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Ilako D, Mwatha S, Wanyama BE, Gichangi M, Bore J, Butcher R, Bakhtiari A, Boyd S, Willis R, Solomon AW, Watitu T, Chelanga D, Nyakundi P, Harding-Esch EM, Matendechero SH. Progress Towards Elimination of Trachoma in Kenya 2017-2020. Ophthalmic Epidemiol 2024:1-11. [PMID: 38320117 DOI: 10.1080/09286586.2023.2280987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/03/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Trachoma is endemic in Kenya. Since baseline trachoma surveys in 2004, a concerted programme has been undertaken to reduce the prevalence of disease. Here, we report on trachoma prevalence surveys carried out between 2017 and 2020 after interventions were implemented in some areas for trachoma elimination purposes. METHODS A total of 48 cross-sectional population-based trachoma prevalence surveys were conducted in 39 evaluation units (EUs; covering 45 subcounties) of Kenya between 2017 and 2020. Thirty EUs were surveyed once and nine EUs were surveyed twice over this period. Individuals ≥ 1 year old were assessed for trachomatous inflammation-follicular (TF), trachomatous inflammation-intense (TI) and trichiasis. Data were collected on household access to water, sanitation and hygiene (WASH). RESULTS A total of 147,573 people were examined. At the end of 2020, in the 39 EUs surveyed, the prevalence of TF in 1-9-year-olds was ≥5% in 11 EUs and the prevalence of trichiasis unknown to the health system in individuals aged ≥15 years was ≥0.2% in 25 EUs. A small minority of households (median <50% for all indicators) had access to improved WASH facilities. CONCLUSION Kenya has made excellent progress towards elimination of trachoma as a public health problem. However, there is more work to do. Between one and three rounds of antibiotic mass drug administration are required in 11 EUs. Sustained investment in surgical provision, continued TT case-finding, promotion of facial cleanliness and environmental improvement are required throughout the surveyed area.
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Affiliation(s)
- D Ilako
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | - S Mwatha
- Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | | | - M Gichangi
- Ophthalmic Services Unit, Ministry of Health, Nairobi, Kenya
| | - J Bore
- Kenya National Bureau of Statics, Nairobi, Kenya
| | - R Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - A Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - S Boyd
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - R Willis
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - A W Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Avenue Appia 20, Geneva, Switzerland
| | - T Watitu
- Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - D Chelanga
- Ophthalmic Services Unit, Ministry of Health, Nairobi, Kenya
| | - P Nyakundi
- Ophthalmic Services Unit, Ministry of Health, Nairobi, Kenya
| | - E M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - S H Matendechero
- Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
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2
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Ilako D, Barasa E, Gichangi M, Mwatha S, Watitu T, Bore J, Rajamani A, Butcher R, Flueckiger RM, Bakhtiari A, Willis R, Solomon AW, Harding-Esch EM, Matendechero SH. Prevalence of Trachomatous Trichiasis in Ten Evaluation Units of Embu and Kitui Counties, Kenya. Ophthalmic Epidemiol 2023; 30:591-598. [PMID: 35037814 PMCID: PMC10581664 DOI: 10.1080/09286586.2021.1986549] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/24/2021] [Accepted: 09/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Late-stage blinding sequalae of trachoma such as trachomatous trichiasis (TT) typically take decades to develop and often do so in the absence of ongoing ocular Chlamydia trachomatis infection. This suggests that most TT risk accumulates in early life; as a result, population-level TT incidence and prevalence can remain high years after C. trachomatis transmission among children has decreased. In Embu and Kitui counties, Kenya, the prevalence of trachomatous inflammation - follicular is low in children. In this survey, we set out to determine the prevalence of TT in ten evaluation units (EUs) in these counties. METHODS We undertook ten cross-sectional prevalence surveys for TT. In each EU, people aged ≥15 years were selected by a two-stage cluster sampling method and examined for TT. Those with TT were asked questions on whether they had been offered management for it. Prevalence was adjusted to the underlying age and gender structure of the population. RESULTS A total of 18,987 people aged ≥15 years were examined. Per EU, the median number of examined participants was 1,656 (range: 1,451 - 3,016) and median response rate was 86% (range: 81 - 95%). The prevalence of TT unknown to the health system in people aged ≥15 years was above the threshold for elimination (≥0.2%) in all ten EUs studied (range: 0.2-0.7%). TT was significantly more common in older than younger individuals and in women than in men. DISCUSSION Provision of surgical services should be strengthened in Embu and Kitui counties of Kenya to achieve the World Health Organization threshold for eliminating TT as a public health problem.
