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Molyneux DH, Asamoa-Bah A, Fenwick A, et al., 2021, The history of the neglected tropical disease movement, TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, Vol: 115, Pages: 169-175, ISSN: 0035-9203
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- Citations: 14
Hotez PJ, Fenwick A, Molyneux D, 2021, The new COVID-19 poor and the neglected tropical diseases resurgence, INFECTIOUS DISEASES OF POVERTY, Vol: 10, ISSN: 2095-5162
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- Citations: 15
Phillips AE, Tohon Z, Dhanani NA, et al., 2020, Evaluating the impact of biannual school-based and community-wide treatment on urogenital schistosomiasis in Niger, PARASITES & VECTORS, Vol: 13, ISSN: 1756-3305
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- Citations: 7
Leta GT, Mekete K, Wuletaw Y, et al., 2020, National mapping of soil-transmitted helminth and schistosome infections in Ethiopia, Parasites and Vectors, Vol: 13, ISSN: 1756-3305
BackgroundAn accurate understanding of the geographical distributions of both soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and the hookworms Necator americanus and Ancylostoma duodenale) and schistosomes (SCH; Schistosoma mansoni and S. haematobium) is pivotal to be able to effectively design and implement mass drug administration (MDA) programmes. The objective of this study was to provide up-to-date data on the distribution of both STH and SCH in Ethiopia to inform the design of the national control program and to be able to efficiently achieve the 75% MDA coverage target set by the WHO.MethodsBetween 2013 and 2015, we assessed the distributions of STH and SCH infections in a nationwide survey covering 153,238 school-aged children (aged 5–15 years), from 625 woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. Nationwide disease maps were developed at the woreda level to enable recommendations on the design of the national MDA programme.ResultsThe prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) being the most prevalent STH, followed by hookworms (7.6%) and T. trichiura (5.9%). The prevalence for any SCH was 4.0% in areas where both SCH species were evaluated. Schistosoma mansoni was the most prevalent SCH (3.5 vs 0.3%). STHs were more prevalent in southwest Ethiopia, whereas SCH was found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2.0% for STHs and 1.6% for SCH. For STH, a total of 251 woredas were classified as moderately (n = 178) or highly endemic (n = 73), and therefore qualify for an annual and biannual MDA program, respectively. For SCH, 67 woredas were classified as endemic and 8 as highly endemic, and hence they require every two years and annual MDA programme, respectively.ConclusionsThe results confirm that Ethiopia is endemic for both STHs and SCH, pos
King CH, Kittur N, Binder S, et al., 2020, Impact of different mass drug administration strategies for gaining and sustaining control of schistosoma mansoni and schistosoma haematobium infection in Africa, American Journal of Tropical Medicine and Hygiene, Vol: 103, Pages: 14-23, ISSN: 0002-9637
This report summarizes the design and outcomes of randomized controlled operational research trialsperformed by the Bill & Melinda Gates Foundation–funded Schistosomiasis Consortium for Operational Research andEvaluation (SCORE) from 2009 to 2019. Their goal was to define the effectiveness and test the limitations of current WHOrecommended schistosomiasis control protocols by performing large-scale pragmatic trials to compare the impact ofdifferent 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 ofpraziquantel 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 incommunities that had treatment holiday years, in which no praziquantel MDA was given. Statistical significance ofdifferences 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 communitiesthat started at low prevalence of infection, and it is likely that programs aiming for elimination of transmission will need toadd supplemental interventions (e.g., snail control, improvement in water, sanitation and hygiene, and behavior changeinterventions) to achieve that next stage of control. Recommendations for future implementation research, includingexploration of the value of earlier program impact assessment combined with intensification of intervention in hot spotlocations, are discussed.
