Young Adults in Endemic Areas: An Untreated Group in Need of School-Based Preventive Chemotherapy for Schistosomiasis Control and Elimination

Parasitologic surveys of young adults in college and university settings are not commonly done, even in areas known to be endemic for schistosomiasis and soil-transmitted helminths. We have done a survey of 291 students and staff at the Kisumu National Polytechnic in Kisumu, Kenya, using the stool microscopy Kato-Katz (KK) method and the urine point-of-care circulating cathodic antigen (POC-CCA) test. Based on three stools/two KK slides each, in the 208 participants for whom three consecutive stools were obtained, Schistosoma mansoni prevalence was 17.8%. When all 291 individuals were analyzed based on the first stool, as done by the national neglected tropical disease (NTD) program, and one urine POC-CCA assay (n = 276), the prevalence was 13.7% by KK and 23.2% by POC-CCA. Based on three stools, 2.5% of 208 participants had heavy S. mansoni infections (≥400 eggs/gram feces), with heavy S. mansoni infections making up 13.5% of the S. mansoni cases. The prevalence of the soil-transmitted helminths (STH: Ascaris lumbricoides, Trichuris trichiura and hookworm) by three stools was 1.4%, 3.1%, and 4.1%, respectively, and by the first stool was 1.4%, 2.4% and 1.4%, respectively. This prevalence and intensity of infection with S. mansoni in a college setting warrants mass drug administration with praziquantel. This population of young adults is ‘in school’ and is both approachable and worthy of inclusion in national schistosomiasis control and elimination programs.

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Evaluating the Impact of Biannual School-Based and Community-Wide Treatment on Urogenital Schistosomiasis in Niger

10.21203/rs.3.rs-39224/v1 ◽

2020 ◽

Author(s):

Anna Elizabeth Phillips ◽

Zilahatou Tohon ◽

Neerav A. Dhanani ◽

Boubacar Sofo ◽

Issa Gnandou ◽

...

Keyword(s):

Randomised Trial ◽

Evidence Base ◽

Cluster Randomised Trial ◽

Relative Reduction ◽

Preventive Chemotherapy ◽

Urogenital Schistosomiasis ◽

Schistosomiasis Control ◽

School Based ◽

Significant Difference ◽

The Impact

Abstract Background The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) coordinated a five-year study implemented in several countries, including Niger, to provide an evidence-base for programmatic decisions regarding cost-effective approaches to preventive chemotherapy for schistosomiasis control. Methods This was a cluster-randomised trial investigating six possible combinations of annual or biannual community-wide treatment (CWT), school-based treatment (SBT), and holidays from mass treatment over four years. The most intense arm involved two years of annual CWT followed by two years of biannual CWT, while the least intensive arm involved one year of annual SBT followed by a year without treatment and two more years of annual SBT. The primary outcome of interest was prevalence and intensity of S. haematobium among 100 children aged 9-to-12-years sampled each year. In addition, 100 children aged 5-to-8 years in their first year of school and 50 adults (aged 20-to-55 years) were tested in the first and final fifth year of the study. Results In total, data was collected from 167,500 individuals across 225 villages in nine districts within the Niger River valley, Western Niger. Overall, prevalence of S. haematobium decreased from baseline to Year 5 across all study arms. The relative reduction of prevalence was greater in biannual compared with annual treatment across all arms, however, the only significant difference was seen in areas with a high starting prevalence. Although adults were not targeted for treatment in SBT arms, a statistically significant decrease in prevalence among adults was seen in moderate prevalence areas receiving biannual (10.7% to 4.8%) SBT (p<0.001). Adults tested in the annual SBT group also showed a decrease in prevalence between Year 1 and Year 5 (12.2% to 11.0%), but this difference was not significant.Conclusions These findings are an important consideration for schistosomiasis control programs that are considering elimination and support the idea that scaling up the frequency of treatment rounds, particularly in areas of low prevalence, will not eliminate schistosomiasis. Interestingly, the finding that prevalence decreased among adults in SBT arms suggests that transmission in the community can be reduced, even where only school children are being treated, which could have logistical and cost-saving implications for the national control programmes.

