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 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 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 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 The impact of mass drug administration expansion to low onchocerciasis prevalence settings in case of connected villages

2021 ◽  
Vol 15 (5) ◽  
pp. e0009011
Author(s):  
Anneke S. de Vos ◽  
Wilma A. Stolk ◽  
Luc E. Coffeng ◽  
Sake J. de Vlas
Keyword(s):  
Intermediate Host ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Human Populations ◽  
Individual Based Model ◽  
Low Prevalence ◽  
The Impact ◽  
Local Transmission

Background The existence of locations with low but stable onchocerciasis prevalence is not well understood. An often suggested yet poorly investigated explanation is that the infection spills over from neighbouring locations with higher infection densities. Methodology We adapted the stochastic individual based model ONCHOSIM to enable the simulation of multiple villages, with separate blackfly (intermediate host) and human populations, which are connected through the regular movement of the villagers and/or the flies. With this model we explore the impact of the type, direction and degree of connectedness, and of the impact of localized or full-area mass drug administration (MDA) over a range of connected village settings. Principal findings In settings with annual fly biting rates (ABR) below the threshold needed for stable local transmission, persistence of onchocerciasis prevalence can well be explained by regular human traffic and/or fly movement from locations with higher ABR. Elimination of onchocerciasis will then theoretically be reached by only implementing MDA in the higher prevalence area, although lingering infection in the low prevalence location can trigger resurgence of transmission in the total region when MDA is stopped too soon. Expanding MDA implementation to the lower ABR location can therefore shorten the duration of MDA needed. For example, when prevalence spill-over is due to human traffic, and both locations have about equal populations, then the MDA duration can be shortened by up to three years. If the lower ABR location has twice as many inhabitants, the reduction can even be up to six years, but if spill-over is due to fly movement, the expected reduction is less than a year. Conclusions/Significance Although MDA implementation might not always be necessary in locations with stable low onchocerciasis prevalence, in many circumstances it is recommended to accelerate achieving elimination in the wider area.

EVALUATION OF LYMPHATIC FILARIASIS AFTER TWO ROUNDS OF MASS DRUG ADMINISTRATION IN LAU LOCAL GOVERNMENT AREA OF TARABA STATE NIGERIA

2021 ◽  
Vol 4 (4) ◽  
pp. 513-519
Author(s):  
D. E. Akafyi ◽  
I. S. Ndams ◽  
S. A. Luka ◽  
F. S. Ojeleye ◽  
S. O. Elkanah ◽  
...  
Keyword(s):  
Local Government ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Clinical Manifestations ◽  
Wuchereria Bancrofti ◽  
Local Government Area ◽  
Filarial Antigen ◽  
Physical Examinations ◽  
The Impact ◽  
Card Test

This study was undertaken to evaluate the effects of Mass Drug Administration (MDA) on Wuchereria bancrofti (microfilariae) after two rounds of combined Ivermectin and Albendazole distribution. A total of 221 participants were recruited in three communities in Lau Local Government Area of Taraba State by convenience sampling method. Questionnaires and physical examinations were used to assess clinical manifestations associated with the infection. Blood samples were collected by finger prick method and stained with Giemsa stain for examination to establish the presence of W. bancrofti while immunochromatographic card test was performed to determine the presence of filarial antigen in serum. Previous data were used to determine the pre-drug prevalence of the parasite. The results showed that the drug did not significantly reduce the clinical manifestations reported among the patients. The microfilariae prevalence and microfilaria mean density after two rounds of drug administration was 19.5% and 1.49%, while the pre- MDA prevalence and microfilaria mean density was 27.8% and 2.44% respectively. There was a statistically significant decrease of microfilaria prevalence (P<0.05) after two rounds of MDA. There was no significant effect of MDA by age, sex and occupation-related microfilariae prevalence in the study area.  In conclusion, the study reveals that microfilaria prevalence and load decreased after two rounds of MDA of combined Ivermectin and Albendazole distribution amongst the studied populations. Routine evaluation of the MDA is required to assess the impact of the drug for the eventual elimination of the infection.

scholarly journals Optimising systemic insecticide use to improve malaria control

2019 ◽  
Vol 4 (6) ◽  
pp. e001776 ◽  
Author(s):  
Hannah R Meredith ◽  
Luis Furuya-Kanamori ◽  
Laith Yakob
Keyword(s):  
Vector Control ◽  
Malaria Transmission ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Companion Animals ◽  
Malaria Vectors ◽  
Systemic Insecticide ◽  
Blood Concentrations ◽  
Systemic Insecticides ◽  
The Impact

