Integrated Parasitological Surveillance Among Schoolchildren in Adamawa State: Operational Challenges and Recommendations

Integrated school-based parasitological surveillance combining monitoring of multiple parasitic infections represents an efficient strategy for guiding preventive chemotherapy priorities in endemic states. This study assessed the operational challenges and effectiveness of integrated parasitological surveillance among schoolchildren in Adamawa State, Northeast Nigeria, during the 2023 to 2024 academic period. A cross-sectional operational research design was employed, enrolling 310 pupils from six government primary schools selected through cluster random sampling. Stool, urine, and blood samples were collected for soil-transmitted helminth, schistosomiasis, and malaria screening respectively. Programme implementation data were obtained from district malaria coordinators and school health supervisors via structured interviews. Laboratory findings documented co-endemicity of soil-transmitted helminths (prevalence 48.7 percent), urinary schistosomiasis (26.4 percent), and malaria (33.9 percent) within the same school populations. Operational challenges included cold chain failures, insufficient sample containers, and low teacher participation in mobilisation. Multi-disease surveillance required 40 percent more staff hours than single-disease approaches with current staffing. The study recommends phased integration models, investment in integrated supply chains, and use of trained community health extension workers for school-based sample collection in Adamawa State. Keywords: integrated surveillance, school children, parasitic co-infections, Adamawa State, operational research.