Interrupting transmission of soil-transmitted helminths: cluster randomised trial evaluating alternative treatment strategies in Kenya

阻断土源性蠕虫的传播：评估肯尼亚替代治疗策略的整群随机试验

基本信息

批准号：
MR/N00597X/1
负责人：
Rachel Pullan
金额：
$ 130.96万
依托单位：
London School of Hygiene & Tropical Medicine
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2015
资助国家：
英国
起止时间：
2015 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FN00597X%2F1
关键词：
Interrupting transmission soil transmitted helminths

项目摘要

Some 1.45 billion people are estimated to be infected worldwide with intestinal worms, also known as soil-transmitted helminths (STH). Chronic and intense STH infections can contribute to malnutrition and iron-deficiency anaemia, and also can adversely affect physical and mental growth in childhood. Globally, STH result in 4.98 million years lived with disability each year. Fortunately, however, the global community is increasingly committed to tackling these infections, with many countries now successfully implementing geographically-targeted programmes that provide mass treatment to school-aged children delivered through schools. However, whilst school-based deworming has many important benefits for treated children, recent mathematical modelling suggests that treating only school-aged children will rarely stop transmission of these parasites, except in very low transmission settings, and that alternative approaches to treatment, including extending coverage and frequency of treatment, are required. To effectively deliver such expanded treatment, there is an associated need to evaluate the impact and cost-effectiveness of using community health workers to treat adult populations. We plan to evaluate the impact of school- versus community-based treatment in reducing the transmission of STH species. A range of quantitative and qualitative assessments will evaluate the costs, cost-effectiveness, acceptability and feasibility of the different strategies and delivery systems. The study will be conducted in two contrasting settings in Kenya - south coastal and western regions - where an estimated 20% of the population are infected with STH. In order to maximize public health relevance, the study will be nested within the ongoing national school-based deworming programme, which is currently treating 4.6 million preschool and school children annually. The study drugs will be donated by GlaxoSmithKline and the full costs of delivery through schools and communities will be covered by the Children's Investment Fund Foundation, with additional input from the Government of Kenya. Cofunding for some of the trial activities are already funded by the Bill & Melinda Gates Foundation. There is tremendous interest in conducting this study. The Government of Kenya, other national governments, funders and international policy makers are seeking clear policy and technical guidance as to the optimal approach to interrupt STH transmission. At the same time, countries are increasingly using community health workers (CHW; community members who provide basic health and medical care to their community, often on a volunteer basis) to deliver a wide range of health interventions, and there is a need to evaluate the benefits of using CHWs to deliver STH treatment. The proposed study, the first of its kind in Africa, will address these policy information gaps. Our proposed study is demand-led at the country level, with partners in Kenya supporting delivery and committed to scaling-up the new strategy, once demonstrated to be beneficial. Not only will the findings inform policy and practice in Kenya and other STH endemic countries, they may also lead to new WHO guidelines on the community control of STH and ultimately have demonstrable benefits for the impoverished communities affected by STH.

