Impact of different mass drug administration strategies for gaining and sustaining control of Schistosoma mansoni and Schistosoma haematobium infection in Africa
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Impact of different mass drug administration strategies for gaining and sustaining control of Schistosoma mansoni and Schistosoma haematobium infection in Africa. / King, Charles H; Kittur, Nupur; Binder, Sue; Campbell, Carl H; N'Goran, Eliézer K; Meite, Aboulaye; Utzinger, Jürg; Olsen, Annette; Magnussen, Pascal; Kinung'hi, Safari; Fenwick, Alan; Phillips, Anna E; Gazzinelli-Guimaraes, Pedro H; Dhanani, Neerav; Ferro, Josefo; Karanja, Diana M S; Mwinzi, Pauline N M; Montgomery, Susan P; Wiegand, Ryan E; Secor, William Evan; Hamidou, Amina A; Garba, Amadou; Colley, Daniel G.
I: American Journal of Tropical Medicine and Hygiene, Bind 103, Nr. 1_Suppl, 2020, s. 14-23.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Impact of different mass drug administration strategies for gaining and sustaining control of Schistosoma mansoni and Schistosoma haematobium infection in Africa
AU - King, Charles H
AU - Kittur, Nupur
AU - Binder, Sue
AU - Campbell, Carl H
AU - N'Goran, Eliézer K
AU - Meite, Aboulaye
AU - Utzinger, Jürg
AU - Olsen, Annette
AU - Magnussen, Pascal
AU - Kinung'hi, Safari
AU - Fenwick, Alan
AU - Phillips, Anna E
AU - Gazzinelli-Guimaraes, Pedro H
AU - Dhanani, Neerav
AU - Ferro, Josefo
AU - Karanja, Diana M S
AU - Mwinzi, Pauline N M
AU - Montgomery, Susan P
AU - Wiegand, Ryan E
AU - Secor, William Evan
AU - Hamidou, Amina A
AU - Garba, Amadou
AU - Colley, Daniel G
PY - 2020
Y1 - 2020
N2 - This report summarizes the design and outcomes of randomized controlled operational research trials performed by the Bill & Melinda Gates Foundation-funded Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) from 2009 to 2019. Their goal was to define the effectiveness and test the limitations of current WHO-recommended schistosomiasis control protocols by performing large-scale pragmatic trials to compare the impact of different schedules and coverage regimens of praziquantel mass drug administration (MDA). Although there were limitations to study designs and performance, analysis of their primary outcomes confirmed that all tested regimens of praziquantel MDA significantly reduced local Schistosoma infection prevalence and intensity among school-age children. Secondary analysis suggested that outcomes in locations receiving four annual rounds of MDA were better than those in communities that had treatment holiday years, in which no praziquantel MDA was given. Statistical significance of differences was obscured by a wider-than-expected variation in community-level responses to MDA, defining a persistent hot spot obstacle to MDA success. No MDA schedule led to elimination of infection, even in those communities that started at low prevalence of infection, and it is likely that programs aiming for elimination of transmission will need to add supplemental interventions (e.g., snail control, improvement in water, sanitation and hygiene, and behavior change interventions) to achieve that next stage of control. Recommendations for future implementation research, including exploration of the value of earlier program impact assessment combined with intensification of intervention in hot spot locations, are discussed.
AB - This report summarizes the design and outcomes of randomized controlled operational research trials performed by the Bill & Melinda Gates Foundation-funded Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) from 2009 to 2019. Their goal was to define the effectiveness and test the limitations of current WHO-recommended schistosomiasis control protocols by performing large-scale pragmatic trials to compare the impact of different schedules and coverage regimens of praziquantel mass drug administration (MDA). Although there were limitations to study designs and performance, analysis of their primary outcomes confirmed that all tested regimens of praziquantel MDA significantly reduced local Schistosoma infection prevalence and intensity among school-age children. Secondary analysis suggested that outcomes in locations receiving four annual rounds of MDA were better than those in communities that had treatment holiday years, in which no praziquantel MDA was given. Statistical significance of differences was obscured by a wider-than-expected variation in community-level responses to MDA, defining a persistent hot spot obstacle to MDA success. No MDA schedule led to elimination of infection, even in those communities that started at low prevalence of infection, and it is likely that programs aiming for elimination of transmission will need to add supplemental interventions (e.g., snail control, improvement in water, sanitation and hygiene, and behavior change interventions) to achieve that next stage of control. Recommendations for future implementation research, including exploration of the value of earlier program impact assessment combined with intensification of intervention in hot spot locations, are discussed.
U2 - 10.4269/ajtmh.19-0829
DO - 10.4269/ajtmh.19-0829
M3 - Journal article
C2 - 32400356
VL - 103
SP - 14
EP - 23
JO - Journal. National Malaria Society
JF - Journal. National Malaria Society
SN - 0002-9637
IS - 1_Suppl
ER -
ID: 247390759