Country operational research priorities pending.
Research questions: Does an innovative community referral linkage improve VL case finding in hard-to-reach areas of Northwest Ethiopia? Does innovative community referral linkage improve patient adherence to VL treatment? Does innovative community referral linkage improve VL patient’s treatment outcomes? Does an electronic referral linkage system improve back and forth communication and feedback between the treatment centre and community?
To determine the appropriate serologic threshold(s) to be used to initiate MDA for onchocerciasis.
Reliability assessment: What is the intra- and inter-rater reliability of current qualitative F and novel quantitative hygiene metrics across study contexts?
Validity assessment: What is the validity of each metric of interest (i.e., quantitative hygiene and qualitative F metrics) with regard to recent personal hygiene practices and trachoma outcomes?
Utility assessment: What is the utility of each metric (i.e., qualitative and quantitative)?
Risk factor assessment: Do proxy facial and hand hygiene outcomes, as measured by the novel quantitative hygiene metric, represent risk factors of incident C. trachomatis infection?"
- Formative component: What is the capacity of the integrated morbidity management and disability prevention (MMDP) programme to incorporate a stigma reduction intervention for people with lower limb lymphoedema, and what are the barriers and facilitators to this?
- Intervention component: Is the stigma reduction intervention effective in increasing demand and access to services within an integrated MMDP programme for people with lower limb lymphoedema?
This study outlines an important first step to understanding NTD program integration in Ethiopia and builds on previous work in SNNPR. The study team plans to carry out significant formative research to better understand what gaps currently exist in the Ethiopian primary health care system that prevent integration of NTD services. They aim to answer the following questions:
- What are the current gaps in the Ethiopian primary health care system for implementing integrated NTD services and how can they be addressed?
- What is the community’s perception and awareness of selected NTDs and how can it be improved?
Following the gap analysis, the study team, along with the ministry of health and NTD taskforce of Ethiopia, will develop interventions to address these gaps. Outputs of the intervention stage are expected to include the following: a detailed description of the intervention, including case definitions, roles and responsibilities at the different levels of the health system, data recording and reporting mechanisms, referral systems; training manuals for the different primary healthcare system levels, job aids, guidance for supportive supervision. The team has made extensive plans to address issues of sustainability and scalability of the project including a cost analysis of the interventions, developing close partnerships with health facilities’ procurement departments, and close engagement during budget planning exercises of district health offices.
This study aims to understand the relationship between trachomatous trichiasis (TT) and mental health disorders over an 18-month study period, by answering the following questions:
- What is the impact of the blinding stage of trachoma (Trachomatous Trichiasis) on common mental disorders such as depression, anxiety and suicidality?
- Will the validation of the 5-Question Stigma Indicators (5-QSI) generic stigma tool help to measure and monitor stigma in trachomatous trichiasis patients in Ethiopia
- What are the drivers for mental disorders in TT patients
- Is there a difference in depression, anxiety and suicidality prevalence between TT cases accepting vs declining TT surgery; and un-operated vs postoperative TT cases? The research team will be trained on good clinical practice through the WHO Mental Health Gap Action Programme (mhGAP). Following interviews, any patient with TT will be referred for surgery and patients found with a mental health disorder will be referred for care. If a negative impact of blinding trachoma on mental health is noted, the researchers plan to use the results of the study to advocate for additional funding for the trachoma program and highlight the need to address mental health in Ethiopia.
Would the same programmatic decisions for Oncho Elimination Mapping be made based off of the Ov16 RDT results as compared to the Ov16 SD ELISA results in 7 woredas included in OEM in Ethiopia?
This study aims to determine if the addition of lymphatic stimulating activities to community-based home-care for lymphoedema can improve outcomes for people affecetd by moderate to late stage disease.
Formative: What is the capacity of the integrated morbidity management and disability prevention (MMDP) programme to incorporate a stigma reduction intervention for people with lower limb lymphoedema, and what are the barriers and facilitators to this?
Intervention: Is the stigma reduction intervention effective in increasing demand and access to services within an integrated MMDP programme for people with lower limb lymphoedema?
This study will address the characteristics of the ocular chlamydia trachomatis population structures within Amhara, a setting which has experienced repeated rounds of antibiotic for trachoma, and whether those circulating populations are different than known sequenced strains.
Through funding from the Wellcome Trust to develop a global atlas of podoconiosis. We aim to advance new knowledge on the geographical distribution and spatial epidemiology of the disease.
i. Conduct national cross-sectional surveys in selected countries to validate the environmental predictive model developed using the mapping data in Ethiopia.
ii. Create evidence consensus maps, develop risk maps and ground-truthing work and delineate the spatial distribution and geographical limits of podoconiosis globally.
iii. Estimate the global burden of podoconiosis by quantifying the number affected, the population at risk and DALYs attributable.
iv. Estimate how much it will cost to control or eliminate podoconiosis globally.
