Community drug distributors for mass drug administration in neglected tropical disease programmes: systematic review and analysis of policy documents

Abstract Due to the COVID-19 pandemic, many key neglected tropical disease (NTD) activities have been postponed. This hindrance comes at a time when the NTDs are progressing towards their ambitious goals for 2030. Mathematical modelling on several NTDs, namely gambiense sleeping sickness, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH), trachoma, and visceral leishmaniasis, shows that the impact of this disruption will vary across the diseases. Programs face a risk of resurgence, which will be fastest in high-transmission areas. Furthermore, of the mass drug administration diseases, schistosomiasis, STH, and trachoma are likely to encounter faster resurgence. The case-finding diseases (gambiense sleeping sickness and visceral leishmaniasis) are likely to have fewer cases being detected but may face an increasing underlying rate of new infections. However, once programs are able to resume, there are ways to mitigate the impact and accelerate progress towards the 2030 goals.

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Mass drug administration campaigns for scabies and impetigo: protocol for a systematic review and meta-analysis

BMJ Paediatrics Open ◽

10.1136/bmjpo-2021-001132 ◽

2021 ◽

Vol 5 (1) ◽

pp. e001132

Author(s):

Pousali Ghosh ◽

Wubshet Tesfaye ◽

Avilasha Manandhar ◽

Thomas Calma ◽

Mary Bushell ◽

...

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Assessment Tool ◽

Statistical Tests ◽

Meta Analysis ◽

Grey Literature ◽

Random Effect ◽

Systematic Evaluation ◽

Clear Understanding

IntroductionScabies is recognised as a neglected tropical disease, disproportionately affecting the most vulnerable populations around the world. Impetigo often occurs secondarily to scabies. Several studies have explored mass drug administration (MDA) programmes, with some showing positive outcomes—but a systematic evaluation of such studies is yet to be reported. The main aim of this systematic review is to generate comprehensive evidence on the effect and feasibility of MDA programmes in reducing the burden of scabies and impetigo.Methods and analysisA systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Electronic databases to be searched will include CINAHL EBSCOhost, Medline Ovid, ProQuest, Science Direct, PubMed and SCOPUS. In addition, grey literature will be explored via the Australian Institute of Health and Welfare, Australian Indigenous HealthInfoNet, Informit, OaIster database and WHO. No language restrictions will be applied. All treatment studies following an MDA protocol, including randomised/quasi-controlled trials, and prospective before–after interventional studies, will be considered. The main outcome is the change in prevalence of scabies and impetigo The Cochrane collaboration risk of bias assessment tool will be used for assessing the methodological quality of studies. A random-effect restricted maximum likelihood meta-analysis will be performed to generate pooled effect (OR) using STATA V.16. Appropriate statistical tests will be carried out to quantify heterogeneity between studies and publication bias.Ethics and disseminationEthical approval is not required since data will be extracted from published works. The findings will be communicated to the scientific community through a peer-reviewed journal publication. This systematic review will present an evidence on the effect of MDA interventions on scabies and impetigo, which is instrumental to obtain a clear understanding of the treatments widely used in these programmes.PROSPERO registration numberCRD42020169544,

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Systematic review of community-based, school-based, and combined delivery modes for reaching school-aged children in mass drug administration programs for schistosomiasis

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0006043 ◽

2017 ◽

Vol 11 (10) ◽

pp. e0006043 ◽

Cited By ~ 17

Author(s):

Michael Burnim ◽

Julianne A. Ivy ◽

Charles H. King

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Community Based ◽

School Aged Children ◽

Delivery Modes ◽

School Based ◽

Administration Programs

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Understanding the Role of Health Workers in the LF Elimination Program in Kenya: Challenges Faced and Suggestions for Improved Program Performance

East African Journal of Health and Science ◽

10.37284/eajhs.3.1.393 ◽

2021 ◽

Vol 3 (1) ◽

pp. 126-144

Author(s):

Bridget W Kimani ◽

Lydiah Wanjiku Kibe ◽

Collins Okoyo ◽

Wyckliff P Omondi ◽

Hadley Matendechero Sultani ◽

...

