Treatment of Schistosomiasis Haematobium with Praziquantel in Children : Its Effect on Educational Performance in Rural Nigeria

Schistosoma haematobium infection is highly endemic in Adim, a rural rice-farming community located within the rain forest of South-eastern Nigeria. With support from Rockefeller Foundation we initiated a treatment programme among the pupils of the only primary school in the community. All children in the school were screened yearly for infection using reagent strips and light microscopy. Infected children were treated with praziquantel (40 mg/kg body weight). To determine the effect of repeated treatment on the educational performance we followed up children (aged 8.0 - 8.9 years) who were in the same school grade through a three-year period. The prevalence of infection in the cohort measured at 12-monthly intervals with a session of treatment in between the screening were 69.1% at the beginning of the programme then 45.2% and 21.6% at the second and third yearly evaluation respectively. The school attendance rate in the cohort decreased from 86.7% at onset of treatment programme to 81.1% by the third yearly evaluation (p=0.24). Standardized, teacher-made educational tests were given to the pupils in between the treatment exercises. The pass rate among the cohort improved following the first treatment session from 81.4% to 90.7%, latter declined to 84.2% following the second treatment session but the net improvement in performance was statistically significant (x^2=7.20; p=0.027). The possibility of enhancement of educational performance as observed in this study should make regular, periodic treatment of children in communities with endemic schistosomiasis a more cost-effective and beneficial public health intervention strategy than was previously assumed