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Soil-transmitted helminths in southern highland Rwanda: associated factors and effectiveness of school-based preventive chemotherapy

Tropical Medicine & International Health ◽

10.1111/tmi.12321 ◽

2014 ◽

Vol 19 (7) ◽

pp. 812-824 ◽

Cited By ~ 23

Author(s):

Olga Staudacher ◽

Jakob Heimer ◽

Florian Steiner ◽

Yvette Kayonga ◽

Jean M. Havugimana ◽

...

Keyword(s):

Associated Factors ◽

Preventive Chemotherapy ◽

Soil Transmitted Helminths ◽

School Based ◽

Southern Highland

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Evaluating the impact of biannual school-based and community-wide treatment on urogenital schistosomiasis in Niger

Parasites & Vectors ◽

10.1186/s13071-020-04411-9 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Anna E. Phillips ◽

Zilahatou Tohon ◽

Neerav A. Dhanani ◽

Boubacar Sofo ◽

Issa Gnandou ◽

...

Keyword(s):

Randomised Trial ◽

Cluster Randomised Trial ◽

Relative Reduction ◽

Preventive Chemotherapy ◽

Urogenital Schistosomiasis ◽

Schistosomiasis Control ◽

School Based ◽

Significant Difference ◽

Control Programmes ◽

The Impact

Abstract Background The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) coordinated a five-year study implemented in several countries, including Niger, to provide an evidence-base for programmatic decisions regarding cost-effective approaches to preventive chemotherapy for schistosomiasis control. Methods This was a cluster-randomised trial investigating six possible combinations of annual or biannual community-wide treatment (CWT), school-based treatment (SBT), and holidays from mass treatment over four years. The most intense arm involved two years of annual CWT followed by 2 years of biannual CWT, while the least intensive arm involved one year of annual SBT followed by a year without treatment and two more years of annual SBT. The primary outcome of interest was prevalence and intensity of Schistosoma haematobium among 100 children aged 9–12 years sampled each year. In addition, 100 children aged 5–8 years in their first year of school and 50 adults (aged 20–55 years) were tested in the first and final fifth year of the study. Results In total, data were collected from 167,500 individuals across 225 villages in nine districts within the Niger River valley, Western Niger. Overall, the prevalence of S. haematobium decreased from baseline to Year 5 across all study arms. The relative reduction of prevalence was greater in biannual compared with annual treatment across all arms; however, the only significant difference was seen in areas with a high starting prevalence. Although adults were not targeted for treatment in SBT arms, a statistically significant decrease in prevalence among adults was seen in moderate prevalence areas receiving biannual (10.7% to 4.8%) SBT (P < 0.001). Adults tested in the annual SBT group also showed a decrease in prevalence between Year 1 and Year 5 (12.2% to 11.0%), but this difference was not significant. Conclusions These findings are an important consideration for schistosomiasis control programmes that are considering elimination and support the idea that scaling up the frequency of treatment rounds, particularly in areas of low prevalence, will not eliminate schistosomiasis. Interestingly, the finding that prevalence decreased among adults in SBT arms suggests that transmission in the community can be reduced, even where only school children are being treated, which could have logistical and cost-saving implications for the national control programmes.

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Mumps epidemiology in the Mid-West of Ireland 2004-2008: increasing disease burden in the university/college setting

Eurosurveillance ◽

10.2807/ese.14.16.19182-en ◽

2009 ◽

Vol 14 (16) ◽

Author(s):

D Whyte ◽

F O’Dea ◽

C McDonnell ◽

N H O’Connell ◽

S Callinan ◽

...

