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Schistosomiasis in Uganda

Parasitic worm infections often trap people in a cycle of poverty, and almost a quarter of the population in Uganda is living below the poverty line. We’re supporting the local government to eliminate these infections, including schistosomiasis.

Schistosomiasis (Bilharzia) in Uganda

Five Facts

  • Population: 44,269,587*.
  • Uganda was the first country to be supported by Unlimit Health.
  • Unlimit Health has been supporting the delivery of treatments for schistosomiasis and soil-transmitted helminthiasis annually in Uganda since 2003. A total of 93,503,797 treatments have been delivered to date.
  • During the 2021/22 fiscal year, Unlimit Health supported the delivery of 793,399 treatments for schistosomiasis, and 793,399 treatments for soil-transmitted helminthiasis.
  • Unlimit Health’s support to Uganda is currently enabled by general donated funds.

Programme Information

  • Programme start date: 2002
  • Treatments delivered in FY2019-20: 2,589,972^
  • Numbers treated to date: 10,369,507^
  • Programme coverage status: Targeting all at-risk school-age children^^

Situation in Uganda

Uganda is situated within the Great Lakes region and even though it is landlocked, almost a fifth of its surface area is covered by open water or swamp land. This includes Lake Victoria containing the source of the River Nile at Jinja, Lake Albert and Lake Edward. Uganda is also home to the Rwenzori Mountains, the highest non volcanic mountain range in Africa often referred to as the Mountains of the Moon and containing the UNESCO World Heritage Rwenzori Mountains National Park.

Prevalence of schistosomiasis and soil-transmitted helminthiasis in Uganda

Uganda has a high burden of neglected tropical diseases (NTDs). These affect mainly the rural poor and result in reduced productivity, hence affecting the development of these populations. 93 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. District level prevalence for soil-transmitted helminths (STH) ranges from 1.8% to 90%.

Children play next to one of the boats at the riverfront in Buwaiswa village, Uganda. Unlimit Health/Malaika Media

Unlimit Health-supported NTD programmes

NTDs in Uganda are managed by the NTD Control Programme (NTDCP), housed in the Vector Borne and NTD Division of the Ministry of Health (VB & NTDs – MoH). Unlimit Health has been supporting the NTDCP technically and financially since 2002, with a primary focus on mass drug administration (MDA) for the treatment of SCH and STH, as well as associated mapping and reassessment surveys and monitoring and evaluation activities.

Uganda delivers treatments to people affected by parasitic infections both through schools and in the community. 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).

Unlimit Health is currently supporting the delivery of treatments for SCH & STH in 18 districts. Unlimit Health is also working closely with the NTDCP as part of the Pediatric Praziquantel Consortium ADOPT Project and on research to understand the impact of existing SCH control activities on Taenia solium (pork tapeworm) infection.

Programme objective

Control and elimination of NTDs is part of the Uganda National Minimum Care Package as highlighted in the Health Sector Development Plan II. Uganda’s current NTD Master Plan covers the period from 2017-2022. It focuses on elimination as a public health problem for both SCH and STH, primarily through MDA but also incorporating health education and advocacy for improved water, sanitation and hygiene (WASH). The Master Plan is complemented by a National Sustainability Plan for NTDs which was launched in 2021.

Challenges specific to Uganda

Hard to reach areas within some districts can pose challenges for treatment delivery. There are also difficulties associated with reaching at-risk but hard to reach groups, for example refugee populations (who are not routinely covered in MDA activities) and non-enrolled school-aged children. The availability of drugs and funding to treat adults and pre-school aged children is also not currently available despite the inclusion of these groups in treatment strategies being recommended by the World Health Organization. While reductions in prevalence have been observed in some areas, there are persistent hotspots of infection in other areas, even after 20 years of national scale treatment. The MoH has also 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.

What does the future look like?

Unlimit Health continues to work closely with NTDCP to reach their goals and objectives, as outlined in their national strategic plans.

