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Evaluation of community directed vector control on transmission of Onchocerca volvulus in a Loa loa co-endemic region

This study will pilot the Slash and Clear methodology in an oncho-Loa loa co-endemic setting. Previous pilots in Uganda and Nigeria have demonstrated that this simple strategy of removing breeding sites can result in significant black fly reductions that last for several months. This study will provide important data on the impact of Slash and Clear on black fly biting, and consequently its impact on oncho elimination. Two intervention and one control community will be compared for two years, with repeated measurements being taken of biting rates.

Countries: Cameroon
Diseases: Loiasis | Onchocerciasis

Improving disease control and elimination decision making with geospatial algorithms

Can geospatial algorithms be used by disease programs to help identify hotspots at community and Implementation Unit level?

Countries:

Improving Mass Drug Administration After Pre-Transmission Assessment Survey (Pre-TAS) Failure: A Mixed Methods Study in Nepal

This study builds on the methods developed for the operational studies ongoing in Ghana and Burkina Faso. The first two research questions are the same as those earlier studies with two new questions added here- question 3 on triple drug therapy (ivermectin, DEC, albendazole – IDA) and 4 on the use of a new rapid ethnography approach.

  1. What factors are associated with effective (and lower) MDA coverage as defined as availability, accessibility, and acceptability in settings that have repeatedly failed Pre-TAS?
  2. What is the impact of an adapted and tailored intervention package on achieving effective coverage?
  3. What messages and community engagement approaches are needed to ensure the acceptability of IDA triple drug therapy in Nepal?
  4. How does the rapid ethnography approach compare to more traditional qualitative analysis methods in terms of cost, timeliness, and ability to provide required information for programmatic decisions? Can local capacity for use of this approach be built rapidly?
Countries: Nepal

Does infection data add evidence to the understanding of trachoma prevalence in low endemic areas?

  1. To evaluate strategies for the elimination of trachoma by evaluating potential makers that show interruption of transmission of C. trachomatis
  2. To determine the prevalence of ocular chlamydial infection among children aged 1 – 9 years old in Mpwapwa and Kalambo District, Tanzania
  3. To determine the associated risk factors of ocular Chlamydia infection among children aged 1 – 9 years old in Mpwapwa and Kalambo District, Tanzania
  4. To determine the usability of antibody test to detect Chlamydia antigen pgp3 using lateral flow assay
  5. To examine the longevity of the antibody response to trachoma antigens in a high and low-prevalence setting
Countries: Tanzania
Diseases: Trachoma

Developing a surveillance framework for the post-elimination phase of the lymphatic filariasis programme in Bangladesh

  • Can the micro-stratification of lymphatic filariasis (LF) transmission assessment surveys positive case and clinical case data be used to identify, map and monitor transmission hotspots as part of an enhanced endgame surveillance strategy?
  • Can targeted molecular xenomonitoring detect ongoing transmission [to the same extent as human surveillance] in defined LF transmission hotspots?

 

Countries: Bangladesh

TAS 3 positive case follow-up

Is there still LF transmission after successful TAS 3?

Countries: Nepal | Nepal

Post-validation survey for the elimination of blinding trachoma to evaluate the effectiveness of a serological surveillance strategy in two provinces of Morocco

Conduct district-wide field trials of the Pgp3 lateral flow assay to measure the seroprevalence of antibodies against the Chlamydia trachomatis antigen Pgp3 in low-prevalence settings.

Countries: Morocco
Diseases: Trachoma

MORBID: Morbidity Operational Research for Bilharziasis Implementation Decisions (Pilot)

A pilot study to identify meaningful and measurable targets for detecting the control of schistosomiasis-related morbidity in Africa. The overall study is designed to answer the following primary evaluation questions:

  • What are the infection levels of Schistosoma mansoni and S. haematobium below which there is little, or no, detectable schistosomiasis-associated morbidity?
  • What are the optimal morbidity markers for S. mansoni and S. haematobium?
  • What are the optimal species-specific morbidity goals for which schistosomiasis control programs should be aiming?
Countries: Kenya | Malawi
Diseases: Schistosomiasis

Follow-up of positive cases of lymphatic filariasis after Transmission Assessment Survey (TAS) 2 and TAS 3 in Burkina Faso

Identify the sampling strategy for tracking positive cases after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of active transmission, while saving program resources

Countries: Burkina Faso

Whole genome sequencing of ocular Chlamydia trachomatis in Amhara region, Ethiopia, an area with persistent hyperendemic trachoma.

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.

