Japan has achieved significant improvements in control and prevention of parasitic infections through school-based approach since 1930s. The use of chemical fertilizer in agriculture, safe water and food, and improved sanitation and hygiene also contributed to the near eradication of endemic parasites. However, parasite infections continued to affect children mostly in resource-limited countries, of which the African continent has one of the highest burdens of diseases. The application of school-based approaches has several advantages where the structure of healthcare systems is not optimal. In Africa, soil-transmitted helminths and schistosomiasis are frequently targets for school-based public health intervention. Mass drug administration (MDA) by teachers at school can reach targeted children effectively and safely. Limitations of this approach include missing unattended children and absentee of teachers. Initially, MDA at school for parasitic infections was thought to improve health and even socioeconomic status of children in the community. However, more recently the socioeconomic impact has been questioned although the reduction of parasitic diseases is still apparent. Moreover, other basic public health measurements such as increased toilet use, assuring safe water access and avoiding human excrement as agricultural fertilizers, are equally important for control and prevention of parasitic diseases. Further global efforts should be continued to achieve equal health to every child in a sustainable way.
School-based approach for parasitic diseases control in Japan and Africa.