“Control and elimination of schistosomiasis require strong partnership that SCIF has provided to MoH, Uganda Since 2003. The country has been able to identify at risk population through assessments, and provision of annual treatments to most at risk population which has delineated the schistosomiasis endemicity areas at micro-level.”

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

Related Research Projects

The ADOPT Programme

Developing a suitable formulation to treat infants and preschool-aged children affected by schistosomiasis.

The ADOPT programme

Pork Tapeworm Research

Understanding the impact of existing schistosomiasis control programmes on pork tapeworm (Taenia solium) in Uganda.

Pork tapeworm research

Where We Work

As a top rated international development nonprofit, we support deworming programmes across sub-Saharan Africa in the following countries:

Burundi

Burundi is one of the smallest countries in Africa, and its more than 11 million inhabitants make it one of the most population dense countries on the continent. The country is endemic for parasitic worm infections including schistosomiasis, and following several years of treatment, we’re supporting the local government to eliminate these diseases for good.

View our work in Burundi

Côte d’Ivoire

Parasitic worm infections are debilitating and disproportionately affect the poor and vulnerable, particularly children. While lack of awareness and limited access to clean water and sanitation continue to present challenges, Côte d’Ivoire’s national programme is committed to achieving the elimination of schistosomiasis. By supporting the Ministry of Health, we’re continuing to fight these diseases using sustainable interventions.

View our work in Côte d’Ivoire

Ethiopia

Ethiopia, in the horn of Africa, is the most populous land-locked country in the world. It bears a significant burden of parasitic worm infections, including schistosomiasis, but we’re supporting the Ministry of Health to implement a multi-year national programme for the control and elimination of these diseases.

View our work in Ethiopia

DRC

Parasitic worm infections (such as schistosomiasis) often trap people in a cycle of poverty, and almost half of the population of the Democratic Republic of the Congo (DRC) is living below the national poverty line. We’re supporting the local government to eliminate these infections.

View our work in DRC

Liberia

Around 40% of Liberia’s population is affected by parasitic worm infections (such as schistosomiasis), but we’ve successfully worked with its government to reach all at-risk school age children with treatment.

View our work in Liberia

Madagascar

Madagascar, one of the largest islands in the world, is a low-income country that has suffered from several years of reduced international aid. In most endemic areas in the country, people have gone untreated for many years. We’re supporting the Ministry of Public Health and Education to reach the largest possible number of people affected by schistosomiasis.

View our work in Madagascar

Niger

A majority of Niger’s population lives in rural areas and almost half of Nigerians live below the poverty line. Access to clean water and sanitation is a daily challenge, but by supporting the Ministry of Health we’ve helped to deliver over 10 million treatments for schistosomiasis and soil-transmitted helminths, and have reached all at-risk school-age children.

View our work in Niger

Sudan

With over half of Sudan’s population unable to use improved water and sanitation, over 20 million people need treatment for parasitic worm infections and schistosomiasis. We’re supporting the country’s government to help maintain an elimination programme with national reach.

View our work in Sudan

Tanzania

Despite the country’s control programme reaching national coverage, the size of population at risk is still significant. We support the Ministry of Health and Pemba’s Public Health Laboratory-Ivo de Carneri to deliver treatments against parasitic worm infections, including schistosomiasis.

View our work in Tanzania

Uganda

Parasitic worm infections often trap people in a cycle of poverty, and almost a quarter of the population in Uganda is living below the poverty line. We’re supporting the local government to eliminate these infections, including schistosomiasis.

View our work in Uganda

Zanzibar

All 11 districts across both islands in Zanzibar are endemic for soil-transmitted helminthiasis (STH) and all but one on Unguja are endemic for urogenital schistosomiasis (SCH) with prevalence ranging from 0.4 – 4.8%.

View our work in Zanzibar

Malawi

All 29 of Malawi’s health districts are endemic for schistosomiasis, with both urogenital and intestinal schistosomiasis present within the country. Disease levels in Malawi range from 1.3% to 25.4%, which are classified as low to moderate prevalence, according to the World Health Organization’s (WHO) endemicity categories.

View our work in Malawi