Uptake of Praziquantel Mass-Drug Administration for Schistosomiasis Control Among School-Age Children in Kpando Municipality in the Volta Region of Ghana

Abstract

Background: Schistosomiasis is one of the neglected tropical diseases of poverty. Ghana has a projected Schistosomiasis prevalence of 23.3 % across the region, with a clustered or localised prevalence of more than 50 % in spots like the Kpando Municipality. The lack of hygiene and play practices in contaminated water in school-age children (SAC) make them especially vulnerable to the disease. Since 2008, a single dose of Praziquantel is given to SAC yearly. The goal is to reach a Schistosomiasis prevalence of less than 1%. Objectives: The purpose of this study was to assess the proportion of praziquantel mass-drug administration uptake among school-age children in selected communities of Kpando Municipality and to determine the factors associated with this uptake. Methods: A cross-sectional study was performed among School-Age Children between 10 to 14 years in five selected communities from each sub-municipality of the Kpando Municipality. Questionnaires were administered to 462 respondents who were randomly sampled. Chi-square or Fisher's exact tests were used to test for associations between the various independent variables and the dependent variable. Logistic regression was performed to test associations with a p-value < 0.05. Results: The coverage of the mass-drug administration reported by the municipality was 42.13% for SAC in and out of school. The uptake among 10 to 14 years SAC during the study was 90.07%. The factors related to the uptake of Praziquantel were school attendance and level of education. Also, awareness of SAC on the MDA had a relationship with uptake. Children who knew that SAC was the target population of the MDA had 3.14 (AOR=3.14, 95%CI: 1.57- 6.30, p-value=0.001) times odds of swallowing Praziquantel compared with children who did not know that SAC was the target population of the MDA. Those who understood the prevention purpose of the MDA were 7.70 times more likely to take Praziquantel (AOR=7.70, 95%CI:3.16-18.77, p-value<0.001). Also, those who identified the importance of the MDA are 8.06 times more likely to take Praziquantel compared to those who did not identify the importance of the MDA(AOR=8.06, 95%CI:1.78- 36.55, p-value=0.007). Those who were willing to take Praziquantel at the next MDA had more than fourfold increased odds of taking the drug (AOR=4.59, 95%CI:1.19-17.67, p-value=0.027). Conclusion: The uptake of Praziquantel MDA in selected communities of the Kpando Municipality among 10 to 14 years SAC was 90.07%. Some of the factors associated with this uptake were the level of education, school attendance, awareness of the MDA, parent support, and willingness to participate at the next MDA. Future interventions should consider a combined community-based MDA.