Keyword(s):

Disease Burden ◽

Preventive Measures ◽

Viral Disease ◽

College And University ◽

West Region ◽

College Setting ◽

The University ◽

University Settings ◽

Provisional Data ◽

Close Contacts

Mumps is a contagious vaccine-preventable viral disease that is experiencing a revival in students attending second and third level colleges. Large mumps outbreaks have been reported in several countries despite the presence of childhood immunisation programmes over many years, including measles, mumps, and rubella (MMR) vaccination. In 2008, 1,377 cases of mumps were notified in Ireland and 1,734 in the first three months of 2009 (provisional data). This paper reviews the recent epidemiology of mumps in the Mid-West region of Ireland and highlights preventive measures. A substantial proportion of cases were not laboratory-confirmed and it is important that doctors continue to notify suspected cases. In the Irish Mid-West, data from enhanced surveillance shows a high proportion of mumps in the age group 15-24 years. Complications were uncommon and rarely severe. Where data were available, over half of the cases did not recall having received two doses of MMR, but most recalled one dose. Parents should continue to ensure children receive both MMR vaccinations so that uptake is optimal for protection. Steps were taken to increase awareness of the disease in the school, college and university settings. Preventive measures implemented to limit mumps transmission in the school/college setting over recent years included vaccination of close contacts, isolation for five days and hand hygiene.

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Thriving in Academia: Understanding and Managing the Complexities of Faculty Work

Perspectives on Issues in Higher Education ◽

10.1044/ihe15.2.77 ◽

2012 ◽

Vol 15 (2) ◽

pp. 77-84 ◽

Cited By ~ 3

Author(s):

Ketevan Mamiseishvili

Keyword(s):

Higher Education ◽

Education Research ◽

Community Engagement ◽

Everyday Life ◽

Work Setting ◽

Higher Education Research ◽

Faculty Work ◽

College And University ◽

Teaching Research ◽

University Settings

In this paper, I will illustrate the changing nature and complexity of faculty employment in college and university settings. I will use existing higher education research to describe changes in faculty demographics, the escalating demands placed on faculty in the work setting, and challenges that confront professors seeking tenure or administrative advancement. Boyer’s (1990) framework for bringing traditionally marginalized and neglected functions of teaching, service, and community engagement into scholarship is examined as a model for balancing not only teaching, research, and service, but also work with everyday life.

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Modelling the impact of COVID-19-related control programme interruptions on progress towards the WHO 2030 target for soil-transmitted helminths

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa156 ◽

2020 ◽

Cited By ~ 1

Author(s):

Veronica Malizia ◽

Federica Giardina ◽

Carolin Vegvari ◽

Sumali Bajaj ◽

Kevin McRae-McKee ◽

...

Keyword(s):

Neglected Tropical Diseases ◽

Control Programme ◽

Mitigation Strategy ◽

Mitigation Strategies ◽

Preventive Chemotherapy ◽

Soil Transmitted Helminths ◽

Individual Based Models ◽

Control Programmes ◽

Catch Up ◽

The Impact

Abstract Background On 1 April 2020, the WHO recommended an interruption of all activities for the control of neglected tropical diseases, including soil-transmitted helminths (STH), in response to the COVID-19 pandemic. This paper investigates the impact of this disruption on the progress towards the WHO 2030 target for STH. Methods We used two stochastic individual-based models to simulate the impact of missing one or more preventive chemotherapy (PC) rounds in different endemicity settings. We also investigated the extent to which this impact can be lessened by mitigation strategies, such as semiannual or community-wide PC. Results Both models show that without a mitigation strategy, control programmes will catch up by 2030, assuming that coverage is maintained. The catch-up time can be up to 4.5 y after the start of the interruption. Mitigation strategies may reduce this time by up to 2 y and increase the probability of achieving the 2030 target. Conclusions Although a PC interruption will only temporarily impact the progress towards the WHO 2030 target, programmes are encouraged to restart as soon as possible to minimise the impact on morbidity. The implementation of suitable mitigation strategies can turn the interruption into an opportunity to accelerate progress towards reaching the target.

