Effect on treatment coverage of adding community-directed treatment to the health facility-based approach of delivering anthelminthic drugs to under-five children during child health week in Mazabuka District, Zambia

The current approach of delivering anthelminthic drugs to children aged 12-59 months through health facilities during child health week (CHW) results in low treatment coverage in certain areas of Zambia. This study was designed to determine the impact on treatment coverage of adding community-directed treatment (ComDT) to the health facility (HF) approach. Treatment coverage was compared in two areas, one with the HF approach alone (HF area) and the other where ComDT was added to the HF approach (HF + ComDT area). Cross-sectional surveys were conducted every 6 months between June 2006 and December 2007 to monitor CHWs. χ2 tests, odds ratios (OR) and their 95% CI were used to compare treatment coverage between and within each treatment arm. Addition of ComDT to the HF approach resulted in significantly higher treatment coverage in the HF + ComDT area compared with the HF area during CHW1, CHW2, CHW3 and CHW4, with ORs (and 95% CIs) of a child being treated in the HF + ComDT area of 2.17 (1.90-2.48), 3.07 (2.68-3.52), 11.17 (9.25-13.48) and 5.07 (4.27-6.01), respectively. We conclude that ComDT has the potential to raise treatment coverage significantly during CHWs. [ClinicalTrials.gov Identifier: NCT00349323]