Clark NJ, Owada K, Ruberanziza E, et al., 2020, Parasite associations predict infection risk: incorporating co-infections in predictive models for neglected tropical diseases, Parasites and Vectors, Vol: 13, Pages: 1-16, ISSN: 1756-3305
BackgroundSchistosomiasis and infection by soil-transmitted helminths are some of the world’s most prevalent neglected tropical diseases. Infection by more than one parasite (co-infection) is common and can contribute to clinical morbidity in children. Geostatistical analyses of parasite infection data are key for developing mass drug administration strategies, yet most methods ignore co-infections when estimating risk. Infection status for multiple parasites can act as a useful proxy for data-poor individual-level or environmental risk factors while avoiding regression dilution bias. Conditional random fields (CRF) is a multivariate graphical network method that opens new doors in parasite risk mapping by (i) predicting co-infections with high accuracy; (ii) isolating associations among parasites; and (iii) quantifying how these associations change across landscapes.MethodsWe built a spatial CRF to estimate infection risks for Ascaris lumbricoides, Trichuris trichiura, hookworms (Ancylostoma duodenale and Necator americanus) and Schistosoma mansoni using data from a national survey of Rwandan schoolchildren. We used an ensemble learning approach to generate spatial predictions by simulating from the CRF’s posterior distribution with a multivariate boosted regression tree that captured non-linear relationships between predictors and covariance in infection risks. This CRF ensemble was compared against single parasite gradient boosted machines to assess each model’s performance and prediction uncertainty.ResultsParasite co-infections were common, with 19.57% of children infected with at least two parasites. The CRF ensemble achieved higher predictive power than single-parasite models by improving estimates of co-infection prevalence at the individual level and classifying schools into World Health Organization treatment categories with greater accuracy. The CRF uncovered important environmental and demographic predictors of parasite infection probab
Mutombo N, Landoure A, Man WY, et al., 2019, The association between child <i>Schistosoma</i> spp. infections and morbidity in an irrigated rice region in Mali: A localized study, ACTA TROPICA, Vol: 199, ISSN: 0001-706X
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- Citations: 1
Clark NJ, Umulisa I, Ruberanziza E, et al., 2019, Mapping Schistosoma mansoni endemicity in Rwanda: a critical assessment of geographical disparities arising from circulating cathodic antigen versus Kato-Katz diagnostics, PLoS Neglected Tropical Diseases, Vol: 13, Pages: 1-21, ISSN: 1935-2727
BackgroundSchistosomiasis is a neglected tropical disease caused by Schistosoma parasites. Intervention relies on identifying high-risk regions, yet rapid Schistosoma diagnostics (Kato-Katz stool assays (KK) and circulating cathodic antigen urine assays (CCA)) yield different prevalence estimates. We mapped S. mansoni prevalence and delineated at-risk regions using a survey of schoolchildren in Rwanda, where S. mansoni is an endemic parasite. We asked if different diagnostics resulted in disparities in projected infection risk.MethodsInfection data was obtained from a 2014 Rwandan school-based survey that used KK and CCA diagnostics. Across 386 schools screened by CCA (N = 19,217). To allow for uncertainty when interpreting ambiguous CCA trace readings, which accounted for 28.8% of total test results, we generated two presence-absence datasets: CCA trace as positive and CCA trace as negative. Samples (N = 9,175) from 185 schools were also screened by KK. We included land surface temperature (LST) and the Normalized Difference Vegetation and Normalized Difference Water Indices (NDVI, NDWI) as predictors in geostatistical regressions.FindingsAcross 8,647 children tested by both methods, prevalence was 35.93% for CCA trace as positive, 7.21% for CCA trace as negative and 1.95% for KK. LST was identified as a risk factor using KK, whereas NDVI was a risk factor for CCA models. Models predicted high endemicity in Northern and Western regions of Rwanda, though the CCA trace as positive model identified additional high-risk areas that were overlooked by the other methods. Estimates of current burden for children at highest risk (boys aged 5–9 years) varied by an order of magnitude, with 671,856 boys projected to be infected by CCA trace as positive and only 60,453 projected by CCA trace as negative results.ConclusionsOur findings show that people in Rwanda’s Northern, Western and capital regions are at high risk of S. mansoni infection. However, variation in id
