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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
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
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.
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.
To evaluate 3D photographs of trachomatous trichiasis (TT) in the training and assessment of trachoma graders.
Long term outcome of the two most commonly used surgical procedures to treat trachomatous trichiasis (TT): PLTR vs BLTR
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 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
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
Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.
Currently MDA is stopped when TF in children aged 1-9 years is below 5%. However, the relationship between TF, presence of infection and antibody has not been studied in a sufficient number of settings to enable predictions of outcome to be confidently made based on baseline prevalence, intervention coverage, and the prevalence of disease and infection at the time of impact survey. There are several districts in Malawi with TF prevalence between 5 and 9.9% which are eligible for one year of interventions, including a single round of MDA. This study will add important data to be used to model outcomes of interventions conducted by trachoma elimination programs, and in particular, help develop operational guidelines for stopping MDA.
To test alternative rapid diagnostic test (RDT) formats for the Wb123 rapid test. In field trials, the current test format was less sensitive that FTS in post-MDA settings whereas alternative Wb123 test formats (ELISA, multiplex) were more sensitive. Our group uses new detection systems, based on nanoshells, to improve RDT performance.
To define a cost-effective strategy to map Ivermectin-naïve districts for Onchocerciasis, Lymphatic Filariasis, and Loiasis in the context of elimination of these NTDs
Estimating Population Denominators and Coverage of Mass Drug Administration Using Polio’s Vaccination Tracking System
To determine the viability of utilizing the polio program’s Vaccination Tracking System (VTS) to generate more accurate population, drug requirement and coverage estimates in NTD programs
Serological indicators to measure the impact of the NTD control program on onchocerciasis in 3 distinct settings in Tanzania
To compare Ov16 ELISA and Ov16 rapid diagnostic test results, and better understand the significance of Ov16 serology in hypo-, meso- and hyper-endemic settings post-treatment.
The primary objective for this request is to evaluate the performance of the Biplex RDT in a cohort of 500 people previously tested for oncho and LF in 2014 (3-year follow up). The evaluation of the Biplex is an add-on to a study that will conduct a longitudinal follow up on a cohort of 500 people from the Tshopo Province. The primary outcomes are serology and clinical manifestations of onchocerciasis, This study also evaluates serology, parasitology and clinical manifestations for other filarial infections, mainly LF, Loa and Mansonella.
Preliminary Findings and Lessons Learned
This study built on an existing onchocerciasis longitudinal follow-up study in Banalia community, Tshopo province, DRC. The location is co-endemic for Oncho, LF, Loa loa and Mansonella perstans. 500 people previously tested in 2014 have been followed up and were retested in 2017. A total of 239, out of 500, agreed to participate in the follow-up activity and provided a blood specimen. Thirty percent were positive by skin snip, 3% were positive by FTS, 15% were found to have loa (thick blood film) and 41% had M. perstans. Ov16 ELISA testing found 67% positive, while the Biplex found 38% Ov16 positive. The sensitivity of the Ov16 biplex compared to the ELISA was 53%.
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.
What is the immune pathogenesis of podoconiosis?
Do endemic Ethiopian plant extracts have potential for use in lymphoedema management?
What is the distribution of mycetoma in Sudan?
Can behavioural change communication lead to earlier presentation of mycetoma in rural Sudan?
Can routine reports be used to identify hot spots of scabies transmission?
Can bioielectrical impedance spectroscopy (BIS) identify patients with podoconiosis lymphoedema?
Integration and scale up of community-based holistic care package for people with lymphoedema in Ethiopia
What are the key elements that constitute optimal physical and psychosocial care for lymphoedema of many causes?
How (and to what extent) does integration of the lymphoedema intervention occur in the different ‘functions’ of the health system? What are the critical factors that influence the process of integration?
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.
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.
Studies of Gene Expression Pattern of Glutathione-S-Transferase (OvGST1) in the host and vector Simulium damnosum s.l.
To study the glutathione-S-transferase (OvGST1) gene expression pattern in the life cycle stages critical for the establishment of infection by Onchocerca volvulus.
How do we motivate community drug distributors (CDDs)?
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.
- 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.
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.