NTD-SC

Bangladesh STH Diagnostic Comparison: PCR vs. Kato-Katz

To determine if a standardized multi-parallel-PCR assay is a more sensitive diagnostic tool for detecting Hookworm, Trichuris trichiura, Ascaris lumbricoides, and Strongyloides prevalence compared to the Kato-Katz stool test.

Countries: Bangladesh

Assessment of LF status in Two Urban Settings of Benin (Cotonou and Porto-Novo)

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.
Countries: Benin

Co-Endemicity of Lymphatic Filariasis and Loiais in the Republic of Congo

Determine Co-Endemicity of Lymphatic Filariasis and Loiais in the Republic of Congo

Countries: Congo

An evaluation of the effectiveness of the trachoma surveillance strategy and the use of alternative diagnostic indicators to validate the elimination of blinding trachoma in Ghana

To determine if PCR or serology techniques are better than TF for assessing Trachoma prevalence during the surveillance phase of Trachoma Elimination Programs.

Countries: Ghana
Diseases: Trachoma | Yaws

Exploring alternative indicators for trachoma endpoint decision-making (Uganda)

Analyze the relationships between the prevalence of the clinical sign follicular trachoma (TF) and the prevalence of infection and antibody to determine whether it may be appropriate to consider one or more alternative indicators for deciding whether trachoma programs can stop MDA.

Countries: Uganda
Diseases: Trachoma

Exploring alternative indicators for trachoma endpoint decision-making (Malawi)

Analyze the relationships between the prevalence of the clinical sign follicular trachoma (TF) and the prevalence of infection and antibody to determine whether it may be appropriate to consider one or more alternative indicators for deciding whether trachoma programs can stop MDA.

Countries: Malawi
Diseases: Trachoma

Piloting the Supervisor's Coverage Tool in Cross River State, Nigeria

To pilot a rapid coverage supervision tool (now known as the Supervisor's Coverage Tool) that can be used to determine if the supervision areas under investigation are likely to have exceeded the WHO threshold for coverage and to serve as an in-process monitoring tool for supervising the MDA distribution. Report to WHO M&E working group; potential for inclusion in future WHO program assessment guidelines.

The Supervisor’s Coverage Tool (SCT) is a quick, simple, and inexpensive monitoring tool that can be used to assess preventive chemotherapy coverage of a mass drug administration (MDA). During the development and optimization process of the tool, the SCT was piloted in communities in Nigeria and Ethiopia. The pilot study in Cross River State, Nigeria, included seven first-level Supervision Areas (SA), which corresponded to villages in four Local Government Areas (LGAs). Drug coverage was assessed for ivermectin and albendazole in four SAs and only Ivermectin in three SAs. 

Findings and lessons learned:

-          The main reasons for not swallowing medicines were community drug distributor (CDD) not showing up, respondent being away at time of drug distribution or not collecting drug from a fixed point of distribution, fear of side effects, drug supply running out, recent migration, and lack of awareness about drug distribution.

-          The SCT permitted LGA coordinators to supervise the drug distribution systematically, which allowed them to find out that in most parts of one LGA treatment was suspended despite the CDD claiming the completion of treatment in the area.

-          Some treatment registers did not include all people living in the SA, therefore some households were not included in the CDDs treatment boundaries. On the other hand, some LGAs had very good treatment registers, proper documentation of treatment from CDDs, and their community also commended them during village gatherings expressing their gratitude.

-          All CDDs were making remarkable effort with little or no reward. Unlike previous monitoring visits where supervisors have to field numerous complaints around incentives, because the SCT gave supervisors an objective evaluation of their work, many CDDs did not feel justified in complaining about incentives.

-          Overall, the SCT was deemed feasible to implement at the supervisory area and the information generated led to programmatic action to improve treatment coverage.

Countries: Nigeria

STH TAS Surveys

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.

Countries: Benin | Tonga

Evaluating treatment coverage for trachoma in two districts in Malawi

To measure the feasibility of using a PPES sampling approach with segmentation within each EA to measure coverage. In addition to collecting data on coverage the team also used mobile devices to collect data on time and distance traveled as well as the availability of village registers. These data contribute to the larger coverage evaluation study taking place in multiple countries.

Preliminary Findings and Lessons Learned

Coverage surveys are an important tool for programs to evaluate their reporting systems and to determine whether effective MDA coverage has been achieved. However, for various reasons coverage surveys are seldom implemented.  Some key challenges are: perceived technical difficulty, lack of resources, and lack of standardized guidance on how to conduct coverage surveys.  This protocol seeks to pilot a newly refined probability sampling with segmentation approach in 2 districts in Malawi.  The two surveys found that the survey coverage was above the WHO target thresholds for Zithromax. Furthermore, the team found the survey methodology to be clear and feasible to implement.  This adds further evidence to the previous studies that support the use of the segmentation approach for coverage surveys across all 5 PC NTDs.

Countries: Malawi
Diseases: Trachoma

Ab assessment by multiplex for LF, Trachoma, and Yaws

Determine the age prevalence of LF antibody following MDA to inform surveillance strategies. Yaws and trachoma testing will also occur during the survey.

Countries: Fiji

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