scholarly journals Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment

2019 ◽  
Author(s):  
Paul BIZIMANA ◽  
Katja POLMAN ◽  
Giuseppina ORTU ◽  
Meryam KRIT ◽  
Frédéric NSABIYUMVA ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Negative Binomial ◽  
Health Centre ◽  
Public Health Problem ◽  
Health Care Facilities ◽  
Incidence Data ◽  
School Based ◽  
Intestinal Schistosomiasis ◽  
The Impact

Abstract BackgroundIntestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration (MDA) with praziquantel have been rolled out in 11 endemic districts. The national programme relies on school based surveys with Kato-Katz (KK) to monitor the impact of MDA. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears (DS) at health centre (HC) level could be used.MethodsWe collected routine incidence data on intestinal schistosomiasis from the Burundian National Health Information System. These data concerned the number of intestinal schistosomiasis cases as detected by DS examination in the HC of all 45 sanitary districts (SD) between 2011 and 2015. A temporal trends analysis was performed using mixed Negative Binomial regression. Sanitary districts with MDA campaigns with praziquantel (n=11) were compared with those without (n=34). In addition, KK-based prevalence data from a school-based national mapping in 2014 were compared with the DS-based incidence data in the 45 SD.ResultsIn the 11 SD applying MDA with praziquantel, the incidence rate decreased significantly for the years 2014 (β2014=-0.826, p=0.010) and 2015 (β2015=-1.294, p<0.001) and for the five-year period (β=-0.286, p<0.001), whereas in the 34 districts without MDA, there was no significant trend (β=-0.087, p=0.219). In most of the 45 SD, the low prevalences based on KK in school children were confirmed by low incidence rates based on DS in the HC.ConclusionsThe results of this preliminary study suggest that routine surveillance data at HC level, may be able to monitor the impact of MDA with praziquantel on intestinal schistosomiasis in Burundi. However, more sensitive POC diagnostic tests, such as the POC-CCA assay are desirable when moving from control to elimination of schistosomiasis. Elimination of intestinal schistosomiasis calls for integration of adequate diagnosis and treatment into routine activities of primary health care facilities.

scholarly journals Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment.

2020 ◽  
Author(s):  
Paul BIZIMANA ◽  
Katja POLMAN ◽  
Giuseppina ORTU ◽  
Meryam KRIT ◽  
Frédéric NSABIYUMVA ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Centre ◽  
Health Information System ◽  
Routine Data ◽  
Direct Smear ◽  
Incidence Data ◽  
Intestinal Schistosomiasis ◽  
The Impact ◽  
Health Centre Level

Abstract Background : Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel have been rolled out in 11 endemic districts. The national programme relies on school-based surveys with Kato-Katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. Methods : From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts between 2011 and 2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n=11) were compared with those without (n=34). In addition, prevalence data on intestinal schistosomiasis based on Kato-Katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. Findings : In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β 2014 =-0.826, p=0.010) and 2015 (β 2015 =-1.294, p<0.001) and for the five-year period (β=-0.286, p<0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β=-0.087, p=0.219). In most of the 45 sanitary districts, the low prevalences based on Kato-Katz in schoolchildren were confirmed by low incidence rates based on direct smear in the health centres. Conclusions : National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the Point-of-care Circulating Cathodic Antigen assay are desirable. Keywords : Direct smear, Health centre, Mass drug administration, Monitoring, Praziquantel, Routine data, Schistosomiasis, Burundi

scholarly journals Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment.

2020 ◽  
Author(s):  
Paul BIZIMANA ◽  
Katja POLMAN ◽  
Giuseppina ORTU ◽  
Meryam KRIT ◽  
Frédéric NSABIYUMVA ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Centre ◽  
Health Information System ◽  
Routine Data ◽  
Direct Smear ◽  
Incidence Data ◽  
Intestinal Schistosomiasis ◽  
The Impact ◽  
Health Centre Level

Abstract Background : Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel have been rolled out in 11 endemic districts. The national programme relies on school-based surveys with Kato-Katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. Methods : From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts between 2011 and 2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n=11) were compared with those without (n=34). In addition, prevalence data on intestinal schistosomiasis based on Kato-Katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. Findings : In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β 2014 = -0.826, p = 0.010) and 2015 (β 2015 = -1.294, p < 0.001) and for the five-year period (β = -0.286, p < 0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β = -0.087, p = 0.219). In most of the 45 sanitary districts, the low prevalences based on Kato-Katz in schoolchildren were confirmed by low incidence rates based on direct smear in the health centres. Conclusions : National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the Point-of-care Circulating Cathodic Antigen assay are desirable. Keywords : Burundi; direct smear; health centre; mass drug administration; monitoring; routine data; praziquantel; schistosomiasis

scholarly journals Evaluating the Impact of Programmatic Mass Drug Administration for Malaria in Zambia Using Routine Incidence Data

