Does mass drug administration of azithromycin reduce child mortality?

IntroductionAzithromycin has been given for tropical infectious diseases such as trachoma and yaws by mass drug administration (MDA). As well as controlling the infectious disease in question, MDA may have a beneficial effect in reducing mortality in young children. However, the dose, formulation, frequency and duration of azithromycin used in certain infectious diseases may vary in different studies, and these differences may have impacts on the effectiveness of azithromycin MDA. Furthermore, whether the dose, formulation, frequency and duration are associated with the effectiveness of azithromycin for reducing child mortality—if indeed this effect can be confirmed—remain unknown. In this study, we will investigate whether different strategies such as different dose, formulation, frequency and duration affect the effectiveness of azithromycin MDA on the prevalence of certain infectious diseases or child mortality.Methods and analysisA narrative systematic review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched. No language restrictions will be applied. All randomised/quasi-controlled trials, observational studies (cross-sectional studies, cohort studies and case–control studies), case series and registered protocols will be considered. Dose, duration, frequency, rounds and formulations of azithromycin used in MDA will be collected and reviewed. The outcomes will be disease prevalence/control in children and child mortality. Data from the individual studies will not be pooled.Ethics and disseminationFormal ethical approval is not required since data will be collected from published studies. This systematic review will be published in a peer-reviewed journal and presented at conference meetings.PROSPERO registration numberCRD42018114902

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Do Net Aid Transfers Reduce Child Mortality?

SSRN Electronic Journal ◽

10.2139/ssrn.1913933 ◽

2011 ◽

Author(s):

John Shellito

Keyword(s):

Child Mortality ◽

Reduce Child Mortality

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The Effectiveness of Reactive Focal Mass Drug Administration (rfMDA) and Reactive Focal Vector Control (RAVC) to Reduce Malaria Transmission: A Cluster-Randomised Controlled Open Label Two-by-Two Factorial Design Trial from the Low-Endemic Setting of Namibia

SSRN Electronic Journal ◽

10.2139/ssrn.3454698 ◽

2019 ◽

Author(s):

Michelle Hsiang ◽

Henry Ntuku ◽

Kathryn W. Roberts ◽

Mi-Suk Kang Dufour ◽

Brooke Whittemore ◽

...

Keyword(s):

Vector Control ◽

Factorial Design ◽

Malaria Transmission ◽

Drug Administration ◽

Mass Drug Administration ◽

Open Label ◽

Endemic Setting ◽

Cluster Randomised ◽

Randomised Controlled

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Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666190206210808 ◽

2020 ◽

Vol 20 (2) ◽

pp. 167-174

Author(s):

Ilo Dicko ◽

Yaya Ibrahim Coulibaly ◽

Modibo Sangaré ◽

Bismark Sarfo ◽

Priscillia Awo Nortey

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Health Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Improve Compliance ◽

Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

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Costing interventions in the field: preliminary cost estimates and lessons learned from an evaluation of community-wide mass drug administration for elimination of soil-transmitted helminths in the DeWorm3 trial

BMJ Open ◽

10.1136/bmjopen-2021-049734 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049734

Author(s):

Katya Galactionova ◽

Maitreyi Sahu ◽

Samuel Paul Gideon ◽

Saravanakumar Puthupalayam Kaliappan ◽

Chloe Morozoff ◽

...

Keyword(s):

Data Collection ◽

Drug Administration ◽

Financial Reporting ◽

Mass Drug Administration ◽

Lessons Learned ◽

Secondary Outcome ◽

Data Quality Control ◽

Soil Transmitted Helminths ◽

Trade Offs ◽

Rich Data

ObjectiveTo present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination of soil-transmitted helminths.DesignTailored data collection instruments covering resource use, expenditure and operational details were developed for each site. These were populated alongside field activities by on-site staff. Data quality control and validation processes were established. Programmed routines were used to clean, standardise and analyse data to derive costs of cMDA and supportive activities.SettingField site and collaborating research institutions.Primary and secondary outcome measuresA strategy for costing interventions in parallel with field activities was discussed. Interim estimates of cMDA costs obtained with the strategy were presented for one of the trial sites.ResultsThe study demonstrated that it was both feasible and advantageous to collect data alongside field activities. Practical decisions on implementing the strategy and the trade-offs involved varied by site; trialists and local partners were key to tailoring data collection to the technical and operational realities in the field. The strategy capitalised on the established processes for routine financial reporting at sites, benefitted from high recall and gathered operational insight that facilitated interpretation of the estimates derived. The methodology produced granular costs that aligned with the literature and allowed exploration of relevant scenarios. In the first year of the trial, net of drugs, the incremental financial cost of extending deworming of school-aged children to the whole community in India site averaged US$1.14 (USD, 2018) per person per round. A hypothesised at-scale routine implementation scenario yielded a much lower estimate of US$0.11 per person treated per round.ConclusionsWe showed that costing interventions alongside field activities offers unique opportunities for collecting rich data to inform policy toward optimising health interventions and for facilitating transfer of economic evidence from the field to the programme.Trial registration numberNCT03014167; Pre-results.

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Estimating the programmatic cost of targeted mass drug administration for malaria in Myanmar

BMC Public Health ◽

10.1186/s12889-021-10842-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shwe Sin Kyaw ◽

Gilles Delmas ◽

Tom L. Drake ◽

Olivier Celhay ◽

Wirichada Pan-ngum ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Malaria Elimination ◽

Unit Cost ◽

Financial Data ◽

Research Activities ◽

High Incidence ◽

Implementation Costs ◽

The Cost ◽

Greater Mekong Subregion

Abstract Background Mass drug administration (MDA) has received growing interest to accelerate the elimination of multi-drug resistant malaria in the Greater Mekong Subregion. Targeted MDA, sometimes referred to as focal MDA, is the practice of delivering MDA to high incidence subpopulations only, rather than the entire population. The potential effectiveness of delivering targeted MDA was demonstrated in a recent intervention in Kayin State, Myanmar. Policymakers and funders need to know what resources are required if MDA, targeted or otherwise, is to be included in elimination packages beyond existing malaria interventions. This study aims to estimate the programmatic cost and the unit cost of targeted MDA in Kayin State, Myanmar. Methods We used financial data from a malaria elimination initiative, conducted in Kayin State, to estimate the programmatic costs of the targeted MDA component using a micro-costing approach. Three activities (community engagement, identification of villages for targeted MDA, and conducting mass treatment in target villages) were evaluated. We then estimated the programmatic costs of implementing targeted MDA to support P. falciparum malaria elimination in Kayin State. A costing tool was developed to aid future analyses. Results The cost of delivering targeted MDA within an integrated malaria elimination initiative in eastern Kayin State was approximately US$ 910,000. The cost per person reached, distributed among those in targeted and non-targeted villages, for the MDA component was US$ 2.5. Conclusion This cost analysis can assist policymakers in determining the resources required to clear malaria parasite reservoirs. The analysis demonstrated the value of using financial data from research activities to predict programmatic implementation costs of targeting MDA to different numbers of target villages.

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