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Affiliation(s)
- D Ilako
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | - E Barasa
- Ophthalmic Services Unit, Ministry of Health, Nairobi, Kenya
| | - M Gichangi
- Ophthalmic Services Unit, Ministry of Health, Nairobi, Kenya
| | - S Mwatha
- Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - T Watitu
- Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - J Bore
- Kenya National Bureau of Statistics, Ministry of Planning, Nairobi, Kenya
| | - A Rajamani
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - R Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | | | - A Bakhtiari
- Task Force for Global Health, Atlanta, GA, USA
| | - R Willis
- Task Force for Global Health, Atlanta, GA, USA
| | - AW Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - EM Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - SH Matendechero
- Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
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3
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de Souza DK, Picado A, Bessell PR, Liban A, Wachira D, Mwiti D, Matendechero SH, Bosch M, Ndung’u JM, Cruz I. Strengthening Visceral Leishmaniasis Diagnosis Capacity to Improve Access to Care in Kenya: The Example of Marsabit County. Front Trop Dis 2022. [DOI: 10.3389/fitd.2021.809757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundVisceral leishmaniasis (VL), also known as kala-azar, is a neglected tropical disease (NTD) that is fatal if not treated early. The WHO targets the elimination of VL as a public health problem in its 2030 NTD road map. However, improving access to VL diagnosis and treatment remains a major challenge in many VL-endemic countries. Kenya is endemic for VL and is among the top 6 high-disease burden countries in the world.MethodsFIND, through its activities in improving the diagnosis of VL and supporting the elimination of the disease in Kenya, has worked with various county ministries of health (MOH) and central MOH over the last couple of years. FIND’s activities in Marsabit county started in 2018. In this work, we present the implementation of activities and the impacts in Marsabit county. We reviewed the data for 2017 and 2019 outbreaks (before and after the implementation of FIND’s activities) and assessed the importance of improving access and community sensitization to VL diagnosis. We assessed the contribution of each facility to the total distance traveled from a perspective of location optimization.ResultsThere was a sharp increase in the number of people tested in the 2017 outbreak compared to the 2019 outbreak. In 2017, 437 people were tested compared to 2,338 in 2019. The county reported 234 and 688 VL cases in 2017 and 2019, respectively. The data revealed a shift in the demographic structures of cases toward the younger population (mean age in 2017 was 17.6 years and 15.3 years in 2019), with more female cases reported in 2019 compared to 2017. In 2017, 44.4% were 10 years of age or under. In 2019, the proportion 10 years or below was 52.2%. The addition of two new diagnosis facilities in 2018 resulted in a decrease in the distance traveled by confirmed VL cases from 28.1 km in 2017 to 10.8 km in 2019. Assessing the impact of facility placement indicated the most optimal facilities to provide VL diagnostic services and minimize the distance traveled by patients. Adding new facilities reduces the travel distance until a point where the addition of a new facility provides no additional impact.ConclusionThe results from this study indicate the need to carefully consider the placement of health facilities in improving access to VL diagnosis and treatment and could serve as an investment case in deciding when to stop adding new facilities in a particular setting. Extending the activities in Kenya to other VL-endemic countries in East Africa will contribute significantly toward the elimination of the disease, addressing the needs of marginalized populations and leaving no one behind.
