Healthy Students for Only 29¢ per Child
Situation in Kilifi
Human intestinal parasites, a great burden of the developing world, sap the health and energy of enormous swaths of children and adults. Hookworm, a parasite spread through contaminated dirt, is estimated to take the same toll as malaria in terms of human morbidity. In some places of the Kilifi District, it is estimated that infection rates run as high as 85-90 percent.
In terms of its effect on education, the poor health of the students is a significant obstacle, leading to chronic absenteeism and poor learning performance. However, there are very inexpensive and easy-to-administer treatments for some of the main causes: de-worming pills combat a number of parasites affecting almost the entire school-aged population.
How It Was Designed
Our de-worming treatment follows World Health Organization guidelines—schools with geohelminth (hookworm) prevalence greater than 50 percent should be mass treated with a medication called albendazole every six months, and schools with schistosomiasis prevalence greater than 30 percent should be mass treated with praziquantel annually. The medication has been used all over the world on numerous occasions, and is considered very safe; the worst side effects are upset stomachs. The treatment is shown to kill 99% of parasites in the body. The medication and any possible side effects are explained to the parents of these students, after which medication is administered in school and under the guidance of medical professionals. The estimated costs today for these drugs are 29¢ (USD) per child per year.
Kilifi Rotary Club, Kenya Ministry of Health, Kilifi District Hospital
What We’re Doing
Kilifi Kids and the Kilifi Rotary Club completed a successful negotiation with the Kilifi District Hospital to provide de-worming treatment to 26,652 kids in 2007. The hospital agreed that Kilifi Kids would pay for the cost of medication and the transportation on treatment days, while the hospital covered planning and survey costs. The District Hospital then conducted surveys of infection rates in the Ganze and Vitengeni areas that were used for determining coverage areas and as a baseline for future infection studies.
In mid-May 2008, 150 primary school teachers were trained in Kilifi town about the problems of intestinal parasites and the procedures for treatment. Later that month, the first treatment was launched at the Basi School, Kilifi. Since that time, treatment has continued twice a year in two zones in the Kilifi District. In total, it is estimated that 36,000 kids from 50 schools will receive de-worming medication over a 4-year period.
In December 2009, we received a $20,000 grant to extend our de-worming program into the Bamba area, a more rural part of the district. We aim to de-worm 5,000 more primary school students annually over the next four years.
How to Learn More
The World Health Organization has a great collection of resources. It includes articles about parasite mitigation, educational materials, and scientific research. Also, the following scholarly articles offer some insight and many specifically discuss de-worming in Kenya in regions outside Kilifi:
- Satayathum SA, Muchiri EM, Ouma JH et al. Factors affecting infection or reinfection with Schistosoma haematobium in coastal Kenya: survival analysis during a nine-year, school-based treatment program. Am J Trop Med Hyg. 2006; 75(1): 83-92.
- Miguel E and Kremer M. Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities. Econometrica. 2004; 159-217.
- Kremer, M. The Role of Randomized Evaluations in Making Progress Towards Universal Basic and Secondary Education. American Academy of Arts and Sciences Working Paper. 2004.
- Olds GR, King C, Hewlett J et al. Double-Blind Placebo-Controlled Study of Concurrent Administration of Albendazole and Praziquantel in Schoolchildren with Schistosomiasis and Geohelminths. The Journal of Infectious Diseases. 1999; 179: 996-1003.
- Partnership for Child Development. The Cost of Large-Scale School Health Programmes which Deliver Anthelmintics in Ghana and Tanzania. Acta Tropica. 1999; 73: 183-204.
- Muchiri EM, Ouma JH, King CH. Dynamics and control of Schistosoma haematobium transmission in Kenya: an overview of the Msambweni Project. Am J Trop Med Hyg. 1996; 55(5 Suppl): 127-34.