Countries: Ethiopia
Diseases: Trachoma

ClearTrachoma: Evaluation of a novel molecular rapid diagnostic device for the detection of Chlamydia trachomatis in trachoma-endemic areas

The primary aim of this study is a first evaluation (384 samples) of the DjinniChip in ocular clinical samples in a trachoma-endemic region in-country, but initially in the controlled environment of a research laboratory setting. The second aim is to determine the DjinniChips resilience and usability by evaluating its performance with a concentration series of positive control swabs in various environmental conditions (hot, dry, dusty, humid).

Countries: Tanzania
Diseases: Trachoma

Production of a New Dual Antigen Test Strip as a Tool to Support Epidemiologic Assessments of Onchocerciasis

How does the performance of the new Ov16/Ov3261 test strip compare to that of the SD Ov16 RDT and the SD Ov16 ELISA?

Diseases: Onchocerciasis

Improving Mass Drug Administration After Transmission Assessment Survey Failure: Results from a Mixed Methods Study

  • What factors are associated with the availability, accessibility, and acceptability of MDA?
  • What is the impact of an adapted and tailored intervention package on effective coverage?
Countries: Ghana | Burkina Faso

Lymphatic Filariasis Positive-Case Follow-up After TAS 2 in Haiti

To identify the sampling strategy for positive case follow-up after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of ongoing transmission, while saving program resources.

Countries: Haiti

Does infection data add evidence to understanding of trachoma prevalence in low endemic areas?

To investigate the utility of an antibody test as a tool for surveillance during the elimination phase of trachoma programmes

Countries: Tanzania
Diseases: Trachoma

Lymphatic filariasis positive-case follow-up after TAS 2 or TAS 3 in Philippines

To identify the sampling strategy for positive case follow-up after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of ongoing transmission, while saving program resources.

Countries: Philippines

Doxycycline for Clinical Management of Filarial Lymphedema (Mali)

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Countries: Mali

Integrating use of point-of-care circulating cathodic antigen rapid diagnostic by community health workers during mass drug administration campaign to increase uptake of praziquantel treatment among adult populations in North-Western Tanzania

To assess if introducing point-of-care Circulating Cathodic Antigen rapid test to community health workers will increase access, compliance and coverage to treatment among adult individuals at Kome Island in North-Western Tanzania, an area on the Lake Victoria highly endemic for schistosomiasis

Countries: Tanzania
Diseases: Schistosomiasis

Does infection data add anything to our understanding of trachoma prevalence in low endemic areas?

To investigate prevalence of ocular chlamydial infection and associated risk factors in children aged 1-9 year in Manyoni district

Countries: Tanzania
Diseases: Trachoma

Development of a molecular diagnostic method for soil-transmitted helminthiases: Epidemiological implications for disease control

To improve STH detection by developing a reliable and easy to perform molecular diagnostic test for epidemiological surveillance and post-elimination monitoring of STH

Countries: Cameroon

Demand creation and services uptake push for onchocerciasis control in Cross River State, Nigeria

To increase onchocerciasis treatment coverage and to optimize service delivery through community mobilization, disease sensitization, training and strengthening of community health extension workers (CHEW), and community control advocates

Countries: Nigeria
Diseases: Onchocerciasis

Monitoring migrant groups as a post-treatment surveillance approach to contain the potential risk of lymphatic filaraisis re-emergence after stopping mass drug administration in Togo

In March 2016, the Republic of Togo submitted an application for validation of the elimination of LF as a public health problem. However, healthcare facility managers in some health regions – especially in the Savanes Region, have reported the presence of migrant groups from neighboring countries which are still endemic to LF – i.e. Ghana, Burkina Faso, Nigeria. Migrants arrive and reside temporarily but recurrently in some localities of these regions. They constitute hotspots that can be source of resurgence, mainly because the nationwide passive surveillance has been stopped in 2016. 

In order to track all population movements that constitute a potential risk to the Republic of Togo, the country proposes to set up a strategy for the identification of these groups, with the contribution of Neglected Tropical Disease (NTD) Focal Points, followed by the research of potential parasite carriers. Isolated cases discovered will be investigated in order to track all imported W. bancrofti. They will be treated, but if an effective hotspot is discovered, rounds of Albendazole and Ivermectin MDA will be implemented a follow up of infected individuals will be maintained. 

The purpose of this study is to contribute maintaining the end of LF transmission across the country.