BackgroundLong-lasting insecticidal nets and indoor residual sprays have significantly reduced the burden of malaria. However, several hurdles remain before elimination can be achieved: mosquito vectors have developed resistance to public health insecticides, including pyrethroids, and have altered their biting behaviour to avoid these indoor control tools. Systemic insecticides, drugs applied directly to blood hosts to kill mosquitoes that take a blood meal, offer a promising vector control option. To date, most studies focus on repurposing ivermectin, a drug used extensively to treat river blindness. There is concern that overdependence on a single drug will inevitably repeat past experiences with the rapid spread of pyrethroid resistance in malaria vectors. Diversifying the arsenal of systemic insecticides used for mass drug administration would improve this strategy’s sustainability.MethodsHere, a review was conducted to identify systemic insecticide candidates and consolidate their pharmacokinetic/pharmacodynamic properties. The impact of alternative integrated vector control options and different dosing regimens on malaria transmission reduction are illustrated through mathematical model simulation.ResultsThe review identified drugs from four classes commonly used in livestock and companion animals: avermectins, milbemycins, isoxazolines and spinosyns. Simulations predicted that isoxazolines and spinosyns are promising candidates for mass drug administration, as they were predicted to need less frequent application than avermectins and milbemycins to maintain mosquitocidal blood concentrations.ConclusionsThese findings will provide a guide for investigating and applying different systemic insecticides to achieve more effective and sustainable control of malaria transmission.

scholarly journals Human population movement can impede the elimination of soil-transmitted helminth transmission in regions with heterogeneity in mass drug administration coverage and transmission potential between villages: a metapopulation analysis

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Carolin Vegvari ◽  
James E. Truscott ◽  
Klodeta Kura ◽  
Roy M. Anderson
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Human Population ◽  
Sub Saharan Africa ◽  
Population Movement ◽  
Mobility Patterns ◽  
Preventive Chemotherapy ◽  
Cross Sectional ◽  
The Impact ◽  
Human Population Movement

Abstract Background Soil-transmitted helminth (STH) infections affect predominantly socio-economically disadvantaged populations in sub-Saharan Africa, East Asia and the Americas. Previous mathematical modelling studies have evaluated optimal intervention strategies to break STH transmission in clusters of villages. These studies assumed that villages are closed independent units with no movement of people in or out of communities. Here we examine how human population movement, for example, of seasonal migrant labourers, affect the outcome of mass drug administration (MDA) programmes. Results We used a stochastic individual-based metapopulation model to analyse the impact of human population movement at varying rates on STH elimination efforts. Specifically, we looked at seasonal clumped movement events of infected individuals into a village. We showed that even if on average 75% of the entire resident population within a village are treated, an annual rate of 2–3% of the population arriving from an untreated source village can reduce the probability of STH elimination to less than 50% in high-prevalence settings. If a village is infection-free, an annual movement rate of 2–3% from an infected source village imposes a risk of re-introduction of STH of 75% or higher, unless the prevalence in the source village is less than 20%. Even a single arrival of 2–3% of the population can impose a risk of re-introducing STH of 50% or greater depending on the prevalence in the source village. The risk of re-introduction also depends on both the age group of moving individuals and STH species, since the pattern of cross-sectional age-prevalence and age-intensity profiles of infection in the human host are species-specific. Conclusions Planning for STH elimination programmes should account for human mobility patterns in defined regions. We recommend that individuals arriving from areas with ongoing STH transmission should receive preventive chemotherapy for STHs. This can most easily be implemented if migration is seasonal and overlaps with treatment rounds, e.g. seasonal migrant labour. Moreover, transmission hotspots in or near treatment clusters should be eliminated, for example, by implementing appropriate water, sanitation and hygiene (WASH) measures and targeting treatment to individuals living in hotspots.

scholarly journals Modeling the Effects of Helminth Infection on the Transmission Dynamics of Mycobacterium tuberculosis under Optimal Control Strategies

2020 ◽  
Vol 2020 ◽  
pp. 1-21
Author(s):  
Aristide G. Lambura ◽  
Gasper G. Mwanga ◽  
Livingstone Luboobi ◽  
Dmitry Kuznetsov
Keyword(s):  
Optimal Control ◽  
Equilibrium Point ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Helminth Infection ◽  
Reproduction Number ◽  
Control Strategies ◽  
Active Tuberculosis ◽  
Control Measures ◽  
The Impact

A deterministic mathematical model for the transmission and control of cointeraction of helminths and tuberculosis is presented, to examine the impact of helminth on tuberculosis and the effect of control strategies. The equilibrium point is established, and the effective reproduction number is computed. The disease-free equilibrium point is confirmed to be asymptotically stable whenever the effective reproduction number is less than the unit. The analysis of the effective reproduction number indicates that an increase in the helminth cases increases the tuberculosis cases, suggesting that the control of helminth infection has a positive impact on controlling the dynamics of tuberculosis. The possibility of bifurcation is investigated using the Center Manifold Theorem. Sensitivity analysis is performed to determine the effect of every parameter on the spread of the two diseases. The model is extended to incorporate control measures, and Pontryagin’s Maximum Principle is applied to derive the necessary conditions for optimal control. The optimal control problem is solved numerically by the iterative scheme by considering vaccination of infants for Mtb, treatment of individuals with active tuberculosis, mass drug administration with regular antihelminthic drugs, and sanitation control strategies. The results show that a combination of educational campaign, treatment of individuals with active tuberculosis, mass drug administration, and sanitation is the most effective strategy to control helminth-Mtb coinfection. Thus, to effectively control the helminth-Mtb coinfection, we suggest to public health stakeholders to apply intervention strategies that are aimed at controlling helminth infection and the combination of vaccination of infants and treatment of individuals with active tuberculosis.

Sign in / Sign up

Export Citation Format

Share Document