Evaluation of a Novel Primary Prevention Technique for the Control of Urogenital Schistosomiasis: A Pilot Intervention in Adasawase, Ghana.
Kosinski, Karen.
2011
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Abstract: In Adasawase, a rural Ghanaian town, 36% of girls (n=43/119) and 51%
of boys (n=69/134) who were screened three times were infected with S. haematobium as of
2008. Praziquantel was administered by Ghana Health Services. In 2009, schoolchildren were
screened three or more times and prevalence was estimated to be 13% (n=13/98) among girls
and 24% (n=29/122) among boys, indicating ongoi... read moreng transmission of S. haematobium. In 2009,
children again received praziquantel. Children in Adasawase contract schistosomiasis in the
Tini River where they play, bathe, and collect water. An intervention in the form of a
novel water recreation area (WRA) was designed and implemented to function as an effective,
sustainable form of primary prevention. It consists of a concrete pool supplied by two
hand-pumped boreholes and a rainwater collection system. Adasawase was selected for the
study based on the relatively high prevalence of urogenital schistosomiasis, strong support
of the project by community leaders, and water availability. Concrete structural elements
were constructed in 2008 and waterproofing and aesthetic touches were completed in 2009.
The WRA was opened for public use after praziquantel treatment in 2009. Community members
operate and maintain the WRA. Local children were encouraged by community leaders to use
the WRA instead of the Tini River for recreation. In 2010, one year after opening the WRA,
children were screened at least three times for S. haematobium eggs; only 2% of girls
(n=2/105) and 5% of boys (n=7/141) were positive, reflecting annual incidence after WRA
construction. Risk factors associated with infection also changed significantly during the
course of the study. Age, sex, and observed river use in 2009 correlated with 2008
infection status. Observed river use and previous infection status were the only
significant risk factors in 2009. Statistical analysis of positive children in 2010 was not
possible due to the small number of positive children. The WRA should be evaluated in other
water-rich regions to determine whether it is effective and sustainable in other settings.
Continued praziquantel administration is still necessary for morbidity control and should
be promoted in conjunction with WRAs.
Thesis (Ph.D.)--Tufts University, 2011.
Submitted to the Dept. of Civil Engineering.
Advisor: David Gute.
Committee: Kwabena Bosompem, John Durant, Jeanine Plummer, and Miguel Stadecker.
Keywords: Public health, Environmental health, and Civil engineering.read less - ID:
- fb494m872
- Component ID:
- tufts:20883
- To Cite:
- DCA Citation Guide EndNote
