Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol.
Current control strategies for soil-transmitted helminths (STH) emphasize morbidity control through mass drug administration (MDA) targeting preschool- and school-age children, women of childbearing age and adults in certain high-risk occupations such as agricultural laborers or miners. This strateg...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC5773085?pdf=render |
| _version_ | 1811197846506962944 |
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| author | Kristjana Hrönn Ásbjörnsdóttir Sitara S Rao Ajjampur Roy M Anderson Robin Bailey Iain Gardiner Katherine E Halliday Moudachirou Ibikounle Khumbo Kalua Gagandeep Kang D Timothy J Littlewood Adrian J F Luty Arianna Rubin Means William Oswald Rachel L Pullan Rajiv Sarkar Fabian Schär Adam Szpiro James E Truscott Marleen Werkman Elodie Yard Judd L Walson DeWorm3 Trials Team |
| author_facet | Kristjana Hrönn Ásbjörnsdóttir Sitara S Rao Ajjampur Roy M Anderson Robin Bailey Iain Gardiner Katherine E Halliday Moudachirou Ibikounle Khumbo Kalua Gagandeep Kang D Timothy J Littlewood Adrian J F Luty Arianna Rubin Means William Oswald Rachel L Pullan Rajiv Sarkar Fabian Schär Adam Szpiro James E Truscott Marleen Werkman Elodie Yard Judd L Walson DeWorm3 Trials Team |
| author_sort | Kristjana Hrönn Ásbjörnsdóttir |
| collection | DOAJ |
| description | Current control strategies for soil-transmitted helminths (STH) emphasize morbidity control through mass drug administration (MDA) targeting preschool- and school-age children, women of childbearing age and adults in certain high-risk occupations such as agricultural laborers or miners. This strategy is effective at reducing morbidity in those treated but, without massive economic development, it is unlikely it will interrupt transmission. MDA will therefore need to continue indefinitely to maintain benefit. Mathematical models suggest that transmission interruption may be achievable through MDA alone, provided that all age groups are targeted with high coverage. The DeWorm3 Project will test the feasibility of interrupting STH transmission using biannual MDA targeting all age groups. Study sites (population ≥80,000) have been identified in Benin, Malawi and India. Each site will be divided into 40 clusters, to be randomized 1:1 to three years of twice-annual community-wide MDA or standard-of-care MDA, typically annual school-based deworming. Community-wide MDA will be delivered door-to-door, while standard-of-care MDA will be delivered according to national guidelines. The primary outcome is transmission interruption of the STH species present at each site, defined as weighted cluster-level prevalence ≤2% by quantitative polymerase chain reaction (qPCR), 24 months after the final round of MDA. Secondary outcomes include the endline prevalence of STH, overall and by species, and the endline prevalence of STH among children under five as an indicator of incident infections. Secondary analyses will identify cluster-level factors associated with transmission interruption. Prevalence will be assessed using qPCR of stool samples collected from a random sample of cluster residents at baseline, six months after the final round of MDA and 24 months post-MDA. A smaller number of individuals in each cluster will be followed with annual sampling to monitor trends in prevalence and reinfection throughout the trial. TRIAL REGISTRATION:ClinicalTrials.gov NCT03014167. |
| first_indexed | 2024-04-12T01:21:17Z |
| format | Article |
| id | doaj.art-9904694195224612964cf3473b4ca0c4 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-12T01:21:17Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-9904694195224612964cf3473b4ca0c42022-12-22T03:53:48ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352018-01-01121e000616610.1371/journal.pntd.0006166Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol.Kristjana Hrönn ÁsbjörnsdóttirSitara S Rao AjjampurRoy M AndersonRobin BaileyIain GardinerKatherine E HallidayMoudachirou IbikounleKhumbo KaluaGagandeep KangD Timothy J LittlewoodAdrian J F LutyArianna Rubin MeansWilliam OswaldRachel L PullanRajiv SarkarFabian SchärAdam SzpiroJames E TruscottMarleen WerkmanElodie YardJudd L WalsonDeWorm3 Trials TeamCurrent control strategies for soil-transmitted helminths (STH) emphasize morbidity control through mass drug administration (MDA) targeting preschool- and school-age children, women of childbearing age and adults in certain high-risk occupations such as agricultural laborers or miners. This strategy is effective at reducing morbidity in those treated but, without massive economic development, it is unlikely it will interrupt transmission. MDA will therefore need to continue indefinitely to maintain benefit. Mathematical models suggest that transmission interruption may be achievable through MDA alone, provided that all age groups are targeted with high coverage. The DeWorm3 Project will test the feasibility of interrupting STH transmission using biannual MDA targeting all age groups. Study sites (population ≥80,000) have been identified in Benin, Malawi and India. Each site will be divided into 40 clusters, to be randomized 1:1 to three years of twice-annual community-wide MDA or standard-of-care MDA, typically annual school-based deworming. Community-wide MDA will be delivered door-to-door, while standard-of-care MDA will be delivered according to national guidelines. The primary outcome is transmission interruption of the STH species present at each site, defined as weighted cluster-level prevalence ≤2% by quantitative polymerase chain reaction (qPCR), 24 months after the final round of MDA. Secondary outcomes include the endline prevalence of STH, overall and by species, and the endline prevalence of STH among children under five as an indicator of incident infections. Secondary analyses will identify cluster-level factors associated with transmission interruption. Prevalence will be assessed using qPCR of stool samples collected from a random sample of cluster residents at baseline, six months after the final round of MDA and 24 months post-MDA. A smaller number of individuals in each cluster will be followed with annual sampling to monitor trends in prevalence and reinfection throughout the trial. TRIAL REGISTRATION:ClinicalTrials.gov NCT03014167.http://europepmc.org/articles/PMC5773085?pdf=render |
| spellingShingle | Kristjana Hrönn Ásbjörnsdóttir Sitara S Rao Ajjampur Roy M Anderson Robin Bailey Iain Gardiner Katherine E Halliday Moudachirou Ibikounle Khumbo Kalua Gagandeep Kang D Timothy J Littlewood Adrian J F Luty Arianna Rubin Means William Oswald Rachel L Pullan Rajiv Sarkar Fabian Schär Adam Szpiro James E Truscott Marleen Werkman Elodie Yard Judd L Walson DeWorm3 Trials Team Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol. PLoS Neglected Tropical Diseases |
| title | Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol. |
| title_full | Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol. |
| title_fullStr | Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol. |
| title_full_unstemmed | Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol. |
| title_short | Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol. |
| title_sort | assessing the feasibility of interrupting the transmission of soil transmitted helminths through mass drug administration the deworm3 cluster randomized trial protocol |
| url | http://europepmc.org/articles/PMC5773085?pdf=render |
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