scholarly journals Implementation of mass drug administration for neglected tropical diseases in Guinea during the COVID-19 pandemic

2021 ◽  
Vol 15 (9) ◽  
pp. e0009807
Author(s):  
Fatoumata Sakho ◽  
Christelly Flore Badila ◽  
Benoit Dembele ◽  
Aissatou Diaby ◽  
Abdoul Karim Camara ◽  
...  

Background Guinea reported its first case of COVID-19 on March 12, 2020. Soon thereafter, a national state of emergency was declared, all land borders were closed, schools were shut down, and public gatherings were limited. Many health activities, including field-based activities targeting neglected tropical diseases (NTDs), were paused. The World Health Organization (WHO) issued updated guidance on the resumption of NTD field-based activities on July 27, 2020. In response, the Guinea Ministry of Health (MoH) and its partners planned and resumed mass drug administration (MDA) in mid-August to September 2020 in 19 health districts. Methodology/principal findings A risk-benefit assessment was conducted to identify potential risks associated with the MDA in the COVID-19 context. Following this assessment, a risk mitigation plan with barrier measures was developed to guide MDA implementation. These measures included COVID-19 testing for all national staff leaving Conakry, mask wearing, social distancing of two meters, and hand washing/sanitizing. A checklist was developed and used to monitor compliance to risk mitigation measures. Data on adherence to risk mitigation measures were collected electronically during the MDA. A total of 120 checklists, representing 120 community drug distributor (CDD) teams (two CDDs per team) and 120 households, were completed. Results indicated that washing or disinfecting hands was practiced by 68.3% of CDD teams, compared to 45.0% among households. Face masks to cover the mouth and nose were worn by 79.2% of CDD teams, while this was low among households (23.3%). In 87.5% of households, participants did not touch the dose pole and in 88.3% of CDD teams, CDDs did not touch the hands of the participants while giving the drugs. A large majority of CDD teams (94.2%) and household members (94.2%) were willing to participate in the MDA despite the pandemic. The epidemiological coverage was ≥65% for lymphatic filariasis, onchocerciasis and soil-transmitted helminths in 10 out of 19 HDs and ≥75% for schistosomiasis for school-aged children in 7 out of 11 HDs. Conclusions/significance Guinea was one of the first countries in Africa to resume MDA activities during the COVID-19 pandemic without causing an observed increase of transmission. The development of a risk mitigation plan and a method to monitor adherence to barrier measures was critical to this unprecedented effort. The rapid incorporation of COVID-19 barrier measures and their acceptance by CDDs and household members demonstrated both the adaptability of the National NTD Program to respond to emerging issues and the commitment of the MoH to implement NTD programs.

2021 ◽  
Vol 15 (8) ◽  
pp. e0009625
Author(s):  
Nyuk Sian Chong ◽  
Stacey R. Smith? ◽  
Marleen Werkman ◽  
Roy M. Anderson

The World Health Organization has recommended the application of mass drug administration (MDA) in treating high prevalence neglected tropical diseases such as soil-transmitted helminths (STHs), schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. MDA—which is safe, effective and inexpensive—has been widely applied to eliminate or interrupt the transmission of STHs in particular and has been offered to people in endemic regions without requiring individual diagnosis. We propose two mathematical models to investigate the impact of MDA on the mean number of worms in both treated and untreated human subpopulations. By varying the efficay of drugs, initial conditions of the models, coverage and frequency of MDA (both annual and biannual), we examine the dynamic behaviour of both models and the possibility of interruption of transmission. Both models predict that the interruption of transmission is possible if the drug efficacy is sufficiently high, but STH infection remains endemic if the drug efficacy is sufficiently low. In between these two critical values, the two models produce different predictions. By applying an additional round of biannual and annual MDA, we find that interruption of transmission is likely to happen in both cases with lower drug efficacy. In order to interrupt the transmission of STH or eliminate the infection efficiently and effectively, it is crucial to identify the appropriate efficacy of drug, coverage, frequency, timing and number of rounds of MDA.


2018 ◽  
Author(s):  
Julia C Dunn ◽  
Alison A Bettis ◽  
Nay Yee Wyine ◽  
Aye Moe Moe Lwin ◽  
Aung Tun ◽  
...  

AbstractMass drug administration (MDA), targeted at school-aged children is the method recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds. In countries with endemic infection, such as Myanmar, the MDA coverage, who is targeted, and rates of reinfection in given environmental and social settings will determine how effective mass drug treatment is in suppressing transmission in the long-term. In this paper, data from an epidemiology study on STH, conducted between June 2015 and June 2016 in the delta region of Myanmar, are analysed to determine the risks of STH infection in the whole community over a year which included two MDA rounds. Risk ratios (RRs) for the four-month reinfection period were below one, whereas RRs for the six-month reinfection period were above one, indicating that more people were infected after six months of exposure post-MDA. Evidence of predisposition, as measured by the Kendall Tau-b statistic, was found for all STH species and across all age groups. This study demonstrates that a six-month gap between MDA in these communities is enough time for STH infection to return to pre-MDA levels and that the same individuals are being consistently infected between MDA rounds.Author summaryMass drug administration (MDA), treating either whole communities or targeted groups without a prior diagnosis, is used as a control strategy for many neglected tropical diseases, including soil-transmitted helminth (STH) infection. MDA takes place at set intervals, aiming to reduce morbidity caused by the target disease and potentially interrupt transmission. In this study we measure STH infection in two villages in the delta region of Myanmar over the course of a year, both before and after MDA rounds, to quantify the effect of treatment on infection and to identify groups with persistent infections. We found that whilst overall prevalence of STH infection decreased over the year, intensity of infection, measured by eggs per gram of faeces, did not significantly decrease. We also found evidence to suggest that particular people are predisposed to STH infection. This is possibly due to non-compliance to MDA, or behavioural and social factors. The findings presented here will provide evidence to support continuing Myanmar’s MDA programme for STH control and using accurate diagnostics to identify and target “predisposed” people for sustained treatment.


