Coverage of community-wide mass drug administration platforms for soil-transmitted helminths in Benin, India, and Malawi: findings from the DeWorm3 project.

Humans Malawi / epidemiology Mass Drug Administration / statistics & numerical data Female Helminthiasis / drug therapy Male Soil / parasitology Benin / epidemiology India / epidemiology Child Adolescent Adult Albendazole / therapeutic use Anthelmintics / therapeutic use Young Adult Child, Preschool Helminths / drug effects Middle Aged Prevalence

Albendazole Community Coverage Mass drug administration Soil-transmitted helminths

Journal

Infectious diseases of poverty

ISSN: 2049-9957

Titre abrégé: Infect Dis Poverty

Pays: England

ID NLM: 101606645

Informations de publication

Date de publication:
08 Oct 2024

Historique:

received: 05 06 2024

accepted: 12 09 2024

medline: 9 10 2024

pubmed: 9 10 2024

entrez: 8 10 2024

Statut: epublish

Résumé

Soil-transmitted helminths (STH) affect approximately 1.5 billion people globally. The current STH control strategy is annual or twice-annual preventive chemotherapy, typically school-based deworming targeting children and women of reproductive age. Mathematical modeling suggests that it may be possible to interrupt STH transmission through high-coverage community-wide mass drug administration (cMDA). DeWorm3 is a cluster randomized trial testing cMDA for prevalence reduction and transmission interruption. The purpose of this study is to describe coverage of cMDA in study clusters over time and correlates of coverage at individual and cluster levels. From 2018-2020, DeWorm3 delivered six rounds of cMDA with 400 mg albendazole at sites in Benin, India, and Malawi. We report coverage, treatment uptake, and directly observed therapy across all rounds. Factors associated with coverage at the cluster level were identified using binomial generalized estimating equations, while factors associated with non-treatment at the individual level were identified using binomial mixed-effects models. Coverage was high across all clusters and rounds, exceeding the WHO target of 75% in all sites and across all rounds (78% to 95%); cluster-level coverage tended to increase over time. Younger, unmarried, and migratory adults were more likely to be untreated at all sites; adult males were more likely to be untreated in Benin and Malawi. Among children, girls were more likely to be untreated, as were non-school-attending and migratory children. Higher adult education was associated with greater odds of non-treatment among adults, but lower odds among children in the household. Belonging to a less wealthy or minority language-speaking household was associated with non-treatment among both adults and children. It is possible to deliver community-wide MDA with high coverage. Unique individual and community-level factors influence treatment across settings, and these may be addressed through targeted programming. Field Studies on the Feasibility of Interrupting the Transmission of Soil-transmitted Helminths (STH), NCT03014167.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

From 2018-2020, DeWorm3 delivered six rounds of cMDA with 400 mg albendazole at sites in Benin, India, and Malawi. We report coverage, treatment uptake, and directly observed therapy across all rounds. Factors associated with coverage at the cluster level were identified using binomial generalized estimating equations, while factors associated with non-treatment at the individual level were identified using binomial mixed-effects models.

RESULTS RESULTS

Coverage was high across all clusters and rounds, exceeding the WHO target of 75% in all sites and across all rounds (78% to 95%); cluster-level coverage tended to increase over time. Younger, unmarried, and migratory adults were more likely to be untreated at all sites; adult males were more likely to be untreated in Benin and Malawi. Among children, girls were more likely to be untreated, as were non-school-attending and migratory children. Higher adult education was associated with greater odds of non-treatment among adults, but lower odds among children in the household. Belonging to a less wealthy or minority language-speaking household was associated with non-treatment among both adults and children.

CONCLUSIONS CONCLUSIONS

It is possible to deliver community-wide MDA with high coverage. Unique individual and community-level factors influence treatment across settings, and these may be addressed through targeted programming.

TRIAL REGISTRATION BACKGROUND

Field Studies on the Feasibility of Interrupting the Transmission of Soil-transmitted Helminths (STH), NCT03014167.

Identifiants

DOI: 10.1186/s40249-024-01241-0 PMID: 39380086

pubmed: 39380086

doi: 10.1186/s40249-024-01241-0

pii: 10.1186/s40249-024-01241-0

doi:

Substances chimiques

Soil 0

Albendazole F4216019LN

Anthelmintics 0

Banques de données

ClinicalTrials.gov

['NCT03014167']

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

Pagination

Subventions

Organisme : Bill and Melinda Gates Foundation

ID : OPP1129535

Informations de copyright

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