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4
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Musuva RM, Odiere MR, Mwinzi PNM, Omondi IO, Rawago FO, Matendechero SH, Kittur N, Campbell CH, Colley DG. Unprotected water sources and low latrine coverage are contributing factors to persistent hotspots for schistosomiasis in western Kenya. PLoS One 2021; 16:e0253115. [PMID: 34534220 PMCID: PMC8448362 DOI: 10.1371/journal.pone.0253115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/31/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Evidence indicates that whereas repeated rounds of mass drug administration (MDA) programs have reduced schistosomiasis prevalence to appreciable levels in some communities referred to here as responding villages (R). However, prevalence has remained high or less than anticipated in other areas referred to here as persistent hotspot villages (PHS). Using a cross-sectional quantitative approach, this study investigated the factors associated with sustained high Schistosoma mansoni prevalence in some villages despite repeated high annual treatment coverage in western Kenya. METHOD Water contact sites selected based on observation of points where people consistently go to collect water, wash clothes, bathe, swim or play (young children), wash cars and harvest sand were mapped using hand-held smart phones on the Commcare platform. Quantitative cross-sectional surveys on behavioral characteristics were conducted using interviewer-based semi-structured questionnaires administered to assess water usage/contact patterns and open defecation. Questionnaires were administered to 15 households per village, 50 pupils per school and 1 head teacher per school. One stool and urine sample was collected from 50 school children aged 9-12 year old and 50 adults from both responding (R) and persistent hotspot (PHS) villages. Stool was analyzed by the Kato-Katz method for eggs of S. mansoni and soil-transmitted helminths. Urine samples were tested using the point-of-care circulating cathodic antigen (POC-CCA) test for detection of S. mansoni antigen. RESULTS There was higher latrine coverage in R (n = 6) relative to PHS villages (n = 6) with only 33% of schools in the PHS villages meeting the WHO threshold for boy: latrine coverage ratio versus 83.3% in R, while no villages met the girl: latrine ratio requirement. A higher proportion of individuals accessed unprotected water sources for both bathing and drinking (68.5% for children and 89% for adults) in PHS relative to R villages. In addition, frequency of accessing water sources was higher in PHS villages, with swimming being the most frequent activity. As expected based upon selection criteria, both prevalence and intensity of S. mansoni were higher in the PHS relative to R villages (prevalence: 43.7% vs 20.2%; P < 0.001; intensity: 73.8 ± 200.6 vs 22.2 ± 96.0, P < 0.0001), respectively. CONCLUSION Unprotected water sources and low latrine coverage are contributing factors to PHS for schistosomiasis in western Kenya. Efforts to increase provision of potable water and improvement in latrine infrastructure is recommended to augment control efforts in the PHS areas.
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Affiliation(s)
- Rosemary M. Musuva
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
- * E-mail:
| | - Maurice R. Odiere
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pauline N. M. Mwinzi
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Isaiah O. Omondi
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Fredrick O. Rawago
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Carl H. Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Daniel G. Colley
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
- Department of Microbiology, University of Georgia, Athens, Georgia, United States of America
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5
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Mabey D, Agler E, Amuasi JH, Hernandez L, Hollingsworth TD, Hotez PJ, Lammie PJ, Malecela MN, Matendechero SH, Ottesen E, Phillips RO, Reeder JC, Szwarcwald CL, Shott JP, Solomon AW, Steer A, Swaminathan S. Towards a comprehensive research and development plan to support the control, elimination and eradication of neglected tropical diseases. Trans R Soc Trop Med Hyg 2021; 115:196-199. [PMID: 33179054 PMCID: PMC7842110 DOI: 10.1093/trstmh/traa114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
To maximise the likelihood of success, global health programmes need repeated, honest appraisal of their own weaknesses, with research undertaken to address any identified gaps. There is still much to be learned to optimise work against neglected tropical diseases. To facilitate that learning, a comprehensive research and development plan is required. Here, we discuss how such a plan might be developed.
