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Patient journey and resources mapping to implement a praziquantel mass drug administration program for children aged
Mhlengi Vella Ncube1,2, Muhubiri Kabuyaya3, Moses John Chimbari3
1School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. mhlengivncube@yahoo.com.
Insights
Schistosomiasis treatment in young children (5 and under) lacks guidelines. This review examined processes and resources for praziquantel (PZQ) administration, recommending affordable, primary healthcare-level resources.
Area of Science:
- Global Health
- Infectious Diseases
- Pediatrics
Background:
- Schistosomiasis infections in early childhood (under 5 years) can impede development in low- and medium-income countries.
- Current praziquantel (PZQ) treatment guidelines from the WHO do not cover children 5 years and younger.
- There is a need to understand the processes and resources for treating this vulnerable age group.
Purpose of the Study:
- To review the processes and resources involved in treating schistosomiasis in children aged 5 years and below using praziquantel (PZQ).
Main Methods:
- An extensive electronic literature search was conducted across multiple databases (Academic Search Complete, CINAHL, Health Source, MEDLINE, Google Scholar) from January 2011 to August 2021.
- The search focused on peer-reviewed articles detailing schistosomiasis treatment in children aged 5 years and younger with PZQ.
Main Results:
- Thirteen studies met the inclusion criteria, outlining a patient journey involving enrolment, examination, diagnosis, anthropometrics, palatability adjustments, PZQ administration, and side effect monitoring.
- Significant variation was observed in the resources utilized for treating this age group.
Conclusions:
- Mass drug administration programs using PZQ for children under 5 in endemic areas should not require pre-treatment diagnosis.
- Treatment resources must be affordable and utilize skills and maintenance capabilities available at the primary healthcare level.
Background:
The early childhood development of millions of children in some low- and medium-income countries may be compromised by schistosomiasis infections contracted at the age of 5 years and below. Currently, there are no standard guidelines for treating schistosomiasis in children that are 5 years and younger using praziquantel (PZQ), the only drug that the World Health Organization (WHO) recommends for treating schistosomiasis. The review is on processes and resources involved in the treatment of schistosomiasis in children aged 5 years and below.
Methods:
An electronic search for peer-reviewed articles published in the period from January 2011 to August 2021 was done in the Academic Search Complete, CINAHL with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE databases via EBSCOHost and Google Scholar databases. The search targeted journals that described the treatment of schistosomiasis in children 5 years and below using praziquantel.
Results:
Thirteen studies met the inclusion criteria. The patient journey for treating schistosomiasis in children aged 5 years old and below using PZQ included the following activities: enrolment of the children into the treatment program; clinical examination; diagnosis; taking anthropometric measurements; feeding the children, making the PZQ palatable to the children; administration of PZQ; and monitoring of side effects. There was also a variation in the resources used to treat children aged 5 and below for schistosomiasis.
Conclusions:
A PZQ mass drug administration program for children aged 5 years old and below in endemic areas should exclude the diagnosis of schistosomiasis before treatment. The resources required in the treatment process should be affordable, and should not require skills and maintenance resources that are beyond those that are available at the primary healthcare level.
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