By Michael Gwarisa in Nyazura
Children at St Peters Tokoyo primary school, about 25 Kilometers from Nyazura Growth point in Makoni District, Manicaland province, have braced the chilly weather to queue for the Bilharzia and Intestinal worms medications being administered under the nationwide Mass Drug Administration (MDA) program.
At Tokoyo Primary school and the nearby clinic, health workers from the Ministry of Health and Child Care (MoHCC) are administering Praziquantel, treatment for Schistosomiasis or Bilharzia. According to a 2021 Community-Based Mapping, Makoni District has an double endemicity of Schistosomiasis and Soil–transmitted helminths (intestinal worms). However, Tokoyo village and five other villages namely Musengewa, Murandu, Nyatsine, Choumhazi and Nyamutanda are endemic to only Schistosomiais.
Bilharzia or Schistosomiasis is an acute and chronic disease caused by parasitic worms. According to the World Health Organisation (WHO), people are infected during routine agricultural, domestic, occupational and recreational activities which expose them to infested water. On the other hand Intestinal worms or Soil-transmitted Helminths, are parasitic worms that live in the human intestines. They spread through soil or water contaminated by human feces that contain the parasite larvae.
Darrel Makoni (10) is now doing Grade 3 at St Peters Tokoyo Priamry School. He and his friends are waiting for their turn to get the tablets. He vividly recalls some time back in 2022, when he was doing Grade 2. He woke up one morning preparing to go to school. As a routine, he uses the rest room before taking a bath everyday. As he was passing out urine, he felt a burning sensation. When he looked down, he noticed that his urine was blood-stained.
He rushed to tell his mother who wasted no time and took him to the Clinic nearby. The nurses told his mother that he had Bilharzia or Schistosomiasis and he had treatment administered to him. Unfortunately, Darrel had to spend two and a half weeks recovering from home. He missed out on his studies which subsequently led to him not writing end of term examinations that year.
I don’t want to experience the pain I experienced back then when I was diagnosed with Bilharzia. The blood in the urine was scary. I don’t want a repeat of that,” says young Darrel as he enters the classroom block where the administration of Praziquantel for Schitsosomiasis is taking place.
In 2022, Mass Drug Administration and several other districts in Manicaland province benefited from a MDA against Schistosomiasis and Soil Transmitted helminthiases.
Darrel and most children in the province received treatment against the disease. The MDA program is being implemented by the Ministry of Health and Child Care (MoHCC) through financial support from Higher Life Foundation and technical support from World Health Organisation (WHO).
The last Mass Drug Administration was conducted in Manicaland in 2022. Meanwhile, at St Peters Tokoyo Primary school, absenteeism linked to Schistosomiasis has greatly reduced since the last MDA exercise in 2022. The school has an enrollment 550 students.
Mr Bonnie Tokoyo, the acting Deputy Head at St Peters Tokoyo said the MDA exercise was crucial as it has improved the learning and health outcomes of children at his school.
“Recently, we haven’t had any case of Bilharzia at this school. We have noted that for effective learning to take place, the children have to be healthy. As long as children are not feeling well, they lose concentration and absenteeism increases. As a result it would affect learning. This exercise improves the health of the children, it improves the health of the children, it means academically, we have people whom we can really assist who are healthy,” said Mr Tokoyo.
Schistosomiasis was estimated to be the third leading cause of Disability Adjusted Life Years among neglected tropical diseases (NTDs) worldwide and second after malaria in Sub-Saharan Africa accounting for 200,000 deaths annually. In Manicaland province, approximately 252 wards had an endemicity of both Schistosomiasis and Soil-transmitted helminthiases.
Mr Patricia Maponga , a Village Health Worker in Nyazura mans six Village namely Tokoyo, Musengewa, Murandu, Nyatsine, Choumhazi and Nyamutanda. Together with her colleagues, they mobilised villagers to take their children for preventive chemotherapy in the schools and clinics in the area ahead of the MDA running from 14 to 21 October 2024.
“This year, because we didn’t get rains, we don’t have water bodies lying around. This means we have not recorded a single case this year. However, the ages that are most affected by this disease in this community are children aged 10 to 16 because these are the kids who mostly play in water bodies that carry the parasites. Before this program, we went around communities educating them on the risks of Bilharzia and why they should allow their children to get the treatment,” said Mrs Maponga.
The MDA program is targeting children aged 5 -15 years.
Sister Lucia Musipa, the Community Health Nurse for Makoni District said Makoni district had an endemicity of Schistosoamisis.
“This area that I am covering is giving only Praziquntal which is research based. This area was found to have a problem of Bilharzia or Schistosomaisis. We started in Chendambuya where we were also giving Praziquantel. The program is being run at ward based level whereby we are giving Praziquantel where the problem of Bilharzia is found. Other areas in Makoni are giving Albendazole because of the problem of worms. Other areas are giving both,” said Sister Musipa.
Meanwhile, Rebecca Mwabvu, the Head of the Global Health Program at Highlife Foundation said through their partnership with the Ministry of health, they have prioritised schoolchildren as high risk groups regarding Bilharzia and Intestinal worms.
“For over a decade we have been supporting the Ministry of health in the implementation of annual treatments for school aged children for Bilharzia and intestinal worms and as well as pre-school aged children,” said Mwabvu.
The MDA program is supported from resources from Delta Philanthropies through Higherlife Foundation which complements government efforts in particular the MoHCC in the elimination of Schistosomiasis and Soil Transmitted Heilmerths.
“Through the investments from Delta Philanthropies, Higherlife Foundation has been partnering the Ministry of Health and Child Care towards elimination of Bilharzia and Intestinal worms in the nation of Zimbabwe. This partnership goes back to 2013 alongside investments from partners such as the End Fund, Pharmaceutical companies, WHO especially in the provision of the, medicine that are used for treatment.”
Makoni District also hosts communities that are hesitant to take up public health interventions such as MDA and vaccinations. These include apostolic sects and other religious groups. However the Ministry of Health through its foot soldiers the Village Health workers managed to mobilise the communities to take up services during the MDA program.
Dr Cephas Fonte from the Manicaland Province Medical directorate said they have since established a long lasting relationship with hesitant groups and this has seen an increase in the uptake of health services.
“They are our friends. We work with them. They manage to help us control diseases such as cholera. We are working with them, including measles as well. Sometimes our clinics may go to open for 24 hours during these special times so that they can actually access health facilities if they want,” said Dr Fonte.
Manicaland province is targeting an estimated 85 percent of coverage under the 2024 Mass Drug Administration (MDA) for Schistosomiasis (Bilharzia) and Soil-transmitted helminthiases program.