Hotez PJ, Fenwick A, Molyneux DH, 2019, Collateral Benefits of Preventive Chemotherapy - Expanding the War on Neglected Tropical Diseases, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 380, Pages: 2389-2391, ISSN: 0028-4793
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- Citations: 18
Ruberanziza E, Owada K, Clark NJ, et al., 2019, Mapping Soil-Transmitted Helminth Parasite Infection in Rwanda: Estimating Endemicity and Identifying At-Risk Populations, TROPICAL MEDICINE AND INFECTIOUS DISEASE, Vol: 4
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- Citations: 11
Hotez PJ, Harrison W, Fenwick A, et al., 2019, Female genital schistosomiasis and HIV/AIDS: Reversing the neglect of girls and women, PLOS NEGLECTED TROPICAL DISEASES, Vol: 13, ISSN: 1935-2735
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- Citations: 29
Hotez PJ, Biritwum N-K, Fenwick A, et al., 2019, Ghana: Accelerating neglected tropical disease control in a setting of economic development, PLOS NEGLECTED TROPICAL DISEASES, Vol: 13, ISSN: 1935-2735
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- Citations: 10
Fenwick A, 2019, Egypt's schistosomiasis control programme in the 1980s prepared the ground for the global elimination of schistosomiasis by 2030, TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, Vol: 113, Pages: 1-3, ISSN: 0035-9203
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- Citations: 4
Gazzinelli-Guimaraes PH, Dhanani N, King CH, et al., 2018, Accuracy of the WHO praziquantel dose pole for large-scale community treatment of urogenital schistosomiasis in northern Mozambique: Is it time for an update?, PLOS NEGLECTED TROPICAL DISEASES, Vol: 12, ISSN: 1935-2735
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- Citations: 6
Jourdan PM, Lamberton PHL, Fenwick A, et al., 2018, <i>Strongyloides stercoralis</i>: the need for accurate information reply, LANCET, Vol: 391, Pages: 2323-2323, ISSN: 0140-6736
Hotez PJ, Fenwick A, Ray SE, et al., 2018, "Rapid impact" 10 years after: The first "decade" (2006-2016) of integrated neglected tropical disease control, PLOS NEGLECTED TROPICAL DISEASES, Vol: 12, ISSN: 1935-2735
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- Citations: 23
Clements MN, Corstjens PLAM, Binder S, et al., 2018, Latent class analysis to evaluate performance of point-of-care CCA for low-intensity Schistosoma mansoni infections in Burundi, Parasites & Vectors, Vol: 11, ISSN: 1756-3305
Background:Kato-Katz examination of stool smears is the field-standard method for detecting Schistosoma mansoni infection. However, Kato-Katz misses many active infections, especially of light intensity. Point-of-care circulating cathodic antigen (CCA) is an alternative field diagnostic that is more sensitive than Kato-Katz when intensity is low, but interpretation of CCA-trace results is unclear. To evaluate trace results, we tested urine and stool specimens from 398 pupils from eight schools in Burundi using four approaches: two in Burundi and two in a laboratory in Leiden, the Netherlands. In Burundi, we used Kato-Katz and point-of-care CCA (CCAB). In Leiden, we repeated the CCA (CCAL) and also used Up-Converting Phosphor Circulating Anodic Antigen (CAA).Methods:We applied Bayesian latent class analyses (LCA), first considering CCA traces as negative and then as positive. We used the LCA output to estimate validity of the prevalence estimates of each test in comparison to the population-level infection prevalence and estimated the proportion of trace results that were likely true positives.Results:Kato-Katz yielded the lowest prevalence (6.8%), and CCAB with trace considered positive yielded the highest (53.5%). There were many more trace results recorded by CCA in Burundi (32.4%) than in Leiden (2.3%). Estimated prevalence with CAA was 46.5%. LCA indicated that Kato-Katz had the lowest sensitivity: 15.9% [Bayesian Credible Interval (BCI): 9.2–23.5%] with CCA-trace considered negative and 15.0% with trace as positive (BCI: 9.6–21.4%), implying that Kato-Katz missed approximately 85% of infections. CCAB underestimated disease prevalence when trace was considered negative and overestimated disease prevalence when trace was considered positive, by approximately 12 percentage points each way, and CAA overestimated prevalence in both models. Our results suggest that approximately 52.2% (BCI: 37.8–5.8%) of the CCAB trace readings were true infections.
