Onchocerciasis LAMP assay to optimize diagnostics and sampling strategies for low-prevalence settings in Cameroon
1. Can the O-150 LAMP assay be established on whole blood? 2. Can the O-150 qPCR methodology be adapted for human sampling?
1. How does the performance of the O-150 LAMP compare to the O-150 qPCR assay?
2. What threshold be used to define positive vs negative results for both assays?
3. Can deep sequencing reveal over potential biomarkers for further investigation?
1. Development of spatio-temporal models and associated statistical methods to enable forward projections of the geographical distribution of prevalence, and hence the risk of resurgence, by combining model-based geostatistical analysis with mechanistic predictive modelling of disease transmission dynamics, using the most recent available data on disease prevalence and environmental risk-factors.
2. To use the results from aim 1 to derive statistically efficient and affordable designs for networks of sentinel sites to enable continued monitoring of prevalence in areas at high risk of resurgence."
Can geostatistical tools be used to develop a stop IDA strategy for LF that can measure <1% Mf prevalence in adults?
To determine the appropriate serologic threshold(s) to be used to initiate MDA for onchocerciasis.
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.
Utility of screening easy to access population sub groups as a surveillance tool in monitoring interruption of LF transmission
The question of how to conduct post-elimination surveillance is a high priority for the NTD community, given that most NTD programs scale back or shut down completely once elimination as a public health problem is achieved. Few solutions exist and this proposal provides an interesting and useful case study for surveillance moving forward. The study team plans to target 1708 pregnant women as a proxy for measuring LF resurgence in a post-elimination context. As a comparison group, they plan to conduct a prevalence survey of 427 households (1708 participants) in the same community to compare LF prevalence found in each methodology. Each participant at the health facility’s residence will be geo-referenced to understand the coverage area. They also plan to conduct interviews with patients and health workers, a time-motion study, and a cost analysis to assess the additional burden on health care workers and the health system. The study will occur in 14 facilities in one district of Malawi where LF was highly endemic prior to the launch of the program.
Can geospatial algorithms be used by disease programs to help identify hotspots at community and Implementation Unit level?
The influence of stigma on social participation and mental well-being amongst men and women affected/disabled by lymphatic filariasis and leprosy in the districts of Jaunpur and Patna in India
To what extent does stigma affect social participation and mental wellbeing among men and women affected/disabled by lymphatic filariasis or leprosy in Jaunpur in Uttar Pradesh and Patna in Bihar?
Assessing the effectiveness of using the Community Directed Intervention (CDI) approach to improve community ownership of Mass Drug Administration (MDA) for Neglected Tropical Diseases (NTDs) in Malawi
This project intends to assess the effectiveness of using the Community Directed Intervention (CDI) approach as a vehicle for delivery of mass drug administration (MDA) campaigns against targeted NTDs namely, schistosomiasis and soil-transmitted helminths (STH) such as Ascaris lumbricoides (roundworms), Trichuris trichiura (whip worms) and Ancylostoma sp. (hookworms) in selected districts of Malawi. The idea is to take advantage of the logistical setup, organizational strength and high degree of efficiency of the national NTD programme to improve delivery of the current MDA efforts to control selected and highly prioritized NTDs of schistosomiasis and STH and to enhance community ownership of the interventions in selected rural and remote communities by using the CDI approach. The primary research question is: Can the CDI approach be effectively used to deliver MDA to control NTDs at community level in rural Malawian districts?
Strategies for the ENdgame: Targeting Infections among Non-compliants in the Elimination of Lymphatic filariasis (SENTINEL)
Non-compliance is a primary barrier to attaining elimination goals. This study aims to utilize data captured in MDA registers to address non-compliance in the Ahanta West District of Ghana, which has been identified as a hotspot of LF transmission with >1% microfilaria (mf) prevalence after 15-16 rounds of MDA. On the basis of information identified in the register, this study proposes to deploy two strategies:
- Engage and Treat individuals who were ill, missed treatment, or were unable to participate during the last MDA, and
- Test and Treat for individuals who might be systemically non-compliant or afraid of adverse events. The use of MDA registers to assist in locating non-compliant individuals is novel and would provide valuable evidence for other programs and represents an alternative strategy for countries struggling with the end game. It may also help provide insight as to whether systematically non-compliant individuals truly serve as a reservoir for LF in areas designated as hotspots. Qualitative data collection will aid in understanding reasons for systematic non-compliance and may lead to changes in social mobilization strategies.