Soil-transmitted helminthiases and schistosomiasis cause significant physical, mental, and nutritional deficiencies, especially among children. Health facility, school, and community-based mass drug administration of anthelminthic drugs targeting children have been rolled out with significant results to counter these effects. This study assessed the factors associated with treatment coverage among children of Mazabuka and Siavonga districts of Zambia. In 2016, we conducted a cross-sectional survey of 1,416 children. Demographic and treatment data were collected using a structured questionnaire. Data were analyzed us m Stata version 15. The statistical methods used were chi-square test and multilevel mixed-effect model. The study comprised 1,416 participants of whom 51.5% (n=695) were males and 48.5% (n=654) females. About half (52.7%, n=746) were school-age and 47.3% (n=670) preschool children. Overall treatment coverage was 53.7% (n=761, 95% confidence interval (CI) 51.1, 56.4). A greater proportion of preschool-age children were treated compared with school-age ones, 65.2% vs 43.4%. p<0.001. Similarly, a greater proportion of school-age and preschool-age children in the Community-directed treatment intervention group were treated than in the regular mass drug administration group (school-age; 77.2% vs. 56.6%, p<0.001, preschool 53.1% vs. 45.5%, p=0.061). The factors significantly associated with treatment among school-age participants were being male (adjusted odds ratio (AOR) 1.83, 95%CI 1.23-2.72), integrated Community Directed Treatment intervention (AOR 5.53; 95%CI 3.41-8.97), and long distance to the health facility (AOR 2.20; 95%CI 1.36-3.56). Among preschool-aged participants, the factors associated with treatment were being in Siavonga district (AOR 0.03; 95%CI 0.01-0.04) and long distance to the health facility (AOR 0.35; 95%CI 0.21-0.59). The treatment coverage among children of Mazabuka and Siavonga districts was influenced by location, sex, distance to the health facility, and treatment approach. Therefore, there is a need to enhance mass drug administration by optimizing community-directed treatment to increase the uptake of helminth and schistosomiasis treatment especially among school-aged children in rural settings. This may contribute significantly to achieving the vision 2030 of ending epidemics of neglected tropical diseases.