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Affiliation(s)
- David Mabey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - John H Amuasi
- African Research Network for Neglected Tropical Diseases, Kumasi AK-039-5028, Ghana
| | - Leda Hernandez
- Department of Health, Infectious Disease Office, National Center for Disease Prevention and Control, Manila 1003, Philippines
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
| | - Peter J Hotez
- Departments of Pediatrics and Molecular Virology & Microbiology, Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030s, USA.,Hagler Institute for Advanced Study at Texas A & M University, College Station, TX 77843, USA.,Department of Biology, Baylor University, Waco, TX 76706, USA.,James A. Baker III Institute of Public Policy, Rice University, Houston, TX 77005, USA.,Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A & M University, College Station, TX 77845, USA
| | - Patrick J Lammie
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Mwelecele N Malecela
- Department of Control of Neglected Tropical Diseases, WHO 1211, Geneva, Switzerland
| | - Sultani H Matendechero
- Division of Communicable Disease Prevention and Control, Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Eric Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Richard O Phillips
- Kumasi Center for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi AK-039-5028, Ghana
| | - John C Reeder
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Disease (TDR), 1211 Geneva 21040-900, Switzerland
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Joseph P Shott
- Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, DC 20004, USA
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, WHO 1211, Geneva, Switzerland
| | - Andrew Steer
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3010, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
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6
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Legge H, Halliday KE, Kepha S, Mcharo C, Witek-McManus SS, El-Busaidy H, Muendo R, Safari T, Mwandawiro CS, Matendechero SH, Pullan RL, Oswald WE. Patterns and Drivers of Household Sanitation Access and Sustainability in Kwale County, Kenya. Environ Sci Technol 2021; 55:6052-6064. [PMID: 33826310 PMCID: PMC8154356 DOI: 10.1021/acs.est.0c05647] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 05/08/2023]
Abstract
Many sanitation interventions suffer from poor sustainability. Failure to maintain or replace toilet facilities risks exposing communities to environmental pathogens, yet little is known about the factors that drive sustained access beyond project life spans. Using data from a cohort of 1666 households in Kwale County, Kenya, we investigated the factors associated with changes in sanitation access between 2015 and 2017. Sanitation access is defined as access to an improved or unimproved facility within the household compound that is functional and in use. A range of contextual, psychosocial, and technological covariates were included in logistic regression models to estimate their associations with (1) the odds of sustaining sanitation access and (2) the odds of gaining sanitation access. Over two years, 28.3% households sustained sanitation access, 4.7% lost access, 17.7% gained access, and 49.2% remained without access. Factors associated with increased odds of households sustaining sanitation access included not sharing the facility and presence of a solid washable slab. Factors associated with increased odds of households gaining sanitation access included a head with at least secondary school education, level of coarse soil fragments, and higher local sanitation coverage. Results from this study can be used by sanitation programs to improve the rates of initial and sustained adoption of sanitation.
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Affiliation(s)
- Hugo Legge
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Katherine E. Halliday
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Stella Kepha
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
- Eastern
and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Carlos Mcharo
- Eastern
and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Stefan S. Witek-McManus
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Hajara El-Busaidy
- Department
of Health, County Government of Kwale, P.O. Box 4-80403, Kwale, Kenya
| | - Redempta Muendo
- Department
of Health, County Government of Kwale, P.O. Box 4-80403, Kwale, Kenya
| | - Th’uva Safari
- Eastern
and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Charles S. Mwandawiro
- Eastern
and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Sultani H. Matendechero
- Division
of Vector Borne and Neglected Tropical Diseases Unit, Ministry of Health, P.O. Box 30016-00100, Nairobi, Kenya
| | - Rachel L. Pullan
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
| | - William E. Oswald
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom
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7
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Kittur N, Campbell CH, Binder S, Shen Y, Wiegand RE, Mwanga JR, Kinung'hi SM, Musuva RM, Odiere MR, Matendechero SH, Knopp S, Colley DG. Discovering, Defining, and Summarizing Persistent Hotspots in SCORE Studies. Am J Trop Med Hyg 2020; 103:24-29. [PMID: 32400365 PMCID: PMC7351310 DOI: 10.4269/ajtmh.19-0815] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) conducted large field studies on schistosomiasis control and elimination in Africa. All of these studies, carried out in low-, moderate-, and high-prevalence areas, resulted in a reduction in prevalence and intensity of Schistosoma infection after repeated mass drug administration (MDA). However, in all studies, there were locations that experienced minimal or no decline or even increased in prevalence and/or intensity. These areas are termed persistent hotspots (PHS). In SCORE studies in medium- to high-prevalence areas, at least 30% of study villages were PHS. There was no consistent relationship between PHS and the type or frequency of intervention, adequacy of reported MDA coverage, and prevalence or intensity of infection at baseline. In a series of small studies, factors that differed between PHS and villages that responded to repeated MDA as expected included sources of water for personal use, sanitation, and hygiene. SCORE studies comparing PHS with villages that responded to MDA suggest the potential for PHS to be identified after a few years of MDA. However, additional studies in different social-ecological settings are needed to develop generalizable approaches that program managers can use to identify and address PHS. This is essential if goals for schistosomiasis control and elimination are to be achieved.
