Our partnership with Uganda

We have been working with the Ugandan Ministry of Health (MoH) to deliver treatments for schistosomiasis and soil-transmitted helminthiasis, as well as associated mapping and reassessment surveys and monitoring and evaluation activities, since 2003. 

We also collaborate closely with the MoH as part of the Pediatric Praziquantel Consortium ADOPT project, and have worked jointly on important research, including on the impact of mass treatment with praziquantel on Taenia solium (pork tapeworm) infection in Uganda. 

As part of our broader approach to control and elimination of parasitic disease, we are also collaborating closely with partners, including the MoH, on a community-led water, sanitation, and behaviour change intervention in Uganda.  

Prevalence of parasitic diseases in Uganda

Uganda has a high burden of neglected tropical diseases (NTDs), including lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil-transmitted helminthiasis among others. 96 out of 135 districts are endemic for schistosomiasis (SCH), with district-level prevalence across these districts ranging from 1.2% to 98%. In Uganda, the predominant species is Schistosoma mansoni which causes intestinal SCH. Of the 96 endemic districts, 26 are categorised as low endemicity (prevalence between 1-9.9%), 25 are categorised as moderate endemicity (prevalence between 10-50%) and 45 are categorised as high endemicity (prevalence >50%). Soil-transmitted helminths (STH) are endemic in all 146 districts, with district-level prevalence ranging from 1.8% to 90%.   

Despite over twenty years of national-scale treatment, there are persistent hotspots of infection. The MoH has suggested that new areas of transmission may have been created through sand mining and paddy rice growing activities common in the eastern parts of the country. In addition,  reliance on fishing and other water-based activities and low levels of access to water supply and sanitation in rural areas continue to be a challenge.  

”In Uganda, NTDs disproportionately affect marginalized and disadvantaged populations, mainly those living in rural areas with limited access to healthcare. Eliminating these diseases is essential for improving public health, promoting education, reducing health disparities, and advancing equity.” 

– Prudence Beinamaryo, Program Manager Bilharzia & Worm Control, Vector Borne & Neglected Tropical Diseases Division, Ministry of Health

Our support

In Uganda, NTD control is part of the Uganda National Minimum Health Care Package as highlighted in the Health Sector Strategic and Investment Plan III. Uganda’s current NTD Master Plan covers the period 2023-2027 and is focused on scaling up NTD control efforts with the eventual aim of achieving prevention, control, and elimination of NTDs in line with the World Health Organization NTD road map. Within the Masterplan, both SCH and STH are targeted for elimination as a public health problem. The Masterplan also highlights the importance of cross-cutting approaches, including WASH and One Health.  

Treatment delivery

Unlimit Health has primarily supported the delivery of school and community-based treatment for SCH, to both school-age children (SAC) and adults. In schools, teachers are responsible for distributing medicines during MDA. In communities, this is the responsibility of Community Medicine Distributors (CMDs) or Village Health Teams (VHTs). 

In 2023/24, we supported the delivery of 639,107 treatments for SCH and STH. 

“As the VHT Coordinator, I encourage people to build latrines and to use them well. I’m requesting the government and non-governmental organisations to continue to support us by bringing awareness to this area for people to better understand how to avoid getting bilharzia.”

– Gerald Nyende, a VHT worker in Buwaiswa, Uganda.  

 

Cross-sectoral approaches

• Community-led water and sanitation action planning: we are collaborating with the MoH, Ministry of Water and Environment, RANAS and others to identify community-specific factors leading to the risk of SCH transmission, and developing community-specific risk-reduction strategies including water, sanitation, environmental modification and behavioural change. 
• ADOPT programme: we are collaborating with the MoH and partners from the Pediatric Praziquantel Consortium to pilot the delivery of a new paediatric treatment option for SCH in pre-SAC aged 2-5 years. ADOPT will pilot integrated delivery through existing programmes and platforms already targeting pre-SAC in endemic countries.   

“We’re proud to have supported Uganda’s ongoing work towards control and elimination of NTDs through our strategic partnership with the MoH. As a Technical Advisor, it’s a real pleasure working with Prudence and her team, and I’m consistently impressed by the dedication and hard work of the Vector Borne & Neglected Tropical Diseases Division and committed health workers throughout the country.”

– Jenny Burrill, Deputy Director: Access