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Lessons Learned in Conducting Mass Drug Administration for Schistosomiasis Control and Measuring Coverage in an
Sue Binder1, Carl H Campbell1, Jennifer D Castleman1
11Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia.
Summary
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) conducted large field studies on mass drug administration (MDA) for schistosomiasis control. While median coverage often met targets, significant village-level variations and challenges in estimating treatment coverage were observed.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Tropical Medicine
Background:
- The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established to guide schistosomiasis control programs through research.
- SCORE implemented large-scale, cluster-randomized field studies focused on mass drug administration (MDA) using praziquantel across five African nations.
- Studies were designed to align with national neglected tropical disease (NTD) control programs to ensure practical relevance for routine implementation.
Purpose of the Study:
- To evaluate the effectiveness and operational challenges of mass drug administration (MDA) for schistosomiasis control in real-world settings.
- To assess the feasibility of achieving high treatment coverage targets in school-aged children and the general population.
- To identify lessons learned from implementing research protocols within national public health frameworks for schistosomiasis and other NTDs.
Main Methods:
- Conducted large cluster-randomized field studies involving mass drug administration (MDA) with praziquantel.
- Set minimum coverage targets of 90% for school-aged children in schools and 75% for all school-aged children.
- Coordinated MDA activities with national neglected tropical disease (NTD) control programs.
Main Results:
- Over 3.5 million treatments were administered across study communities during the 4-year intervention period.
- By year 4, median village coverage met or exceeded targets in most studies, with the exception of Mozambique.
- Significant variations in coverage were observed at the village level, with some areas showing very low or high treatment rates; denominator estimation for coverage was frequently problematic.
Conclusions:
- SCORE's operational research provided valuable insights into implementing schistosomiasis control strategies within national programs.
- Achieving consistent high coverage across all communities remains a challenge, highlighting the need for robust monitoring and evaluation.
- Lessons from SCORE's experience are applicable to future large-scale MDA campaigns for schistosomiasis and other NTDs, particularly in resource-limited settings.
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