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Affiliation(s)
- Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Ye Shen
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia
| | - Ryan E Wiegand
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph R Mwanga
- Department of Epidemiology, Biostatistics and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Safari M Kinung'hi
- Mwanza Research Centre, National Institute of Medical Research, Mwanza, Tanzania
| | - Rosemary M Musuva
- Neglected Tropical Diseases Unit, Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Maurice R Odiere
- Neglected Tropical Diseases Unit, Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Sultani H Matendechero
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Nairobi, Kenya
| | - Stefanie Knopp
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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8
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Colley DG, Fleming FM, Matendechero SH, Knopp S, Rollinson D, Utzinger J, Castleman JD, Kittur N, King CH, Campbell CH, Kabole FM, Kinung'hi S, Ramzy RMR, Binder S. Contributions of the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) to Schistosomiasis Control and Elimination: Key Findings and Messages for Future Goals, Thresholds, and Operational Research. Am J Trop Med Hyg 2020; 103:125-134. [PMID: 32400345 PMCID: PMC7351304 DOI: 10.4269/ajtmh.19-0787] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Herein, we summarize what we consider are major contributions resulting from the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) program, including its key findings and key messages from those findings. Briefly, SCORE's key findings are as follows: i) biennial mass drug administration (MDA) with praziquantel can control schistosomiasis to moderate levels of prevalence; ii) MDA alone will not achieve elimination; iii) to attain and sustain control throughout endemic areas, persistent hotspots need to be identified following a minimal number of years of annual MDA and controlled through adaptive strategies; iv) annual MDA is more effective than biennial MDA in high-prevalence areas; v) the current World Health Organization thresholds for decision-making based on the prevalence of heavy infections should be redefined; and vi) point-of-care circulating cathodic antigen urine assays are useful for Schistosoma mansoni mapping in low-to-moderate prevalence areas. The data and specimens collected and curated through SCORE efforts will continue to be critical resource for future research. Besides providing useful information for program managers and revision of guidelines for schistosomiasis control and elimination, SCORE research and outcomes have identified additional questions that need to be answered as the schistosomiasis community continues to implement effective, evidence-based programs. An overarching contribution of SCORE has been increased cohesiveness within the schistosomiasis field-oriented community, thereby fostering new and productive collaborations. Based on SCORE's findings and experiences, we propose new approaches, thresholds, targets, and goals for control and elimination of schistosomiasis, and recommend research and evaluation activities to achieve these targets and goals.
