Country operational research priorities pending.
The DeWorm3 Project is a series of hybrid trials testing the feasibility of interrupting the transmission of soil transmitted helminths (STH), while conducting implementation science research that contextualizes clinical research findings and provides guidance on opportunities to optimize delivery of STH interventions.
The purpose of DeWorm3 implementation science studies is to ensure rapid and efficient translation of evidence into practice. Research methods include: (1) stakeholder mapping and network analysis, (2) qualitative research, (3) structural readiness surveys, (4) process mapping, and (5) economic evaluation (costing and cost-effectiveness).
Implementation science research aims include:
1)To systematically identify stakeholders influencing standard of care targeted and community-wide MDA and map their potential role and involvement in scale-up of community-wide MDA for STH.
2)To identify implementation-related barriers and facilitators to community-wide MDA for STH from the perspective of various stakeholders.
3)To quantify the readiness of the health system to deliver community-wide MDA for STH programs.
4)To map the intervention delivery process and identify any discrepancies between planned and implemented activities in order to optimize the trial intervention.
5)To compare the financial and economic costs and incremental cost-effectiveness of community-wide and targeted MDA for STH in the short- and long-term.
To determine whether there is LF transmission in Cotonou and Porto-Novo, which are the two main urban locations of Benin where the LF status is undetermined. A study will be conducted to evaluate the prevalence of LF using antigenemia and antibody testing (FTS and Wb123). An entomological survey will be implemented to understand the dynamic of LF transmission and potential barriers to LF MDA in urban settings.
Preliminary study findings:
- While mass drug administration (MDA) in Benin is on track to eliminate LF in most endemic cities, 50 such cities – including the country’s largest cities, Cotonou and Porto Novo – never received treatements.
- In 2016, more than 15 years after mapping, LF endemicity was re-evaluated in Cotonou and Porto Novo to put in place adequate strategies for LF elimination. This study constituted that re-mapping effort.
- The various surveys, conducted in vectors and humans through collection of entomological and parasitological data, reveal an absence of LF transmission in Cotonou and Porto Novo.
- The results demonstrate that the number of cities endemic for LF in Benin has dropped from 50 to 48.
- However, the study revealed a lack of awareness of LF by residents and health workers, highlighting the need for more education and awareness raising on the disease.
Pilot Assessment of Soil-Transmitted Helminthiasis in the Context of Transmission Assessment Surveys for Lymphatic Filariasis in Benin and Tonga. A transmission assessment survey (TAS) is recommended to determine if MDA for LF can be stopped within an evaluation unit (EU) after at least five rounds of annual treatment. The TAS also provides an opportunity to simultaneously assess the impact of these MDAs on STH and to determine the frequency of school-based MDA for STH after community-wide MDA is no longer needed for LF.