Jourdan PM, Lamberton PHL, Fenwick A, et al., 2018, Soil-transmitted helminth infections, LANCET, Vol: 391, Pages: 252-265, ISSN: 0140-6736
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- Citations: 345
Phillips AE, Gazzinelli-Guimarães PH, Aurelio HO, et al., 2018, Urogenital schistosomiasis in Cabo Delgado, northern Mozambique: baseline findings from the SCORE study., Parasites & Vectors, Vol: 11, ISSN: 1756-3305
BACKGROUND: The results presented here are part of a five-year cluster-randomised intervention trial that was implemented to understand how best to gain and sustain control of schistosomiasis through different preventive chemotherapy strategies. This paper presents baseline data that were collected in ten districts of Cabo Delgado province, northern Mozambique, before treatment. METHODS: A cross-sectional study of 19,039 individuals was sampled from 144 villages from May to September 2011. In each village prevalence and intensity of S. haematobium were investigated in 100 children first-year students (aged 5-8 years), 100 school children aged 9-12 years (from classes 2 to 7) and 50 adults (20-55 years). Prevalence and intensity of S. haematobium infection were evaluated microscopically by two filtrations, each of 10 ml, from a single urine specimen. Given that individual and community perceptions of schistosomiasis influence control efforts, community knowledge and environmental risk factors were collected using a face-to-face interview. Data were entered onto mobile phones using EpiCollect. Data summary was made using descriptive statistics. Chi-square and logistic regression were used to determine the association between dependent and independent variables. RESULTS: The overall prevalence of urogenital schistosomiasis was 60.4% with an arithmetic mean intensity of infection of 55.8 eggs/10 ml of urine. Heavy infections were detected in 17.7%, of which 235 individuals (6.97%) had an egg count of 1000 eggs/10 ml or more. There was a significantly higher likelihood of males being infected than females across all ages (62% vs 58%; P < 0.0005). Adolescents aged 9-12 years had a higher prevalence (66.6%) and mean infection intensity (71.9 eggs/10 ml) than first-year students (63.1%; 58.2 eggs/10 ml). This is the first study in Mozambique looking at infection rates among adults. Although children had higher le
Phillips AE, Gazzinelli-Guimaraes PH, Aurelio HO, et al., 2017, Assessing the benefits of five years of different approaches to treatment of urogenital schistosomiasis: A SCORE project in Northern Mozambique., PLoS Neglected Tropical Diseases, Vol: 11, ISSN: 1935-2727
BACKGROUND: In Mozambique, schistosomiasis is highly endemic across the whole country. The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) coordinates a five-year study that has been implemented in various African countries, including Mozambique. The overall goal of SCORE was to better understand how to best apply preventive chemotherapy with praziquantel (PZQ) for schistosomiasis control by evaluating the impact of alternative treatment approaches. METHODS: This was a cluster-randomised trial that compared the impact of different treatment strategies in study areas with prevalence among school children of ≥21% S. haematobium infection by urine dipstick. Each village was randomly allocated to one of six possible combinations of community-wide treatment (CWT), school-based treatment (SBT), and/or drug holidays over a period of four years, followed by final data collection in the fifth year. The most intense intervention arm involved four years of CWT, while the least intensive arm involved two years of SBT followed by two consecutive years of PZQ holiday. Each study arm included 25 villages randomly assigned to one of the six treatment arms. The primary outcome of interest was change in prevalence and intensity of S. haematobium among 100 children aged 9-to-12-years that were sampled each year in every village. In addition to children aged 