Korean J Parasitol.  2020 Apr;58(2):109-119. 10.3347/kjp.2020.58.2.109.

Effectiveness of Mass Drug Administration on Neglected Tropical Diseases in Schoolchildren in Zanzibar, Tanzania

  • 1Department of Environmental Medical Biology, Institute of Tropical Medicine and Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722, Korea
  • 2Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
  • 3Department of Environmental and Tropical Medicine and International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
  • 4Department of Parasitology, College of Medicine, Korea University, Seoul 02841, Korea
  • 5Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, Seoul 03080, Korea
  • 6Institute of Parasitic Diseases, Korea Association of Health Promotion, Seoul 07649, Korea
  • 7Department of Microbiology and Immunology, Eulji University College of Medicine, Daejeon 34824, Korea
  • 8Department of Parasitology and Medical Research Institute, Parasite Resource Bank, Chungbuk National University School of Medicine, Cheongju 28644, Korea
  • 9Integrated Helminth Control Program, Ministry of Health and Social Welfare, Zanzibar, Tanzania


Soil-transmitted helminths and Schistosoma haematobium affect more than 3 billion people globally and mainly occur in sub-Saharan Africa. The present study assessed the overall infection status of a 1716-student cohort of school-children in Zanzibar and applied mass drug administration (MDA) to the cohort from 2007 to 2009. Schools in Pemba, Zanzibar, had a much higher prevalence of soil-transmitted helminth infections than those in Unguja, and the Chaani, Ghana, and Machui schools of Unguja exhibited high S. haematobium infection rates. The MDA program only partially controlled parasite infections, owing to high rates of re-infection. The infection rate of S. haematobium across all 10 schools, for example, was only reduced by 1.8%, and even this change not significant, even though the S. haematobiuminfection rates of the Chaani and Mzambarauni schools were significantly reduced from 64.4 and 23.4%, respectively, at the first screening, to 7.3 and 2.3% at the last screening. The overall infection rate of Ascaris lumbricoides was reduced from 36.0% at the first screening to 22.6% at the last screening. However, the infection rates for both Trichuris trichiuraand hookworm were generally unaffected by MDA. In the future, parasite control programs should involve strategically designed MDA schedules and holistic intervention (e.g., sanitation improvement, hygiene behavior changes, and control of intermediated hosts).


soil-transmitted helminth; neglected tropical disease; mass drug administration; Zanzibar
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