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The Myth of the Digital Native and What It Means for Higher Education

The Oxford Handbook of Cyberpsychology ◽

10.1093/oxfordhb/9780198812746.013.7 ◽

2018 ◽

pp. 97-114

Author(s):

Linda Corrin ◽

Tiffani Apps ◽

Karley Beckman ◽

Sue Bennett

Keyword(s):

Higher Education ◽

Young Adults ◽

Young People ◽

Digital Technology ◽

University Education ◽

Childhood And Adolescence ◽

Digital Native ◽

College And University ◽

Radical Transformation

The term “digital native” entered popular and academic discourse in the early 1990s to characterize young people who, having grown up surrounded by digital technology, were said to be highly technologically skilled. The premise was mobilized to criticize education for not meeting the needs of young people, thereby needing radical transformation. Despite being repeatedly discredited by empirical research and scholarly argument, the idea of the digital native has been remarkably persistent. This chapter explores the myth of the digital native and its implications for higher education. It suggests that the myth’s persistence signals a need to better understand the role of technology in young people’s lives. The chapter conceptualizes technology “practices,” considers how young adults experience technology in their college and university education, and how their practices are shaped by childhood and adolescence. The chapter closes with some propositions for educators, institutions, and researchers.

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Evaluating survey designs for targeting preventive chemotherapy against Schistosoma haematobium and Schistosoma mansoni across Sub-Saharan Africa: a geostatistical analysis and modelling study

10.21203/rs.3.rs-36950/v3 ◽

2020 ◽

Author(s):

Kimberly Fornace ◽

Claudio Fronterrè ◽

Fiona M Fleming ◽

Hope Simpson ◽

Honorat Zoure ◽

...

Keyword(s):

Cost Effectiveness ◽

Schistosoma Haematobium ◽

Sampling Strategy ◽

Sub Saharan Africa ◽

Spatial Distributions ◽

Preventive Chemotherapy ◽

School Based ◽

Control Programmes ◽

Sub Saharan ◽

Survey Designs

Abstract Background: Schistosomiasis control programmes primarily use school-based surveys to identify areas for mass drug administration of preventive chemotherapy. However, as the spatial distribution of schistosomiasis can be highly focal, transmission may not be detected by surveys implemented at districts or larger spatial units. Improved mapping strategies are required to accurately and cost-effectively target preventive chemotherapy to remaining foci across all possible spatial distributions of schistosomiasis. Methods: Here, we use geostatistical models to quantify the spatial heterogeneity of Schistosoma haematobium and S. mansoni across sub-Saharan Africa using the most comprehensive dataset available on school-based surveys. Applying this information to parameterise simulations, we assess the accuracy and cost of targeting alternative implementation unit sizes across the range of plausible schistosomiasis distributions. We evaluate the consequences of decisions based on survey designs implemented at district and subdistrict levels sampling different numbers of schools. Cost data were obtained from field surveys conducted across multiple countries and years, with cost effectiveness evaluated as the cost per correctly identified school. Results: Models identified marked differences in prevalence and spatial distributions between countries and species; however, results suggest implementing surveys at subdistrict level increase the accuracy of treatment classifications across most scenarios. While sampling intensively at the subdistrict level resulted in the highest classification accuracy, this sampling strategy resulted in the highest costs. Alternatively, sampling the same numbers of schools currently recommended at the district level but stratifying by subdistrict increased cost effectiveness.Conclusions: This study provides a new tool to evaluate schistosomiasis survey designs across a range of transmission settings. Results highlight the importance of considering spatial structure when designing sampling strategies, illustrating that a substantial proportion of children may be undertreated even when an implementation unit is correctly classified. Control programmes need to weigh the increased accuracy of more detailed mapping strategies against the survey costs and treatment priorities.

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What do young adults’ educational experiences tell us about Early School Leaving processes?