Keyword(s):

Community Health ◽

Drug Administration ◽

Mass Drug Administration ◽

Neglected Tropical Diseases ◽

Tropical Diseases ◽

Program Performance ◽

Health Extension Workers ◽

Treatment Coverage ◽

Study Results ◽

Community Drug Distributors

The Kenyan Ministry of Health and its partners through the Division of Vector-Borne and Neglected Tropical Diseases, is in charge of the Lymphatic Filariasis Mass Drug Administration programme. This is implemented through the national, county, and sub-county neglected tropical diseases coordinators. The current study sought to understand the roles, challenges faced and suggestions of how program performance can be improved by the community health extension workers, county and sub-county neglected tropical diseases coordinators. Two wards of the Kaloleni sub-county; Kilifi County were purposively selected. In 2015, Kaloleni and Kayafungo wards had a treatment coverage of 58% and 54% respectively; 62% and 39% respectively in 2016, all below the recommended minimum treatment coverage of 65%. Qualitative data was collected through sixteen in-depth interviews with community health extension workers and two semi-structured interviews with the county and sub-county neglected tropical diseases coordinators. Data were analysed by QSR NVIVO version 10 according to identified themes. The study results show the various roles in planning and implementation of the program include; supply chain management; health information education communication and records management; health workforce training and management, leadership and governance, and service delivery. Challenges faced included insufficiency of drugs supplied and information education communication materials, the inadequacy of community drug distributors selected and trained, poor facilitation for training and supervision of community drug distributors, limited duration of the mass drug administration, and delayed reporting due to poor network coverage. The results of this study show that the community health extension workers, county and sub-county neglected tropical diseases coordinators are not fully involved in program leadership and governance, a role that is taken up at the national level. They should be involved in all the stages of the mass drug administration program to create ownership to improve the program performance

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A systematic review and meta-analysis on the rate of human schistosomiasis reinfection

10.1101/2020.07.18.20156703 ◽

2020 ◽

Author(s):

Abdallah Zacharia ◽

Vivian Mushi ◽

Twilumba Makene

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Meta Analysis ◽

Geographical Area ◽

Original Research ◽

Reinfection Rate ◽

Urogenital Schistosomiasis ◽

Intestinal Schistosomiasis ◽

Human Schistosomiasis

Background While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity information on the global schistosomiasis reinfection rate. Objective This systematic review and meta−analysis aimed at summarizing studies that estimated the human schistosomiasis reinfection rate. Materials and methods The protocol for this review was prepared to guide authors throughout the process. However, registration was not sought. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on human schistosomiasis reinfection rate. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta−analysis was conducted using statistical R version 3.6.2 and R Studio using ′meta′ and ′metafor′ packages. Heterogeneity and publication bias of the studies were determined using Q − test and Egger′s regression test respectively. Random effect model was employed to estimate pooled reinfection rates. Results A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5 − 9 scores) quality. The overal calculated and pooled schistosomiasis reinfection rates were 36.1% (±23.3%) and 33.2% (95% CI, 26.5 − 40.5%) respectively. For intestinal schistosomiasis, the calculated and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8 − 51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3% − 29.2%) respectively. Results of subgroup analysis showed that, the type of Schistosoma species, participants age group, sample size and geographical area had influence on disparity variation in Schistosomiasis reinfection rate (p < 0.05). Conclusion Despite the control measures in place, the re-infection rate was still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing through schistosomiasis elimination and intensive programmatic strategies should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six month, intensive snails control and health education.

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PREVALENCE THRESHOLDS THAT SHOULD BE APPLIED IN SCHISTOSOMIASIS MASS DRUG ADMINISTRATION PRGROGRAMMES: SYSTEMATIC REVIEW AND META-ANALYSIS

10.1101/2021.05.10.21256643 ◽

2021 ◽

Author(s):

Anthony Danso-Appiah ◽

Amadou Djirmay Garba ◽

Nathan C Lo ◽

Massimiliano Orso ◽

Kwadwo Owusu Akuffo ◽

...