2020 ◽  
Vol 27 ◽  
Author(s):  
Kush K. Maheshwari ◽  
Debasish Bandyopadhyay

Background: Neglected tropical diseases (NTDs) affect a huge population of the world and majority of the victims belong to the poor community of the developing countries. Until now, the World Health Organization (WHO) has identified 20 tropical diseases as NTDs that must be addressed with high priority. However, many heterocyclic scaffolds have demonstrated potent therapeutic activity against several NTDs. Objective: There are three major objectives: (1) To discuss the causes, symptoms, and current status of all the 20 NTDs; (2) To explore the available heterocyclic drugs, and their mechanism of actions (if known) that are being used to treat NTDs; (3) To develop general awareness on NTDs among the medicinal/health research community and beyond. Methods: The 20 NTDs have been discussed according to their alphabetic orders along with the possible heterocyclic remedies. Current status of treatment with an emphasis on the heterocyclic drugs (commercially available and investigational) has been outlined. In addition, brief discussion of the impacts of NTDs on socio-economic condition is included. Results: NTDs are often difficult to diagnose and the problem is worsened by the unhealthy hygiene, improper awareness, and inadequate healthcare in the developing countries where these diseases primarily affect poor people. The statistics include duration of suffering, numbers affected, and access to healthcare and medication. The mechanism of actions of various heterocyclic drugs, if reported, have been briefly summarized. Conclusion: Scientists and pharmaceutical corporations should allocate more resources to reveal the in-depth mechanism of actions of many heterocyclic drugs that are currently being used for the treatment of NTDs. Analysis of current heterocyclic compounds and development of new medications can help in the fight to reduce/remove the devastating effects of NTDs. An opinion-based concise review has been presented. Based on available literature, this is the first effect to present all the 20 NTDs and related heterocyclic compounds under the same umbrella.


2011 ◽  
Vol 85 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Ann S. Goldman ◽  
Molly A. Brady ◽  
Luccene Desir ◽  
Abdel Direny ◽  
Roland Oscard ◽  
...  

2018 ◽  
Vol 3 (4) ◽  
pp. 122 ◽  
Author(s):  
Alayne Adams ◽  
Myriam Vuckovic ◽  
Eleanor Birch ◽  
Tara Brant ◽  
Stephanie Bialek ◽  
...  

Since 1950, the global urban population grew from 746 million to almost 4 billion and is expected to reach 6.4 billion by mid-century. Almost 90% of this increase will take place in Asia and Africa and disproportionately in urban slums. In this context, concerns about the amplification of several neglected tropical diseases (NTDs) are warranted and efforts towards achieving effective mass drug administration (MDA) coverage become even more important. This narrative review considers the published literature on MDA implementation for specific NTDs and in-country experiences under the ENVISION and END in Africa projects to surface features of urban settings that challenge delivery strategies known to work in rural areas. Discussed under the thematics of governance, population heterogeneity, mobility and community trust in MDA, these features include weak public health infrastructure and programs, challenges related to engaging diverse and dynamic populations and the limited accessibility of certain urban settings such as slums. Although the core components of MDA programs for NTDs in urban settings are similar to those in rural areas, their delivery may need adjustment. Effective coverage of MDA in diverse urban populations can be supported by tailored approaches informed by mapping studies, research that identifies context-specific methods to increase MDA coverage and rigorous monitoring and evaluation.


2020 ◽  
pp. bjophthalmol-2020-315815
Author(s):  
Catherine E Oldenburg ◽  
Solomon Aragie ◽  
Abdou Amza ◽  
Anthony W Solomon ◽  
Jessica Brogdon ◽  
...  

Background/AimsAlthough tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.MethodsWe conducted a survey at the beginning of a trachoma eradication session at the 2019 Coalition for Operational Research on Neglected Tropical Diseases meeting in National Harbor, Maryland, USA. We asked respondents what the most important goal of azithromycin mass drug administration was for trachoma (control, elimination of infection or eradication) and if and when they believed trachoma eradication would occur. We then asked what the biggest obstacles were to global eradication.ResultsFifty-six surveys were returned (95%). Most (91%) participants reported that the most important goal of azithromycin mass drug administration was control or elimination of infection, and 24% of participants reported that global eradication was not possible. Of the 76% who reported a year by which they believed trachoma could be eradicated, most fell between 2040 and 2050. Commonly cited barriers to global eradication included lack of surveillance tools to confirm eradication or monitor for infection recrudescence (32%) and lack of resources (23%).ConclusionsDevelopment of alternative indicators for trachoma surveillance and continued investment in trachoma programmes, particularly focused support in the most heavily affected populations, might increase enthusiasm for the feasibility of eradication.


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