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Discovering, Defining, and Summarizing Persistent Hotspots in SCORE Studies
Nupur Kittur1, Carl H Campbell1, Sue Binder1
11Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia.
Summary
Persistent hotspots (PHS) of schistosomiasis resist mass drug administration (MDA) despite overall prevalence reduction. Identifying and addressing these PHS is crucial for schistosomiasis elimination goals.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Public Health
Background:
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) studies in Africa demonstrated mass drug administration (MDA) reduces Schistosoma infection.
- However, persistent hotspots (PHS) with minimal or no decline in infection were observed in up to 30% of villages.
Purpose of the Study:
- To analyze factors contributing to persistent hotspots (PHS) in schistosomiasis control.
- To identify potential strategies for addressing PHS to achieve schistosomiasis elimination.
Main Methods:
- Analysis of SCORE field studies in low-, moderate-, and high-prevalence areas across Africa.
- Comparison of PHS with villages that responded effectively to repeated MDA.
Main Results:
- No consistent relationship found between PHS and intervention type, MDA coverage, or baseline infection levels.
- Differences in water sources, sanitation, and hygiene were noted between PHS and responsive villages in smaller studies.
Conclusions:
- Persistent hotspots (PHS) pose a significant challenge to schistosomiasis elimination efforts.
- Identifying PHS after a few years of MDA is possible, but generalizable approaches require further research across diverse social-ecological settings.
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