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Meta Analysis ◽

Risk Of Bias ◽

Sensitivity Analyses ◽

School Age Children ◽

School Age ◽

Intensity Of Infection ◽

Global Prevalence

Background WHO-recommended prevalence thresholds for deciding schistosomiasis mass drug administration (MDA) are based on anecdotal evidence and unclear. Objectives This systematic review and meta-analysis commissioned by the WHO, as part of its new schistosomiasis evidence-based guideline development, was to generate a single and global prevalence threshold that should be applied in MDA programmes. Methods We searched several databases from 1979 to 31st March 2021 without language restriction. Two reviewers selected studies, extracted data and assessed the risk of bias using relevant risk of bias tools and resolved disagreements through discussion. The review followed the PRISMA guidelines. Data were analysed and presented as prevalence reduction (PR) and relative risk (RR) for dichotomous outcomes or mean difference for continuous outcomes with their 95% confidence intervals (CIs). Meta-regression of observations on prevalence rates and intensity of infection of MDA programmes and sensitivity analyses to assess the robustness of the results to the risk of bias components were performed. Evidence on benefits, harms, values, preferences, compliance, acceptability, equity and feasibility were also assessed. The overall level of evidence was graded using GRADE. Results Out of 1,232 studies retrieved, 38 studies met our inclusion criteria and 34 studies were included in the meta-analysis. No direct relation was observed between prevalence and intensity of infection. Praziquantel reduced prevalence of S. haematobium in school age children (SAC) at 12 months (RR 0.38, 95% CI 0.28 to 0.52; 8 studies, n=37,868); at 24 months (RR 0.30; 95% CI 0.30 to 0.52; 7 studies; n=37107); at 36 months (RR 0.39, 95% CI 0.21 to 0.71; 5 studies, n=28,146). There was no significant reduction in prevalence at 48 months (2 studies, n=10,954). For S. mansoni, there were reductions in prevalence at 12 months (RR 0.56, 95% CI 0.46 to 0.69; 14 studies, n=86,073); 24 months (RR 0.46; 95% CI 0.32 to 0.66; 14 studies; n=83,721);36 months (RR 0.44, 95% CI 0.33 to 0.58; 7 studies, n=70,933) and at 48 months (RR 0.25, 95% CI 0.11 to 0.59; 5 studies; n=27,483). Further analyses were performed from a series of created prevalence thresholds of 5%, 10%, 15%, 20%, 30% and ≥40% which showed differences in effect of MDA when each of the thresholds was applied. For annual MDA of school age children (SAC), school-based treatment (SBT) appears to perform better than community-wide treatment (CWT) in terms of prevalence reduction. For the different schistosome species, the model suggests, using the same prevalence threshold, it will take shorter time to reach elimination for S. haematobium than S. mansoni; annual MDA using SBT approach for S. haematobium will require about 10 years to achieve elimination whereas it will take over 10 years to around 15 years to achieve elimination for S. mansoni. Conclusion The evidence presented in this systematic review suggests that 10% prevalence should be used as the global prevalence threshold for implementing MDA in endemic countries.

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The Added Value of Water, Sanitation, and Hygiene Interventions to Mass Drug Administration for Reducing the Prevalence of Trachoma: A Systematic Review Examining

Journal of Environmental and Public Health ◽

10.1155/2013/682093 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Anyess Travers ◽

Sheryl Strasser ◽

Stephanie L. Palmer ◽

Christine Stauber

Keyword(s):

Systematic Review ◽

Drug Administration ◽

Mass Drug Administration ◽

Added Value ◽

World Health ◽

Sanitation And Hygiene ◽

Pubmed Database ◽

Health Organization ◽

Hygiene Education ◽

The Impact

Trachoma is the leading cause of infectious blindness worldwide. The SAFE strategy, the World Health Organization-recommended method to eliminate blinding trachoma, combines developments in water, sanitation, surgery, and antibiotic treatment. Current literature does not focus on the comprehensive effect these components have on one another. The present systematic review analyzes the added benefit of water, sanitation, and hygiene education interventions to preventive mass drug administration of azithromycin for trachoma. Trials were identified from the PubMed database using a series of search terms. Three studies met the complete criteria for inclusion. Though all studies found a significant change in reduction of active trachoma prevalence, the research is still too limited to suggest the impact of the “F” and “E” components on trachoma prevalence and ultimately its effects on blindness.

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