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Affiliation(s)
- Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Fiona M Fleming
- Department of Infectious Disease Epidemiology, Schistosomiasis Control Initiative, London, United Kingdom
| | - Sultani H Matendechero
- Division of Communicable Disease Prevention and Control, Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Stefanie Knopp
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - David Rollinson
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jennifer D Castleman
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Fatma M Kabole
- Neglected Diseases Programme, Ministry of Health of Zanzibar, Zanzibar, United Republic of Tanzania
| | - Safari Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza, United Republic of Tanzania
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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9
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Oswald WE, Kepha S, Halliday KE, Mcharo C, Safari T, Witek-McManus S, Hardwick RJ, Allen E, Matendechero SH, Brooker SJ, Njenga SM, Mwandawiro CS, Anderson RM, Pullan RL. Patterns of individual non-treatment during multiple rounds of mass drug administration for control of soil-transmitted helminths in the TUMIKIA trial, Kenya: a secondary longitudinal analysis. Lancet Glob Health 2020; 8:e1418-e1426. [PMID: 33069302 PMCID: PMC7564382 DOI: 10.1016/s2214-109x(20)30344-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/09/2020] [Accepted: 07/15/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Few studies have been done of patterns of treatment during mass drug administration (MDA) to control neglected tropical diseases. We used routinely collected individual-level treatment records that had been collated for the Tuangamize Minyoo Kenya Imarisha Afya (Swahili for Eradicate Worms in Kenya for Better Health [TUMIKIA]) trial, done in coastal Kenya from 2015 to 2017. In this analysis we estimate the extent of and factors associated with the same individuals not being treated over multiple rounds of MDA, which we term systematic non-treatment. METHODS We linked the baseline population of the TUMIKIA trial randomly assigned to receive biannual community-wide MDA for soil-transmitted helminthiasis to longitudinal records on receipt of treatment in any of the four treatment rounds of the study. We fitted logistic regression models to estimate the association of non-treatment in a given round with non-treatment in the previous round, controlling for identified predictors of non-treatment. We also used multinomial logistic regression to identify factors associated with part or no treatment versus complete treatment. FINDINGS 36 327 participants were included in our analysis: 16 236 children aged 2-14 years and 20 091 adults aged 15 years or older. The odds of having no treatment recorded was higher if a participant was not treated during the previous round of MDA (adjusted odds ratio [OR] 3·60, 95% CI 3·08-4·20 for children and 5·58, 5·01-6·21 for adults). For children, school attendance and rural residence reduced the odds of receiving part or no treatment, whereas odds were increased by least poor socioeconomic status and living in an urban or periurban household. Women had higher odds than men of receiving part or no treatment. However, when those with pregnancy or childbirth in the previous 2 weeks were excluded, women became more likely to receive complete treatment. Adults aged 20-25 years were the age group with the highest odds of receiving part (OR 1·41, 95% CI 1·22-1·63) or no treatment (OR 1·81, 95% CI 1·53-2·14). INTERPRETATION Non-treatment was associated with specific sociodemographic groups and characteristics and did not occcur at random. This finding has important implications for MDA programme effectiveness, the relevance of which will intensify as disease prevalence decreases and infections become increasingly clustered. FUNDING Bill & Melinda Gates Foundation, Joint Global Health Trials Scheme of the Medical Research Council, UK Department for International Development, Wellcome Trust, Children's Investment Fund Foundation, and London Centre for Neglected Tropical Diseases.
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Affiliation(s)
- William E Oswald
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Stella Kepha
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya; Pwani University Bioscience Research Centre, Pwani University, Kilifi, Kenya
| | - Katherine E Halliday