9-to-12 years, 100 children aged 5-8 years in their first-year of school and 50 adults (aged 20-55 years) were tested in the first and final fifth year of the study. Prevalence and intensity of S. haematobium infection was evaluated by two filtrations, each of 10mL, from a single urine specimen. PRINCIPAL FINDINGS: In total, data was collected from 81,167 individuals across 149 villages in ten districts of Cabo Delgado province, Northern Mozambique. Overall PZQ treatment resulted in a significant reduction in the prevalence of S. haematobium infection from Year 1 to Year 5, where the average prevalence
Clements MN, Donnelly CA, Fenwick A, et al., 2017, Interpreting ambiguous 'trace' results in Schistosoma mansoni CCA tests: estimating sensitivity and specificity of ambiguous results with no gold standard, PLoS Neglected Tropical Diseases, Vol: 11, ISSN: 1935-2727
BackgroundThe development of new diagnostics is an important tool in the fight against disease. Latent Class Analysis (LCA) is used to estimate the sensitivity and specificity of tests in the absence of a gold standard. The main field diagnostic for Schistosoma mansoni infection, Kato-Katz (KK), is not very sensitive at low infection intensities. A point-of-care circulating cathodic antigen (CCA) test has been shown to be more sensitive than KK. However, CCA can return an ambiguous ‘trace’ result between ‘positive’ and ‘negative’, and much debate has focused on interpretation of traces results.Methodology/Principle findingsWe show how LCA can be extended to include ambiguous trace results and analyse S. mansoni studies from both Côte d’Ivoire (CdI) and Uganda. We compare the diagnostic performance of KK and CCA and the observed results by each test to the estimated infection prevalence in the population.Prevalence by KK was higher in CdI (13.4%) than in Uganda (6.1%), but prevalence by CCA was similar between countries, both when trace was assumed to be negative (CCAtn: 11.7% in CdI and 9.7% in Uganda) and positive (CCAtp: 20.1% in CdI and 22.5% in Uganda). The estimated sensitivity of CCA was more consistent between countries than the estimated sensitivity of KK, and estimated infection prevalence did not significantly differ between CdI (20.5%) and Uganda (19.1%). The prevalence by CCA with trace as positive did not differ significantly from estimates of infection prevalence in either country, whereas both KK and CCA with trace as negative significantly underestimated infection prevalence in both countries.ConclusionsIncorporation of ambiguous results into an LCA enables the effect of different treatment thresholds to be directly assessed and is applicable in many fields. Our results showed that CCA with trace as positive most accurately estimated infection prevalence.
Chami GF, Kontoleon AA, Bulte E, et al., 2017, Diffusion of treatment in social networks and mass drug administration., Nature Communications, Vol: 8, ISSN: 2041-1723
Information, behaviors, and technologies spread when people interact. Understanding these interactions is critical for achieving the greatest diffusion of public interventions. Yet, little is known about the performance of starting points (seed nodes) for diffusion. We track routine mass drug administration-the large-scale distribution of deworming drugs-in Uganda. We observe friendship networks, socioeconomic factors, and treatment delivery outcomes for 16,357 individuals in 3491 households of 17 rural villages. Each village has two community medicine distributors (CMDs), who are the seed nodes and responsible for administering treatments. Here, we show that CMDs with tightly knit (clustered) friendship connections achieve the greatest reach and speed of treatment coverage. Importantly, we demonstrate that clustering predicts diffusion through social networks when spreading relies on contact with seed nodes while centrality is unrelated to diffusion. Clustering should be considered when selecting seed nodes for large-scale treatment campaigns.