Countries: Togo

Investigation of possible ongoing Schistosoma hybridization in Nigeria and implications for response to treatment

To investigate the presence and epidemiology of Schistosoma hybrids in Nigeria. The acquisition of new genes through hybridization may generate new phenotypes that might differ in virulence, drug resistance, pathology, and host use, ultimately leading to the emergence of new diseases. Hybrids can develop into a new emerging pathogen, necessitating new control strategies in zones where both parental species overlap, an intense and rapid control response is required to minimize further spread of the hybrid and possible escalation of human schistosomiasis.

Countries: Nigeria
Diseases: Schistosomiasis

Doxycycline for Clinical Management of Filarial Lymphedema (Sri Lanka)

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Countries: Sri Lanka

Adding Antibody Testing to Mini-TAS

To compare results from Brugia Rapid tests (in 3 districts) and FTS (in 2 districts) with Wb123 rapid tests and Wb123 and Bm14 ELISA testing.

 

Preliminary Findings

  • In March and April 2017, NIMPE had organized teams to go to the field to collect samples. In Duy Tien district, all of 20 primary schools were visited and 320 pupils were tested. In Quang Ninh district, all of 21 primary schools were visited and 323 students participated in the survey. In Le Thuy district, 35 of 38 primary schools were visited and 344 pupils had blood samples taken. 
  • In total, 987 serum samples were collected but one sample was ran out of serum after doing quick tests (Brugia rapid and FTS). Finally, 986 samples were collected for the antibodies test. The serum samples were kept in frieze (-20 0 C) until analysis. Base on the cut–off 0.096 that was calculated by CDC, no positive case was found by this technique.
  • Wb123 testing was applied in all three districts to detect W. bancrofti antibody. All 986 samples were tested, but no positive case was found. This result did not indicate that the Wb123 testing accuracy is equivalent to FTS but did show that no cross action with B. malayi and other parasites was found within the study. 
  • All 986 serum samples that collected from the three districts in the Mini TAS were tested by Bm14 to detect B.malayi antibody. No positive case was recorded and this result was comparable to the result from Brugia rapid test.
  • Following these data, the researchers supposed that the ELISA testing could be comparable to the quick testing with regards to accuracy. However, since no positive case was found and we could not conclude about the sensitivity and the specificity of the test. Therefore, a further study should be continued especially in endemic areas in which possibly can find some positive cases for assessment and conclusion.
Countries: Viet Nam

Integrated Transmission Assessment Surveys (iTAS) and Onchocerciasis evaluation in areas of Co-Endemicity for both infections in Tanzania

To determine the validity and programmatic feasibility of an integrated transmission assessment survey (F-TAS), to be used to simultaneously assess Onchocerciasis (Oncho) and Lymphatic Filariasis (LF) prevalence in areas co-endemic for the two infections that have completed the recommended treatment for one or both infections.

Countries: Tanzania

Doxycycline for Clinical Management of Filarial Lymphedema (India)

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Countries: India

Determination of the prevalence of LF infection in districts not included in LF control activities and of the basis for integrated implementation of LF - onchocerciasis elimination strategies in potentially co-endemic areas

Field validation of the diagnostic performance of the Wb123/Ov16 biplex rapid diagnostic test and Wb123 ELISA, compared to the filariasis test strip (FTS) in a setting initially found to be non-endemic for lymphatic filariasis, in which clinical cases have been identified.

Countries: Ghana

Field Validation of Wb123 monoplex, Haiti

To compare the performance of antigen (FTS) and antibody (Wb123 monoplex) tools in programmatic settings (TAS).

Preliminary Findings and Lessons Learned

The goal of this study is to compare the performance of antigen (FTS) and antibody (Wb123 monoplex, Wb123 ELISA, multiplex) tools in programmatic settings (TAS). In order to strengthen the existing TAS platform we need to better understand which diagnostic indicator(s) are best-suited for making programmatic decisions. The TAS was conducted in Trou de Nord and Plaisance EUs.  Both EUs passed the TAS, but positive FTS were identified (4 and 2, respectively). However the Wb123 RDT found ZERO positive children, of the over 2000 tested. While the Wb123 ELISA testing is still ongoing, this initial result agrees with findings from other studies, all of which suggest that the Wb123 RDT is too insensitive a tool to be of programmatic use.

Countries: Haiti

District-Level Integrated Mapping of Onchocerciasis, Lymphatic Filariasis, and Loiasis in Nigeria

  • To define a cost-effective and accurate method to map ivermectin-naïve districts for Onchocerciasis, Lymphatic Filariasis and Loiasis and identify districts eligible for safe treatment with ivermectin MDA.
  • To validate a statistical model of Loiasis prevalence and intensity by comparing the model results to data from a prevalence assessment.
Countries: Nigeria

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