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Carlos Mcharo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Th'uva Safari
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Stefan Witek-McManus
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert J Hardwick
- London Centre for Neglected Tropical Disease Research, Faculty of Medicine, Department of Infectious Disease Epidemiology, School of Public Health, St Mary's Campus, Imperial College London, London, UK
| | - Elizabeth Allen
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sultani H Matendechero
- Neglected Tropical Diseases Unit, Division of Communicable Disease Prevention and Control, Ministry of Health, Nairobi, Kenya
| | - Simon J Brooker
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Charles S Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Faculty of Medicine, Department of Infectious Disease Epidemiology, School of Public Health, St Mary's Campus, Imperial College London, London, UK
| | - Rachel L Pullan
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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10
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Njenga SM, Kanyi HM, Arnold BF, Matendechero SH, Onsongo JK, Won KY, Priest JW. Integrated Cross-Sectional Multiplex Serosurveillance of IgG Antibody Responses to Parasitic Diseases and Vaccines in Coastal Kenya. Am J Trop Med Hyg 2020; 102:164-176. [PMID: 31769388 PMCID: PMC6947807 DOI: 10.4269/ajtmh.19-0365] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Accurate and cost-effective identification of areas where co-endemic infections occur would enable public health managers to identify opportunities for implementation of integrated control programs. Dried blood spots collected during cross-sectional lymphatic filariasis surveys in coastal Kenya were used for exploratory integrated detection of IgG antibodies against antigens from several parasitic infections (Wuchereria bancrofti, Schistosoma mansoni, Plasmodium spp., Ascaris lumbricoides, and Strongyloides stercoralis) as well as for detection of responses to immunizing agents used against vaccine-preventable diseases (VPDs) (measles, diphtheria, and tetanus) using a multiplex bead assay (MBA) platform. High heterogeneity was observed in antibody responses by pathogen and antigen across the sentinel sites. Antibody seroprevalence against filarial antigens were generally higher in Ndau Island (P < 0.0001), which also had the highest prevalence of filarial antigenemia compared with other communities. Antibody responses to the Plasmodium species antigens circumsporozoite protein (CSP) and merozoite surface protein-1 (MSP-1)19 were higher in Kilifi and Kwale counties, with Jaribuni community showing higher overall mean seroprevalence (P < 0.0001). Kimorigo community in Taita–Taveta County was the only area where antibody responses against S. mansoni Sm25 recombinant antigen were detected. Seroprevalence rates to Strongyloides antigen NIE ranged between 3% and 26%, and there was high heterogeneity in immune responses against an Ascaris antigen among the study communities. Differences were observed between communities in terms of seroprevalence to VPDs. Seroprotection to tetanus was generally lower in Kwale County than in other counties. This study has demonstrated that MBA holds promise for rapid integrated monitoring of trends of infections of public health importance in endemic areas.
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Affiliation(s)
- Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Henry M Kanyi
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Benjamin F Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Sultani H Matendechero
- Department of Preventive and Promotive Services, Neglected Tropical Diseases Programme, Ministry of Health, Nairobi, Kenya
| | | | - Kimberly Y Won
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeffrey W Priest
- Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Halliday KE, Oswald WE, Mcharo C, Beaumont E, Gichuki PM, Kepha S, Witek-McManus SS, Matendechero SH, El-Busaidy H, Muendo R, Chiguzo AN, Cano J, Karanja MW, Musyoka LW, Safari TK, Mutisya LN, Muye IJ, Sidigu MA, Anderson RM, Allen E, Brooker SJ, Mwandawiro CS, Njenga SM, Pullan RL. Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya. PLoS Negl Trop Dis 2019; 13:e0007427. [PMID: 31398204 PMCID: PMC6719894 DOI: 10.1371/journal.pntd.0007427] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 09/03/2019] [Accepted: 04/30/2019] [Indexed: 11/19/2022] Open
Abstract
TRIAL REGISTRATION ClinicalTrials.gov NCT02397772.