Assoum M, Ortu G, Basanez M-G, et al., 2017, Spatiotemporal distribution and population at risk of soil-transmitted helminth infections following an eight-year school-based deworming programme in Burundi, 2007-2014, Parasites & Vectors, Vol: 10, ISSN: 1756-3305
Background: Investigating the effect of successive annual deworming rounds on the spatiotemporal distribution ofinfection prevalence and numbers at risk for soil-transmitted helminths (STHs) can help identify communitiesnearing elimination and those needing further interventions. In this study, we aim to quantify the impact ofan 8-year mass drug administration (MDA) programme (from 2007 to 2014) on the spatiotemporal distribution ofprevalence of STH infections and to estimate the number of school-aged children infected with STHs in Burundi.Methods: During annual longitudinal school-based surveys in Burundi between 2007 and 2011, STH infection andanthropometric data for a total of 40,656 children were collected; these data were supplemented with data froma national survey conducted in 2014. Bayesian model based geostatistics (MBG) were used to generate predictiveprevalence maps for each STH species and year. The numbers of children at-risk of infection per district between2008 and 2014 were estimated as the product of the predictive prevalence maps and population density maps.Results: Overall, the degree of spatial clustering of STH infections decreased between 2008 and 2011; in 2014 thegeographical clusters of all STH infections reappeared. The reduction in prevalence was small for Ascaris lumbricoidesand Trichuris trichiura in the centre and central north of the country. Our predictive prevalence maps for hookwormindicate a reduction in prevalence along the periphery of the country. The predicted number of children infected withany STH species decreased substantially between 2007 and 2011, but in 2014 there was an increase in the predictednumber of children infected with A. lumbricoides and T. trichiura. In 2014, the districts with the highest predictednumber of children infected with A. lumbricoides, T. trichiura and hookworms were Kibuye district (n = 128,903),Mabayi district (n = 35,302) and Kiremba (n = 87,511), respectively.Conclusions: While the MDA programme
Shen Y, King CH, Binder S, et al., 2017, Protocol and baseline data for a multi-year cohort study of the effects of different mass drug treatment approaches on functional morbidities from schistosomiasis in four African countries, BMC INFECTIOUS DISEASES, Vol: 17
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- Citations: 13
Knowles SCL, Sturrock HJW, Turner H, et al., 2017, Optimising cluster survey design for planning schistosomiasis preventive chemotherapy, PLOS Neglected Tropical Diseases, Vol: 11, ISSN: 1935-2735
BackgroundThe cornerstone of current schistosomiasis control programmes is delivery of praziquantel to at-risk populations. Such preventive chemotherapy requires accurate information on the geographic distribution of infection, yet the performance of alternative survey designs for estimating prevalence and converting this into treatment decisions has not been thoroughly evaluated.Methodology/Principal findingsWe used baseline schistosomiasis mapping surveys from three countries (Malawi, Côte d’Ivoire and Liberia) to generate spatially realistic gold standard datasets, against which we tested alternative two-stage cluster survey designs. We assessed how sampling different numbers of schools per district (2–20) and children per school (10–50) influences the accuracy of prevalence estimates and treatment class assignment, and we compared survey cost-efficiency using data from Malawi. Due to the focal nature of schistosomiasis, up to 53% simulated surveys involving 2–5 schools per district failed to detect schistosomiasis in low endemicity areas (1–10% prevalence). Increasing the number of schools surveyed per district improved treatment class assignment far more than increasing the number of children sampled per school. For Malawi, surveys of 15 schools per district and 20–30 children per school reliably detected endemic schistosomiasis and maximised cost-efficiency. In sensitivity analyses where treatment costs and the country considered were varied, optimal survey size was remarkably consistent, with cost-efficiency maximised at 15–20 schools per district.Conclusions/SignificanceAmong two-stage cluster surveys for schistosomiasis, our simulations indicated that surveying 15–20 schools per district and 20–30 children per school optimised cost-efficiency and minimised the risk of under-treatment, with surveys involving more schools of greater cost-efficiency as treatment costs rose.
