Sustaining control of schistosomiasis

Africa map of regionsProgram managers need good data on the optimal use of various approaches to mass drug administration (MDA) in areas where prevalence is moderate, and where the focus is on ensuring that prevalence rates of schistosomiasis do not rise, and, if possible, that they continue to decline. SCORE is supporting efforts in Cote d’Ivoire, Kenya, and Niger to understand the benefits and costs of alternative approaches to mass drug administration (MDA) for schistosomiasis in such communities.

Studies of sustaining control were implemented in communities with S. haematobium or S. mansoni prevalence among school children of 10-24% (see Box 2 for study arms in Cote d’Ivoire and Kenya). Each study arm includes 25 villages. Programs will provide different communities with various combinations of school-based MDA and drug holidays over a period of 4 years, followed by final data collection, analysis, and dissemination of results in the fifth year. In Niger, the study will compare twice a year treatment with treatment once a year. The primary outcome of interest is change in prevalence and intensity of schistosomiasis among children ages 9 – 12. We expect to test 100 children in this age group each year in each village in each study arm that is receiving MDA.

At the beginning and end of the 5-year period, rates of infection and intensity of infection among children 8 years of age and younger will also be determined. Cost data will be collected using protocols consistent with those being used for studies of integration of NTD control being funded elsewhere by the Bill & Melinda Gates Foundation.

These sustaining studies were implemented during 2010 and 2011 in all study areas. Several papers have been written to describe the baseline efforts including the first-year data. See Publications.

In some study sites, smartphones are being used to collect data and transmit it to servers. Systems in use include EpiCollect (Kenya, Mozambique, and Tanzania) and LINKS (Côte d’Ivoire), with assistance from Imperial College and the Task Force for Global Health, respectively.

Box 2 – Study Arms: Studies of Sustaining Control of Schistosomiasis