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@article{Brooker:2015:10.1136/bmjopen-2015-008950,
author = {Brooker, SJ and Mwandawiro, CS and Halliday, KE and Njenga, SM and Mcharo, C and Gichuki, PM and Wasunna, B and Kihara, JH and Njomo, D and Alusala, D and Chiguzo, A and Turner, HC and Teti, C and Gwayi-Chore, C and Nikolay, B and Truscott, JE and Hollingsworth, TD and Balabanova, D and Griffiths, UK and Freeman, MC and Allen, E and Pullan, RL and Anderson, RM},
doi = {10.1136/bmjopen-2015-008950},
journal = {BMJ Open},
title = {Interrupting transmission of soil-transmitted helminths: a study protocol for cluster randomised trials evaluating alternative treatment strategies and delivery systems in Kenya},
url = {http://dx.doi.org/10.1136/bmjopen-2015-008950},
volume = {5},
year = {2015}
}

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TY  - JOUR
AB  - Introduction In recent years, an unprecedented emphasis has been given to the control of neglected tropical diseases, including soil-transmitted helminths (STHs). The mainstay of STH control is school-based deworming (SBD), but mathematical modelling has shown that in all but very low transmission settings, SBD is unlikely to interrupt transmission, and that new treatment strategies are required. This study seeks to answer the question: is it possible to interrupt the transmission of STH, and, if so, what is the most cost-effective treatment strategy and delivery system to achieve this goal?Methods and analysis Two cluster randomised trials are being implemented in contrasting settings in Kenya. The interventions are annual mass anthelmintic treatment delivered to preschool- and school-aged children, as part of a national SBD programme, or to entire communities, delivered by community health workers. Allocation to study group is by cluster, using predefined units used in public health provision—termed community units (CUs). CUs are randomised to one of three groups: receiving either (1) annual SBD; (2) annual community-based deworming (CBD); or (3) biannual CBD. The primary outcome measure is the prevalence of hookworm infection, assessed by four cross-sectional surveys. Secondary outcomes are prevalence of Ascaris lumbricoides and Trichuris trichiura, intensity of species infections and treatment coverage. Costs and cost-effectiveness will be evaluated. Among a random subsample of participants, worm burden and proportion of unfertilised eggs will be assessed longitudinally. A nested process evaluation, using semistructured interviews, focus group discussions and a stakeholder analysis, will investigate the community acceptability, feasibility and scale-up of each delivery system.
AU  - Brooker,SJ
AU  - Mwandawiro,CS
AU  - Halliday,KE
AU  - Njenga,SM
AU  - Mcharo,C
AU  - Gichuki,PM
AU  - Wasunna,B
AU  - Kihara,JH
AU  - Njomo,D
AU  - Alusala,D
AU  - Chiguzo,A
AU  - Turner,HC
AU  - Teti,C
AU  - Gwayi-Chore,C
AU  - Nikolay,B
AU  - Truscott,JE
AU  - Hollingsworth,TD
AU  - Balabanova,D
AU  - Griffiths,UK
AU  - Freeman,MC
AU  - Allen,E
AU  - Pullan,RL
AU  - Anderson,RM
DO  - 10.1136/bmjopen-2015-008950
PY  - 2015///
SN  - 2044-6055
TI  - Interrupting transmission of soil-transmitted helminths: a study protocol for cluster randomised trials evaluating alternative treatment strategies and delivery systems in Kenya
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2015-008950
UR  - http://hdl.handle.net/10044/1/37586
VL  - 5
ER  -

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