Fenwick A, 2017, Schistosomiasis research and control since the retirement of Sir Patrick Manson in 1914, TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, Vol: 111, Pages: 191-198, ISSN: 0035-9203
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- Citations: 9
Chami GF, Kontoleon AA, Bulte E, et al., 2017, Community-directed mass drug administration is undermined by status seeking in friendship networks and inadequate trust in health advice networks, SOCIAL SCIENCE & MEDICINE, Vol: 183, Pages: 37-47, ISSN: 0277-9536
Over 1.9 billion individuals require preventive chemotherapy through mass drug administration (MDA). Community-directed MDA relies on volunteer community medicine distributors (CMDs) and their achievement of high coverage and compliance. Yet, it is unknown if village social networks influence effective MDA implementation by CMDs. In Mayuge District, Uganda, census-style surveys were conducted for 16,357 individuals from 3,491 households in 17 villages. Praziquantel, albendazole, and ivermectin were administered for one month in community-directed MDA to treat Schistosoma mansoni, hookworm, and lymphatic filariasis. Self-reported treatment outcomes, socioeconomic characteristics, friendship networks, and health advice networks were collected. We investigated systematically missed coverage and noncompliance. Coverage was defined as an eligible person being offered at least one drug by CMDs; compliance included ingesting at least one of the offered drugs. These outcomes were analyzed as a two-stage process using a Heckman selection model. To further assess if MDA through CMDs was working as intended, we examined the probability of accurate drug administration of 1) praziquantel, 2) both albendazole and ivermectin, and 3) all drugs. This analysis was conducted using bivariate Probit regression. Four indicators from each social network were examined: degree, betweenness centrality, closeness centrality, and the presence of a direct connection to CMDs. All models accounted for nested household and village standard errors. CMDs were more likely to offer medicines, and to accurately administer the drugs as trained by the national control programme, to individuals with high friendship degree (many connections) and high friendship closeness centrality (households that were only a short number of steps away from all other households in the network). Though high (88.59%), additional compliance was associated with directly trusting CMDs for health advice. Effective treatment pro
Savioli L, Albonico M, Colley DG, et al., 2017, Building a global schistosomiasis alliance: an opportunity to join forces to fight inequality and rural poverty, INFECTIOUS DISEASES OF POVERTY, Vol: 6, ISSN: 2049-9957
Ortu G, Ndayishimiye O, Clements M, et al., 2017, Countrywide reassessment of Schistosoma mansoni infection in Burundi using a urine-circulating cathodic antigen rapid test: informing the national control program., American Journal of Tropical Medicine and Hygiene, Vol: 96, Pages: 664-673, ISSN: 1476-1645
Following implementation of the national control program, a reassessment of Schistosoma mansoni prevalence was conducted in Burundi to determine the feasibility of moving toward elimination. A countrywide cluster-randomized cross-sectional study was performed in May 2014. At least 25 schools were sampled from each of five eco-epidemiological risk zones for schistosomiasis. Fifty randomly selected children 13-14 years of age per school were included for a single urine-circulating cathodic antigen (CCA) rapid test and, in a subset of schools, for duplicate Kato-Katz slides preparation from a single stool sample. A total of 17,331 children from 347 schools were tested using CCA. The overall prevalence of S. mansoni infection, when CCA trace results were considered negative, was 13.5% (zone range [zr] = 4.6-17.8%), and when CCA trace results were considered positive, it was 42.8% (zr = 34.3-49.9%). In 170 schools, prevalence of this infection determined using Kato-Katz method was 1.5% (zr ==0-2.7%). The overall mean intensity of S. mansoni infection determined using Kato-Katz was 0.85 eggs per gram (standard deviation = 10.86). A majority of schools (84%) were classified as non-endemic (prevalence = 0) using Kato-Katz; however, a similar proportion of schools were classified as endemic when CCA trace results were considered negative (85%) and nearly all (98%) were endemic when CCA trace results were considered positive. The findings of this nationwide reassessment using CCA rapid test indicate that Schistosoma infection is still widespread in Burundi, although its average intensity is probably low. Further evidence is now needed to determine the association between CCA rapid test positivity and low-intensity disease transmission.
Phillips AE, Gazzinelli-Guinmaraes P, Aurelio O, et al., 2017, IMPACT OF DIFFERENT TREATMENT STRATEGIES OVER FIVE YEARS FOR SCHISTOSOMIASIS IN MOZAMBIQUE, 66th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene (ASTMH), Publisher: AMER SOC TROP MED & HYGIENE, Pages: 33-33, ISSN: 0002-9637
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