Equitable access to Mass Drug Administration for trachoma elimination: an ethnographic study to understand factors associated with low coverage in Kenya and Tanzania
Main objectives are firstly to identify and understand better the factors behind low and unequal MDA coverage and compliance in trachoma endemic areas in Tanzania and Kenya with nomadic populations, secondly to prioritize factors in terms of amenability to intervention. The researcher will then use the evidence generated to design specific interventions that could improve the reach and impact of campaigns of Zithromax MDA in both countries. While there are contextual differences between nomadic societies throughout Africa, research among the Masai in Tanzania and Kenya should inform programme services in other settings with nomadic populations. Particular attention will be given to gender-sensitivity; that is, interventions that will improve access and use by women as well as men.
To investigate the utility of an antibody test as a tool for surveillance during the elimination phase of trachoma programmes
Sustaining the Gains of NTD elimination programs through focused support of community drug distributors
To sustain the gains of active community drug distributors (CDDs) by enhancing their performance through intervention at the individual, community and primary health care center levels to reach NTD elimination and control goals.
To investigate prevalence of ocular chlamydial infection and associated risk factors in children aged 1-9 year in Manyoni district
To evaluate 3D photographs of trachomatous trichiasis (TT) in the training and assessment of trachoma graders.
Long term outcome of the two most commonly used surgical procedures to treat trachomatous trichiasis (TT): PLTR vs BLTR
Ascertain whether the difference in outcome (measured in rate of post-operative trachomatous trichiasis, or TT), between the posterior lamellar tarsal rotation (PLTR) and bilamellar tarsal rotation (BLTR) is sustained at four years or whether they give different results from what has been found at 1 year.
To understand the nature (quality and quantity) of post epilation lashes and their visual significance in unoperated minor trachomatous trichiasis (TT) cases and case with post-operative trichiasis
To analyze the relationships between the currently used indicator for impact assessments - prevalence of the clincial sign TF - and the prevalence of infection and antibody among 1-9 year old children in hyperendemic districts prior to mass drug administration
Currently MDA is stopped when TF in children aged 1-9 years is below 5%. However, the relationship between TF, presence of infection and antibody has not been studied in a sufficient number of settings to enable predictions of outcome to be confidently made based on baseline prevalence, intervention coverage, and the prevalence of disease and infection at the time of impact survey. There are several districts in Malawi with TF prevalence between 5 and 9.9% which are eligible for one year of interventions, including a single round of MDA. This study will add important data to be used to model outcomes of interventions conducted by trachoma elimination programs, and in particular, help develop operational guidelines for stopping MDA.
Estimating Population Denominators and Coverage of Mass Drug Administration Using Polio’s Vaccination Tracking System
To determine the viability of utilizing the polio program’s Vaccination Tracking System (VTS) to generate more accurate population, drug requirement and coverage estimates in NTD programs