2020 ◽  
Author(s):  
Maya Fraser ◽  
John M Miller ◽  
Kafula Silumbe ◽  
Michael Hainsworth ◽  
Mutinta Mudenda ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Malaria Elimination ◽  
Negative Binomial ◽  
Comparison Group ◽  
Malaria Incidence ◽  
Group Analysis ◽  
Routine Data ◽  
Incidence Data ◽  
The Impact

Abstract Background In 2016, the Zambian National Malaria Elimination Centre started programmatic mass drug administration (pMDA) campaigns with dihydroartemisinin-piperaquine as a malaria elimination tool in Southern Province. Two rounds were administered, 2 months apart (coverage 70% and 57%, respectively). We evaluated the impact of 1 year of pMDA on malaria incidence using routine data. Methods We conducted an interrupted time series with comparison group analysis on monthly incidence data collected at the health facility catchment area (HFCA) level, with a negative binomial model using generalized estimating equations. Programmatic mass drug administration was conducted in HFCAs with greater than 50 cases/1000 people per year. Ten HFCAs with incidence rates marginally above this threshold (pMDA group) were compared with 20 HFCAs marginally below (comparison group). Results The pMDA HFCAs saw a 46% greater decrease in incidence at the time of intervention than the comparison areas (incidence rate ratio = 0.536; confidence interval = 0.337–0.852); however, incidence increased toward the end of the season. No HFCAs saw a transmission interruption. Conclusions Programmatic mass drug administration, implemented during 1 year with imperfect coverage in low transmission areas with suboptimal vector control coverage, significantly reduced incidence. However, elimination will require additional tools. Routine data are important resources for programmatic impact evaluations and should be considered for future analyses.

scholarly journals Modelling trachoma post 2020: Opportunities for mitigating the impact of COVID-19 and accelerating progress towards elimination

2020 ◽  
Author(s):  
Anna Borlase ◽  
Seth Blumberg ◽  
E Kelly Callahan ◽  
Michael S Deiner ◽  
Scott D Nash ◽  
...  
Keyword(s):  
Public Health ◽  
Mathematical Model ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Problem ◽  
Public Health Problem ◽  
Appropriate Use ◽  
Alternative Strategies ◽  
The Impact

AbstractBackgroundThe COVID-19 pandemic has disrupted planned annual antibiotic mass drug administration (MDA) activities which have formed the cornerstone of the largely successful global efforts to eliminate trachoma as a public health problem.MethodsUsing a mathematical model we investigate the impact of interruption to MDA in trachoma-endemic settings. We evaluate potential measures to mitigate this impact and consider alternative strategies for accelerating progress in those areas where the trachoma elimination targets may not be achievable otherwise.ResultsWe demonstrate that for districts which were hyperendemic at baseline, or where the trachoma elimination thresholds have not already been achieved after 3 rounds of MDA, the interruption to planned MDA could lead to a delay greater than the duration of interruption. We also show that an additional round of MDA in the year following MDA resumption could effectively mitigate this delay. For districts where probability of elimination under annual MDA was already very low, we demonstrate that more intensive MDA schedules are needed to achieve agreed targets.ConclusionThrough appropriate use of additional MDA, the impact of COVID-19 in terms of delay to reaching trachoma elimination targets can be effectively mitigated. Additionally, more frequent MDA may accelerate progress towards 2030 goals.

scholarly journals What is the impact of acquired immunity on the transmission of schistosomiasis and the efficacy of current and planned mass drug administration programmes?