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Affiliation(s)
- Katherine E. Halliday
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | - William E. Oswald
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Carlos Mcharo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Emma Beaumont
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Paul M. Gichuki
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Stella Kepha
- School of Public Health, Makerere University, Kampala, Uganda
| | - Stefan S. Witek-McManus
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sultani H. Matendechero
- Neglected Tropical Diseases Unit, Division of Communicable Disease Prevention and Control, Ministry of Health, Nairobi, Kenya
| | | | - Redempta Muendo
- Department of Health, County Government of Kwale, Kwale, Kenya
| | | | - Jorge Cano
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mary W. Karanja
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Leah W. Musyoka
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Tuva K. Safari
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Lennie N. Mutisya
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Idris J. Muye
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Maureen A. Sidigu
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Roy M. Anderson
- Faculty of Medicine, Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, School of Public Health, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Elizabeth Allen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Simon J. Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Charles S. Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rachel L. Pullan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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12
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Pullan RL, Halliday KE, Oswald WE, Mcharo C, Beaumont E, Kepha S, Witek-McManus S, Gichuki PM, Allen E, Drake T, Pitt C, Matendechero SH, Gwayi-Chore MC, Anderson RM, Njenga SM, Brooker SJ, Mwandawiro CS. Effects, equity, and cost of school-based and community-wide treatment strategies for soil-transmitted helminths in Kenya: a cluster-randomised controlled trial. Lancet 2019; 393:2039-2050. [PMID: 31006575 PMCID: PMC6525786 DOI: 10.1016/s0140-6736(18)32591-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/04/2018] [Accepted: 10/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND School-based deworming programmes can reduce morbidity attributable to soil-transmitted helminths in children but do not interrupt transmission in the wider community. We assessed the effects of alternative mass treatment strategies on community soil-transmitted helminth infection. METHODS In this cluster-randomised controlled trial, 120 community units (clusters) serving 150 000 households in Kenya were randomly assigned (1:1:1) to receive albendazole through annual school-based treatment targeting 2-14 year olds or annual or biannual community-wide treatment targeting all ages. The primary outcome was community hookworm prevalence, assessed at 12 and 24 months through repeat cross-sectional surveys. Secondary outcomes were Ascaris lumbricoides and Trichuris trichiura prevalence, infection intensity of each soil-transmitted helminth species, and treatment coverage and costs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02397772. FINDINGS After 24 months, prevalence of hookworm changed from 18·6% (95% CI 13·9-23·2) to 13·8% (10·5-17·0) in the annual school-based treatment group, 17·9% (13·7-22·1) to 8·0% (6·0-10·1) in the annual community-wide treatment group, and 20·6% (15·8-25·5) to 6·2% (4·9-7·5) in the biannual community-wide treatment group. Relative to annual school-based treatment, the risk ratio for annual community-wide treatment was 0·59 (95% CI 0·42-0·83; p<0·001) and for biannual community-wide treatment was 0·46 (0·33-0·63; p<0·001). More modest reductions in risk were observed after 12 months. Risk ratios were similar across demographic and socioeconomic subgroups after 24 months. No adverse events related to albendazole were reported. INTERPRETATION Community-wide treatment was more effective in reducing hookworm prevalence and intensity than school-based treatment, with little additional benefit of treating every 6 months, and was shown to be remarkably equitable in coverage and effects. FUNDING Bill & Melinda Gates Foundation, the Joint Global Health Trials Scheme of the Medical Research Council, the UK Department for International Development, the Wellcome Trust, and the Children's Investment Fund Foundation.
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Affiliation(s)
- Rachel L Pullan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Katherine E Halliday
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - William E Oswald
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Carlos Mcharo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Emma Beaumont
- Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stella Kepha
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya; Pwani University Bioscience Research Centre, Pwani University, Kilifi, Kenya
| | - Stefan Witek-McManus
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul M Gichuki
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Elizabeth Allen
- Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tom Drake
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Catherine Pitt
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sultani H Matendechero
- Neglected Tropical Diseases Unit, Division of Communicable Disease Prevention and Control, Ministry of Health, Nairobi, Kenya
| | | | - Roy M Anderson
- Faculty of Medicine, Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, School of Public Health, St Mary's Campus, Imperial College London, London, UK
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Simon J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Charles S Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
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13
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Freeman MC, Akogun O, Belizario V, Brooker SJ, Gyorkos TW, Imtiaz R, Krolewiecki A, Lee S, Matendechero SH, Pullan RL, Utzinger J. Challenges and opportunities for control and elimination of soil-transmitted helminth infection beyond 2020. PLoS Negl Trop Dis 2019; 13:e0007201. [PMID: 30973872 PMCID: PMC6459486 DOI: 10.1371/journal.pntd.0007201] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Matthew C. Freeman
- Department of Environmental Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | | | - Vicente Belizario
- College of Public Health, University of the Philippines Manila, Manila, the Philippines
| | - Simon J. Brooker
- Global Health, Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Theresa W. Gyorkos
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Rubina Imtiaz
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - Alejandro Krolewiecki
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta, Oran, Argentina
| | - Seung Lee
- Save the Children, Washington, DC, United States of America
| | | | - Rachel L. Pullan
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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