Coverage validation survey of preventive chemotherapy for schistosomiasis in interruption of transmission districts of Ethiopia, 2025

BACKGROUND: Ethiopia bears a substantial burden of neglected tropical diseases, including schistosomiasis, which remains a major public health problem in endemic areas. Preventive chemotherapy is the main strategy for controlling and eliminating schistosomiasis. This study aimed to assess the reach of the mass drug administration program and validate the reported praziquantel coverage in interruption-of-transmission districts of Ethiopia. METHODS: A community-based cross-sectional survey was conducted from 1 to 30 August 2025 in eight purposively selected districts across three Ethiopian regions targeted for schistosomiasis interventions. Using a three-stage sampling method, data were collected using WHO-standard tools via KoboToolbox. The data were analyzed using descriptive statistics, including frequencies and percentages, in SPSS version 26 to estimate program reach and survey coverage. RESULT: The average programs reach (participants who offered praziquantel) was 84.2%, while surveyed coverage (participants who reported swallowing the drug) was 83.0% (95% CI: 82.7-83.3%). West Badewacho district achieved the highest survey coverage, 95.4%, while Hammer and Bena Tsemay districts achieved 92.1% and 92.4%, respectively. The lowest coverage was recorded in Menit Goldya (66.2%), Mizan (72.0%), and South Bench (72.4%). Treatment uptake among those offered praziquantel was 98.5%. CONCLUSIONS: The survey showed that praziquantel treatment coverage was below the 95% target and the national reported average, with notable variation across districts. Surveyed coverage was largely influenced by whether the treatment was offered; districts with lower program reach consistently had lower treatment coverage. Improving the delivery and offering of praziquantel at the community level is therefore essential to increase treatment uptake.