2021 ◽  
Vol 15 (12) ◽  
pp. e0009946
Author(s):  
Klodeta Kura ◽  
Robert J. Hardwick ◽  
James E. Truscott ◽  
Roy M. Anderson
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Public Health Problem ◽  
Basic Reproductive Number ◽  
World Health ◽  
Reproductive Number ◽  
Acquired Immunity ◽  
High Transmission ◽  
Age Related ◽  
The Impact

Schistosomiasis causes severe morbidity in many countries with endemic infection with the schistosome digenean parasites in Africa and Asia. To control and eliminate the disease resulting from infection, regular mass drug administration (MDA) is used, with a focus on school-aged children (SAC; 5–14 years of age). In some high transmission settings, the World Health Organization (WHO) also recommends the inclusion of at-risk adults in MDA treatment programmes. The question of whether ecology (age-dependant exposure) or immunity (resistance to reinfection), or some combination of both, determines the form of observed convex age-intensity profile is still unresolved, but there is a growing body of evidence that the human hosts acquire some partial level of immunity after a long period of repeated exposure to infection. In the majority of past research modelling schistosome transmission and the impact of MDA programmes, the effect of acquired immunity has not been taken into account. Past work has been based on the assumption that age-related contact rates generate convex horizontal age-intensity profiles. In this paper, we use an individual based stochastic model of transmission and MDA impact to explore the effect of acquired immunity in defined MDA programmes. Compared with scenarios with no immunity, we find that acquired immunity makes the MDA programme less effective with a slower decrease in the prevalence of infection. Therefore, the time to achieve morbidity control and elimination as a public health problem is longer than predicted by models with just age-related exposure and no build-up of immunity. The level of impact depends on the baseline prevalence prior to treatment (the magnitude of the basic reproductive number R0) and the treatment frequency, among other factors. We find that immunity has a larger impact within moderate to high transmission settings such that it is very unlikely to achieve morbidity and transmission control employing current MDA programmes.

scholarly journals The impact of mass drug administration on Schistosoma haematobium infection: what is required to achieve morbidity control and elimination?

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Klodeta Kura ◽  
Robert J. Hardwick ◽  
James E. Truscott ◽  
Jaspreet Toor ◽  
T. Deirdre Hollingsworth ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Schistosoma Haematobium ◽  
Treatment Guidelines ◽  
Public Health Problem ◽  
Data Availability ◽  
World Health ◽  
Morbidity Control ◽  
Health Organization ◽  
The Impact

Abstract Background Schistosomiasis remains an endemic parasitic disease causing much morbidity and, in some cases, mortality. The World Health Organization (WHO) has outlined strategies and goals to combat the burden of disease caused by schistosomiasis. The first goal is morbidity control, which is defined by achieving less than 5% prevalence of heavy intensity infection in school-aged children (SAC). The second goal is elimination as a public health problem (EPHP), achieved when the prevalence of heavy intensity infection in SAC is reduced to less than 1%. Mass drug administration (MDA) of praziquantel is the main strategy for control. However, there is limited availability of praziquantel, particularly in Africa where there is high prevalence of infection. It is therefore important to explore whether the WHO goals can be achieved using the current guidelines for treatment based on targeting SAC and, in some cases, adults. Previous modelling work has largely focused on Schistosoma mansoni, which in advance cases can cause liver and spleen enlargement. There has been much less modelling of the transmission of Schistosoma haematobium, which in severe cases can cause kidney damage and bladder cancer. This lack of modelling has largely been driven by limited data availability and challenges in interpreting these data. Results In this paper, using an individual-based stochastic model and age-intensity profiles of S. haematobium from two different communities, we calculate the probability of achieving the morbidity and EPHP goals within 15 years of treatment under the current WHO treatment guidelines. We find that targeting SAC only can achieve the morbidity goal for all transmission settings, regardless of the burden of infection in adults. The EPHP goal can be achieved in low transmission settings, but in some moderate to high settings community-wide treatment is needed. Conclusions We show that the key determinants of achieving the WHO goals are the precise form of the age-intensity of infection profile and the baseline SAC prevalence. Additionally, we find that the higher the burden of infection in adults, the higher the chances that adults need to be included in the treatment programme to achieve EPHP.

scholarly journals Modelling trachoma post-2020: opportunities for mitigating the impact of COVID-19 and accelerating progress towards elimination

2021 ◽  
Author(s):  
Anna Borlase ◽  
Seth Blumberg ◽  
E Kelly Callahan ◽  
Michael S Deiner ◽  
Scott D Nash ◽  
...  
Keyword(s):  
Public Health ◽  
Mathematical Model ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Problem ◽  
Public Health Problem ◽  
Appropriate Use ◽  
Alternative Strategies ◽  
The Impact