European Educational Research Journal ◽

10.1177/1474904120946885 ◽

2020 ◽

Vol 19 (5) ◽

pp. 463-481

Author(s):

Sofia A Santos ◽

Cosmin Nada ◽

Eunice Macedo ◽

Helena C Araújo

Keyword(s):

Young Adults ◽

Educational Transitions ◽

Early School Leaving ◽

School Disengagement ◽

Educational Trajectories ◽

The North ◽

School Based ◽

Early School ◽

Secure Learning ◽

Support Mechanisms

What leads young people to disengage and leave school early? This paper focuses on young adults’ educational trajectories, with the objective of identifying useful insights for improving school measures and strategies against early school leaving and school disengagement. Specifically, it draws upon an empirical study with young adults from the north of Portugal. Longitudinal bio-interviews took place with young men and women, aged 17 to 24, who were enrolled in secondary education at mainstream schools or in alternative learning contexts or who were early school leavers. A set of critical moments and circumstances were identified as turning points in the young adults’ descriptions of their school trajectories, revealing both obstacles and incentives to continue studying. Based on these narratives, the study identifies some risk and protective factors for early school leaving and makes suggestions about how to improve school-based measures to prevent school disengagement. Some key recommendations for schools include: increased support mechanisms during educational transitions; a firm stance on bullying and the creation of violence-free and secure learning environments; enhancing socio-emotional support and encouraging the emergence of relationships of care; and providing meaningful education by ensuring the school content is aligned with students’ motivations and needs.

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The Geshiyaro Project: a study protocol for developing a scalable model of interventions for moving towards the interruption of the transmission of soil-transmitted helminths and schistosome infections in the Wolaita zone of Ethiopia

Parasites & Vectors ◽

10.1186/s13071-019-3757-4 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 3

Author(s):

Kalkidan Mekete ◽

Alison Ower ◽

Julia Dunn ◽

Heven Sime ◽

Gemechu Tadesse ◽

...

Keyword(s):

Population Level ◽

Risk Behaviour ◽

Control Programme ◽

Parasitic Infections ◽

Preventive Chemotherapy ◽

Treatment Coverage ◽

Household Level ◽

Soil Transmitted Helminths ◽

Compliance To Treatment ◽

The Impact

Abstract Background National deworming programmes rely almost exclusively on mass drug administration (MDA) to children to control morbidity caused by these parasitic infections. The provision of other interventions, consisting of preventive chemotherapy at high population level coverage together with water, sanitation and hygiene (WaSH) and changes in risk behaviour, should enable sustainable control of soil-transmitted helminths (STH) and schistosomiasis and ultimately interrupt transmission. Methods/Design Two interventions will be implemented by the project: (i) community-wide biannual albendazole and annual praziquantel treatment with a target of 80–90% treatment coverage (“expanded MDA”); and (ii) provision of WaSH with behaviour change communication (BCC), within the Wolaita zone, Ethiopia. The project has three study arms: (i) expanded community-wide MDA, WaSH and BCC; (ii) expanded community-wide MDA only; and (iii) annual school-based MDA (the current National STH/schistosomiasis Control Programme). The impact of these interventions will be evaluated through prevalence mapping at baseline and endline (after four rounds of MDA), combined with annual longitudinal parasitological surveillance in defined cohorts of people to monitor trends in prevalence and reinfection throughout the project. Treatment coverage and individual compliance to treatment will be monitored by employing fingerprint biometric technology and barcoded identification cards at treatment. WaSH utilisation will be evaluated through school and household level observations and annual WaSH assessment survey. Complementary qualitative surveys will explore practices, cultural and social drivers of risk behaviours, uptake of WaSH and treatment, and assessing the impact of the BCC. Discussion The study has the potential to define an ‘End Game’ for STH and schistosomiasis programmes through provision of multiple interventions. Interrupting transmission of these infections would eliminate the need for long-term repeated MDA, lead to sustained health improvements in children and adults, thereby allowing health systems to focus on other disease control priorities.

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