Schistosomiasis

Understanding the basic pharmacology of praziquantel tailored to paediatric setting and developing a treatment access plan for this age class

Helping increase and sustain the scale-up of preventive chemotherapy campaigns in West and Central Africa

To strengthen the capacity of the 5 African university departments hosting the Malaria Capacity Development Consortium (MCDC) programme

Will providing enhanced MDA at the community level while achieving treatment coverage of 75% or greater in children (5-17) and adults substantially decrease S. mansoni infection in previously identified persistent hot-spot communities?  

Is molecular detection of schistosome infection (patent and pre-patent) in snails a useful tool for program managers as prevalence and intensity of infection in people approaches very low levels?

How do villages which do not show substantial decreases in the prevalence of schistosomiasis despite repeated, high coverage mass drug administration (persistent hot-spot villages) differ from villages which show substantial decrease in prevalence across various factors (declining prevalence villages)?

Economic evaluation of SCORE projects with priority given to elimination studies

To identify antigens that can be produced as recombinant proteins and to document elimination of schistosomiasis.

To identify antigens that differentiate between infections with Schistosoma mansoni and Schistosoma haematobium and that can be used in an ELISA, lateral flow assay or multiplex format.

Rigorous assessment of the efficacy of (multiple) doses with Praziquantel in the treatment of S. mansoni infections using standard and novel highly sensitive diagnostic tools.

To compare the feasibility and programmatic implications of employing the Supervisor's Coverage Tool in schools vs. communities to monitor a school-based MDA.

The Supervisor’s Coverage Tool (SCT) is a rapid in-process monitoring tool for improving mass drug administration (MDA) coverage that has been approved by WHO for use in communities.  However, questions remain as to whether it may also serve as a useful tool when implemented in schools.  To answer this question, a direct comparison of school- vs. community-based SCT implementation was conducted in 13 Supervision Areas (SAs) in 7 Local Government Areas (LGAs), in 3 states in Nigeria.  Within each SA, one SCT was conducted in the school and an independent SCT was conducted in a village within the catchment area of the same school. The SCTs were all monitoring the coverage for the same school-based MDA for praziquantel and mebendazole. The goal was to understand how the information learned through the SCT would vary based on the two different sampling frames. 

Findings and lessons learned:

-          The SCT helped find targeted schools for which a mass drug administration (MDA) was planned but were missed. Several unregistered (illegal) schools were missed as their existence was not known, therefore they were not targeted and included in the MDA; however, upon identification of these schools through the SCT, the schools were reached during mop-up and added to the database for future MDAs.

-          An existing school feeding program increased students’ praziquantel intake in all northern Nigeria schools that were visited.

-          In two SAs, school SCT results showed good coverage; however, the actual reported school coverage was below the recommended threshold. The discrepancy was due to a great number of student absences because of farming activities or drop outs after enrolment. Since any selected student who is absent is skipped by the SCT and a new student is selected in their place, the resulting coverage classification could be an inflation of the true coverage.

-          Surveyors preferred SCT implementation in schools vs. community because household enumeration can be time-consuming.

-          When SCT results from the school and the village were directly compared for the same population, the community-based SCT always resulted in an equal or lower classification of coverage, likely because community-based SCTs include the entire target population in the sampling frame, as opposed to being limited to school-attending children.