Abstract Background The COVID-19 pandemic has disrupted planned annual antibiotic mass drug administration (MDA) activities that have formed the cornerstone of the largely successful global efforts to eliminate trachoma as a public health problem. Methods Using a mathematical model we investigate the impact of interruption to MDA in trachoma-endemic settings. We evaluate potential measures to mitigate this impact and consider alternative strategies for accelerating progress in those areas where the trachoma elimination targets may not be achievable otherwise. Results We demonstrate that for districts that were hyperendemic at baseline, or where the trachoma elimination thresholds have not already been achieved after three rounds of MDA, the interruption to planned MDA could lead to a delay to reaching elimination targets greater than the duration of interruption. We also show that an additional round of MDA in the year following MDA resumption could effectively mitigate this delay. For districts where the probability of elimination under annual MDA was already very low, we demonstrate that more intensive MDA schedules are needed to achieve agreed targets. Conclusion Through appropriate use of additional MDA, the impact of COVID-19 in terms of delay to reaching trachoma elimination targets can be effectively mitigated. Additionally, more frequent MDA may accelerate progress towards 2030 goals.

scholarly journals Feasibility of onchocerciasis elimination using a “test-and-not-treat” strategy in Loa loa co-endemic areas

2020 ◽  
Author(s):  
David J Blok ◽  
Joseph Kamgno ◽  
Sebastien D Pion ◽  
Hugues C Nana-Djeunga ◽  
Yannick Niamsi-Emalio ◽  
...  
Keyword(s):  
Adverse Events ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Treatment Duration ◽  
Loa Loa ◽  
Serious Adverse Events ◽  
Endemic Areas ◽  
The Individual ◽  
The Impact ◽  
Main Strategy

Abstract Background Mass drug administration (MDA) with ivermectin is the main strategy for onchocerciasis elimination. Ivermectin is generally safe but associated with serious adverse events in individuals with high Loa loa microfilarial densities (MFD). Therefore, ivermectin MDA is not recommended in areas where onchocerciasis is hypo-endemic and L. loa is co-endemic. To eliminate onchocerciasis in those areas, a test-and-not-treat (TaNT) strategy has been proposed. We investigated whether onchocerciasis elimination can be achieved using TaNT and the required duration. Methods We used the individual-based model ONCHOSIM to predict the impact of TaNT on onchocerciasis microfilarial (mf) prevalence. We simulated pre-control mf prevalence levels from 2-40%. The impact of TaNT was simulated under varying levels of participation, systematic non-participation and exclusion from ivermectin due to high L. loa MFD. For each scenario, we assessed the time to elimination, defined as bringing onchocerciasis mf prevalence below 1.4%. Results In areas with 30-40% pre-control mf prevalence, the model predicted that it would take between 14 and 16 years to bring the mf prevalence below 1.4% using conventional MDA, assuming 65% participation. TaNT would increase the time to elimination by up to 1.5 years, depending on the level of systematic non-participation and the exclusion rate. At lower exclusion rates (≤2.5%), the delay would be less than six months. Conclusions Our model predicts that onchocerciasis can be eliminated using TaNT in L. loa co-endemic areas. The required treatment duration using TaNT would be only slightly longer than in areas with conventional MDA, provided that participation is good.

scholarly journals Spatio-temporal dynamics of schistosomiasis in Rwanda between 2001 and 2012: impact of the national Neglected Tropical Disease control programme

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Elias Nyandwi ◽  
Tom Veldkamp ◽  
Frank Badu Osei ◽  
Sherif Amer
Keyword(s):  
Temporal Dynamics ◽  
Public Health Problem ◽  
Incidence Rates ◽  
Control Programme ◽  
Scan Statistics ◽  
Major Public Health Problem ◽  
Implementation Phase ◽  
Incidence Data ◽  
Spatio Temporal ◽  
The Impact

Schistosomiasis is recognised as a major public health problem in Rwanda. We aimed to identify the spatio-temporal dynamics of its distribution at a fine-scale spatial resolution and to explore the impact of control programme interventions. Incidence data of Schistosoma mansoni infection at 367 health facilities were obtained for the period 2001-2012. Disease cluster analyses were conducted using spatial scan statistics and geographic information systems. The impact of control interventions was assessed for three distinct sub-periods. Findings demonstrated persisting, emerging and re-emerging clusters of schistosomiasis infection across space and time. The control programme initially caused an abrupt increase in incidence rates during its implementation phase. However, this was followed by declining and disappearing clusters when the programme was fully in place. The findings presented should contribute to a better understanding of the dynamics of schistosomiasis distribution to be used when implementing future control activities, including prevention and elimination efforts.

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