Investigating the role of drug delivery strategy in MDA drug coverage

Haiti, like many other countries, has made considerable progress in the elimination of lymphatic filariasis. To date, 118 out of 140 communes have passed TAS and stopped MDA. However, little is understood about why some communes have persistent transmission despite five or more rounds of MDA. The proposed study aims to identify alternative approaches to MDA that may help to increase access, uptake, and coverage, particularly for individuals who typically do not comply with MDAs. This cluster-randomized design will test a novel approach (door to door strategy) against the standard health post-based delivery method. Additionally, the study aims to identify non-compliant individuals and better understand their reasons for non-participation. Furthermore, a cost analysis will be undertaken as part of this study to understand the potential implications for the country program should the door-to-door strategy prove effective in reaching higher numbers of people.

Countries: Haiti

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

Trachomatous Trichiasis Management in Tanzania: Investigation of the productivity of case finding and referral of patients to trichiasis surgery services

One of important pillar of Trachoma elimination as a public health problem is to manage through epilation and surgery trachomatous trichiasis (TT) to reach in endemic district less than 0.1% of TT prevalence or less than 0.2% prevalence in adults of 15 years and older. However, surveys in 3 districts of Tanzania where numbers of TT surgeries were performed showed an unexpected higher prevalence despite intervention. This mixed methods study will help to address the main question as to why trachoma impact surveys demonstrating unexpectedly high TT prevalence in communities where TT surgical intervention is ongoing and how could this intervention/burden gap be addressed? The aim is to look at the case finding techniques effectiveness in all the communities and factors that affect TT referral and quality surgical services.

Countries: Tanzania
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

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