only Praziquantel will be administered in Gwagwalada and Bwari Area Council,” the coordinator said.
Also, a coalition of civil society organisations (CSOs), has said that over 50 per cent of children across the six area councils in the FCT were infected with schistosomiasis.
The CSOs noted know open defection and poor hygiene practices were factors responsible for the intestinal worm infection, saying that two of the area councils; Gwagwalada and Kwali, were also endemic to soil transmitted helminths.
The NTD technical specialist, Christian Blind Missionary (CBM) Nigeria country office, Joseph Kumbur, jujwho raised concerns over what he described as poor awareness, funding and strict instructions from parents to their children and wards not to take the drugs, gave assurances that they were safe and reliable with mild adverse effects of not more than three days, especially when taken on an empty stomach.
However, Dr. Nebe noted that significant gap still exist in treatment of SAC due to low scale up of interventions in all endemic LGAs, data gap and under treatment of hot spots/high burden communities within endemic LGAs.
On the way forward, she advocated for sustained and retained effective therapeutic & geographic coverage, disaggregation of Schistosomiasis mapping data into sub-districts (wards) for more objective planning & implementation
She also urged on adaption of control/elimination guidelines to clearly define what happens when Infection or transmission control has been achieved in preparation for interruption of transmission & elimination, implement intermediate vector control interventions and focused advocacy efforts at National, State and LGAs levels.
