Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania

Objective To determine the impact of deworming on anaemia as part of a larg e-scale school-based anthelmintic treatment programme in the Tanga Region o f the United Republic of Tanzania. Methods Both the reduction in the prevalence of anaemia and the cost per ca se prevented were taken into consideration. Cross-sectional studies involve d parasitological examination and anaemia evaluation before and at 10 month s and 15 months after schoolchildren were dewormed. Findings Baseline studies indicated that the prevalence of anaemia (haemogl obin < 110 g/l) was high (54%) among schoolchildren, particularly those wit h high intensities of hookworm and schistosomiasis. Attributable fraction a nalysis suggested that hookworm and schistosomiasis were responsible for 6% and 15%, of anaemia cases, respectively. Fifteen months after deworming wi th albendazole and praziquantel the prevalence of anaemia was reduced by a quarter and that of moderate-to-severe anaemia (haemoglobin < 90 g/l) was r educed by nearly a half. The delivery of these anthelmintics through the sc hool system was achieved at the relatively low cost of US$ 1 per treated ch ild. The cost per anaemia case prevented by deworming schoolchildren was in the range US$ 6-8, depending on the haemoglobin threshold used. Conclusions The results suggested that deworming programmes should be inclu ded in public health strategies for the control of anaemia in schoolchildre n where there are high prevalences of hookworm and schistosomiasis.