Can routine reports be used to identify hot spots of scabies transmission?
Do endemic Ethiopian plant extracts have potential for use in lymphoedema management?
What is the immune pathogenesis of podoconiosis?
Can bioielectrical impedance spectroscopy (BIS) identify patients with podoconiosis lymphoedema?
The Starworms project aims to strengthen the monitoring and surveillance of drug efficacy and anthelmintic resistance in soil-transmitted helminth (STH) programs. As such, it will support deworming programs in their quest to eliminate STHs as a public health problem by 2020. The specific objectives are (1) to validate diagnostic tools to monitor drug efficacy and the spread of anthelmintic resistance, (2) to create a surveillance system that monitors the global patterns of drug efficacy and spread of anthelmintic resistance in STH programs, and (3) to develop supporting tools to plan, analyze and follow up on surveys on drug efficacy and the spread of anthelmintic resistance.
To understand the nature (quality and quantity) of post epilation lashes and their visual significance in unoperated minor trachomatous trichiasis (TT) cases and case with post-operative trichiasis
Ascertain whether the difference in outcome (measured in rate of post-operative trachomatous trichiasis, or TT), between the posterior lamellar tarsal rotation (PLTR) and bilamellar tarsal rotation (BLTR) is sustained at four years or whether they give different results from what has been found at 1 year.
To evaluate 3D photographs of trachomatous trichiasis (TT) in the training and assessment of trachoma graders.
To assess the programmatic feasibility of and determine the most appropriate age group and sampling strategy for an oncho mapping survey for ivermectin-naïve areas
To analyze the relationships between the currently used indicator for impact assessments - prevalence of the clincial sign TF - and the prevalence of infection and antibody among 1-9 year old children in hyperendemic districts prior to mass drug administration
What are the differences at 1 year post-baseline in the prevalence of trachoma and Ct infection in villages randomized to an enhanced antibiotic treatment regimen characterized by a routine community-wide MDA followed by two rounds of treatment targeted to children 6 months to 9 years in quick succession (1-2 weeks apart) compared to villages randomized to annual standard-of-care community-wide MDA?
Does community-based treatment of podoconiosis lymphoedema reduce the frequency of attacks of acute dermatolymphangioadenitis?
Study the impact of WASH on Trachoma by adding an STH intervention and post-treatment evaluation. WASH intervention and control communities will be treated with albendazole and STH burden will be assessed pre-treatment and at annual intervals thereafter.
This study is piloting the Supervisor's Coverage Tool (formerly the Coverage Supervision Tool, or CST) approach that is meant to provide a platform for district- and sub-district-level supervisors to monitor the success of the last MDA. It is meant to be conducted at the sub-district level two weeks following MDA and provides a pass/fail result regarding whether the target coverage threshold was met. It is designed as a quick and inexpensive in-process monitoring tool for use by sub-national level NTD management teams/supervisors to help improve or maintain the success of future MDA rounds.
Preliminary Findings and Lessons Learned
A recurring request from the national neglected tropical disease (NTD) programme teams is for a quick, inexpensive and simple tool that the programmes can use to assess preventive chemotherapy (PC) coverage. Consequently, the WHO, in collaboration with partners, has developed a Supervisor’s Coverage Tool (SCT) that can be used to improve the coverage of PC delivered through mass drug administration (MDA). The SCT gives supervisors a supportive supervision tool with which to strengthen the performance of the community drug distributors (CDDs) and their first-level supervisors, providing an opportunity to identify and solve problems related to low MDA coverage.
This tool was first piloted in the Benishangul-Gumuz region in western Ethiopia in close collaboration with RTI and the regional health bureau. The results suggested that the tool was both feasible for district-level staff to implement and resulted in programmatically useful information.
The methodology behind this tool was presented at the WHO Working Group on Monitoring and Evaluation of Preventive Chemotherapy (WG M&E) in 2015 and 2016. Evidence from four field studies in Ethiopia, Nigeria (two separate occasions) and the Philippines confirms the value and feasibility of using the Supervisor’s Coverage Tool (SCT) by sub-district health supervisors.
Consequently, the Scientific and Technical Advisory Group for Neglected Tropical Diseases has recommended that the SCT be made available to national programmes for immediate use. Information from SCT should be used to take appropriate data-driven, corrective action at sub-district levels. Additional evidence will be gathered about the tool’s use and applications in other treatment settings such as school-based platforms and urban settings.
Demonstrate the utility of a new mapping strategy based on school cluster random sampling Using PPES. A secondary objective is to assess the value of laboratory-based antibody assays as confirmatory tests and additional diagnostic tools for measuring LF transmission.
POC/CCA screening/mapping tool initial Studies