To determine the feasibility and best practices of using the Supervisor's Coverage Tool to monitor community and school-based distribution and integrated MDA.
The Supervisor’s Coverage Tool (SCT) is a rapid, simple, and inexpensive tool designed for use in Neglected Tropical Diseases (NTD) programs mass drug administration (MDA) to monitor drug coverage and compliance, to supervise community drug distributors (CDD), and to identify areas that may need mop-up. After successfully piloting the SCT in Ethiopia and Nigeria in 2015, additional testing of the tool was suggested to assess the feasibility of the tool in different regions and new settings. Therefore, the SCT was implemented in the Philippines in July 2016.
After the completion of training, the field work was conducted in two provinces, in six Supervision Areas (SA) consisting of one or more puroks (subdivisions) per barangay (village). Two survey populations were represented in the SCT implementation covering a community-based distribution for Lymphatic Filariasis (LF), excluding children aged 5-18 years and a school-based distribution for LF for all children aged 5-18 years.
Findings and lessons learned:
- The most common reasons for not swallowing drugs were fear of side effects, not feeling well, forgetting, being too busy, and the taste of the medicine.
- When an accurate register of all the households in the SA exists, it is possible to complete the SCT in each SA in less than a day because the registers greatly aid the random selection process.
- Implementing the SCT during the last week or two of the MDA was advantageous as it enabled the program to implement the action plan to improve the current MDA using the personnel, budget, and infrastructure that was already in place for the MDA.
- It is important to consider whether or not Community Drug Distributors (CDD) should accompany the SCT teams during interviews, as their presence may influence the answers of the respondents.
- It is strongly recommended that when possible, CDDs use directly observed treatment (DOT). If DOT is not possible, CDDs should remind participants that there is no advantage in delaying swallowing the drugs, and that it is actually better when everyone swallows the drugs at the same time.
- Overall, the Philippines SCT pilot was a success, as it was the first time it was implemented in the Western Pacific region, and it was also used to monitor multiple distributions (both school- and community-based).
To complete mapping of NTDs in AFRO and support transitioning of new diagnostics tools into program use.
To validate the Brugia antibody tests as a tool for stopping LF MDA.
Field validation of sampling strategies for integrating STH surveys into Transmission Assessment Surveys (Indonesia)
To validate a new TAS-STH survery in a complex progammatic setting.
Determine the best data-capture system and implementation model to overcome data flow challenges faced by national MDA programs. Test and compare the effectiveness of 4 different data-tracking platforms currently in use (or development) in NTD endemic countries: 1) Build on existing national capacity, 2) Cloud-based SMS system, 3) Robo-call platform.
Preliminary study findings:
o The current process for tracking treatment information through paper-based forms can be complicated and leaves room for human error, as multiple aggregations of data must be collected manually between administrative levels before reaching the national level.
o This study found that the process of collecting and reporting paper records on the stock and delivery of ivermectin, albendazole and Praziquantel took between two and three months.
o The study found that robo-call surveys have the potential to add a new stream of information on drug stock between national supervisors and sub-district implementation teams, allowing program staff to take corrective actions in response to issues with drug supply.
o The proactive timing of the calls as well as the interactive component of responding to verbal questions through the phone makes this system useful to supervisors.
o Robo-calls were found to be helpful to monitor drug levels prior to MDA at sub-district level and to ensure appropriate quantities of drug stock were reaching lower administrative level, but as post-MDA drug stock is returned to the district level, physical observation of district-level storerooms was the most effective way to assess drug quantities post-MDA.
o SMS reporting made data accessible at the national level and to administrative units in real time.
o Less than half of the registered supervisors submitted SMS reports, resulting in a significant difference in the number and type of treatments reported when compared to paper forms.
o Greater training and ongoing management is needed to take full advantage of the speed and data accuracy improvements from robo-call and SMS surveys.
The Feasibility of a ‘Re-mapping’ Protocol for Lymphatic Filariasis in Areas where Transmission is Uncertain in Bangladesh
To implement a new re-mapping strategy for LF in low-prevalence areas.
Comparison of antigenemia by ICT and FTS RDT, antibody responses to Wb123 and Ov 16 by ELISA , and Wb123/Ov16 Biplex RDT on LF sentinel sites
To compare antigenemia results by ICT and FTS RDT, antibody responses to Wb123 and Ov 16 by ELISA , and Wb123/Ov16 Biplex RDT on LF sentinel sites.
To compare skin snip microfiladermia with antibody responses against Ov16 antigen in general population in epidemiological assessments post CDTi.