The role of the primary health care system in prevention, control and elimination of schistosomiasis in Burundi

Schistosomiasis is a major public health problem in the world, especially in (sub)tropical countries. It affects more than 78 countries in the world, of which more than 90% are in sub-Saharan Africa. Linked to poverty, its consequences are of great importance for individuals, households, communities and countries. In Burundi, the disease is known for several decades. Only S. mansoni is endemic in the country. The main objective of this thesis was to explore the capacities of Burundi to integrate schistosomiasis control into the PHC system and provide evidence-based recommendations for the integration of schistosomiasis case management, disease surveillance, and other schistosomiasis control activities. The integration of schistosomiasis case management in the routine activities of health centres requires the improvement of health care providers’ knowledge — in charge of consultations and patient referrals — and the availability of praziquantel. Despite the obvious shortcomings, routine monthly reporting from health centres to DNHIS of intestinal schistosomiasis cases after confirmation by DS of stools, appeared to be able to monitor the impact of MDA with praziquantel in the general population; therefore, it could be used as an indicator for the disease surveillance in the country. However, more sensitive tests are recommended and desirable, such as the point-of-care Circulating Cathodic Antigen (POC-CCA) test, especially in low endemic settings such as Burundi and in view of the country elimination goal. For the integration of the four remaining activities beyond case management at the health centre level, the integration is favourable for health education, but not for the control of snail, clean water supply and sanitation, which require the (technical) involvement of other sectors beyond the MOH and international financial support which may not be sustainable in Burundi.

Publication year:2021

Keywords:Doctoral thesis

Accessibility:Closed