MUNISI DISSERTATION REPORT FINAL[1].pdf - muhas

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1.1. STATEMENT OF THE PROBLEM
Poverty and inadequate water supplies and sanitation are important determinants of
transmission of STH infections. In such conditions, soil-transmitted helminths species are
commonly co-endemic (Bethony et al., 2006, WHO, 2002).In Same district 734 out of 29360
households have no toilets. This constitutes 2.5 percent of the total households in the district.
The percentage of households without toilet facility in Same district is above the average of
the region. The most common source of drinking water is from unprotected wells (The united
Republic of Tanzania, 2002).These conditions suggests that STH are endemic in Same district.
Periodic treatment of the endemic population with a broad spectrum anti-helminthic drug has
been advocated as a cheap and effective mean of reducing the worm burden and its related
morbidity (Andrade et al., 2001). NSSCP implemented the first round of school deworming
campaign in Kilimanjaro Region including Same district in August 2008 (SCI, 2009), the
second round is scheduled in the fifth phase of the NTDCP which is yet to be done. It is also
known that an important factor in STH treatment is reinfection, where rates of STH infection
has been observed to reach between 44% to 80% of pretreatment rates, within a period of less
than 36 months depending on the parasite species (Bethony et al, 2006). However since the
last mass chemotherapy against STH in the district, no survey has been done to determine the
prevalence and intensity of STH. As WHO recommends a baseline survey in school children
to determine the prevalence and intensity of infections (Montresor et al., 1998) as
governments need to target treatment appropriately, based on reliable and up-to-date
information on the geographical distribution of infection (Pullan et al., 2011).
It has also been reported that in many tropical regions, anaemia, iron deficiency, malaria and
multiple helminths (most importantly Geohelminths and Schistosomes) infections coexist and
are interrelated (Stoltzfus et al,2000). There are limited information in Same district regarding
the coexistance of soil-transmitted helminths, malnutrition and anaemia.