据估计，大约14.5亿人被肠蠕虫感染，也称为土壤传播的蠕虫（STH）。慢性和强烈的STH感染会导致营养不良和铁缺乏贫血，也可能对儿童期的身体和精神成长产生不利影响。在全球范围内，STH每年有498万年的残疾生活。但是，幸运的是，全球社区越来越致力于解决这些感染，现在许多国家成功地实施了针对地理位置的计划，这些计划为通过学校分娩的学龄儿童提供大规模治疗。但是，尽管基于学校的驱虫对经过治疗的儿童具有许多重要的好处，但最近的数学建模表明，只有学龄儿童很少会停止这些寄生虫的传播，除非在非常低的传播环境中，否则需要进行替代治疗方法，包括扩展覆盖范围和治疗频率。为了有效地提供这种扩展的治疗，有必要评估使用社区卫生工作者治疗成人人群的影响和成本效益。我们计划评估学校与社区治疗在减少STH物种传播方面的影响。一系列定量和定性评估将评估不同策略和交付系统的成本，成本效益，可接受性和可行性。该研究将在肯尼亚 - 南海岸和西部地区的两个对比环境中进行 - 估计有20％的人口感染了STH。为了最大程度地提高公共卫生的相关性，该研究将嵌套在正在进行的国家学校驱动计划中，该计划目前每年每年对460万学龄前儿童和学龄儿童进行治疗。该研究药物将由葛兰素史克（Glaxosmithkline）捐赠，通过学校和社区的全部交付成本将由儿童投资基金会基金会涵盖，肯尼亚政府的额外意见。 Bill＆Melinda Gates基金会已经为某些试验活动提供了资金。进行这项研究非常感兴趣。肯尼亚政府，其他国家政府，资助者和国际政策制定者正在寻求有关中断STH传播的最佳方法的明确政策和技术指导。同时，各国越来越多地使用社区卫生工作者（CHW；经常在志愿者的基础上为社区提供基本的健康和医疗服务的社区成员）来提供广泛的健康干预措施，并且有必要评估使用CHW提供STH治疗的好处。拟议的研究是非洲的第一个研究，将解决这些政策信息差距。我们拟议的研究是在国家一级以需求为主导的，肯尼亚的合作伙伴支持交付并致力于扩大新战略，曾经被证明是有益的。这些调查结果不仅会为肯尼亚和其他STH特有国家的政策和实践提供依据，而且还可能导致有关STH社区控制的新指南，并最终为受STH影响的贫困社区带来了可观的好处。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Assessment of the required performance and the development of corresponding program decision rules for neglected tropical diseases diagnostic tests: Monitoring and evaluation of soil-transmitted helminthiasis control programs as a case study.

DOI：
10.1371/journal.pntd.0009740
发表时间：
2021-09
期刊：
PLoS neglected tropical diseases
影响因子：
3.8
作者：
Levecke B;Coffeng LE;Hanna C;Pullan RL;Gass KM
通讯作者：
Gass KM

Patterns of individual non-treatment during multiple rounds of mass drug administration for control of soil-transmitted helminths in the TUMIKIA trial, Kenya: a secondary longitudinal analysis.

DOI：
10.1016/s2214-109x(20)30344-2
发表时间：
2020-11
期刊：
The Lancet. Global health
影响因子：
0
作者：
Oswald WE;Kepha S;Halliday KE;Mcharo C;Safari T;Witek-McManus S;Hardwick RJ;Allen E;Matendechero SH;Brooker SJ;Njenga SM;Mwandawiro CS;Anderson RM;Pullan RL
通讯作者：
Pullan RL

Domains of transmission and association of community, school, and household sanitation with soil-transmitted helminth infections among children in coastal Kenya.

肯尼亚沿海儿童土源性蠕虫感染的传播领域以及社区、学校和家庭卫生条件与相关性。

DOI：
10.1371/journal.pntd.0007488
发表时间：
2019
期刊：
PLoS neglected tropical diseases
影响因子：
3.8
作者：
Oswald WE
通讯作者：
Oswald WE

Patterns and Drivers of Household Sanitation Access and Sustainability in Kwale County, Kenya.

DOI：
10.1021/acs.est.0c05647
发表时间：
2021-05-04
期刊：
Environmental science & technology
影响因子：
11.4
作者：
Legge H;Halliday KE;Kepha S;Mcharo C;Witek-McManus SS;El-Busaidy H;Muendo R;Safari T;Mwandawiro CS;Matendechero SH;Pullan RL;Oswald WE
通讯作者：
Oswald WE

Domains of transmission and association of community, school, and household sanitation with soil-transmitted helminth infections among children in coastal Kenya

肯尼亚沿海儿童土源性蠕虫感染的传播领域以及社区、学校和家庭卫生设施与土源性蠕虫感染的关联