Coverage of community-wide mass drug administration platforms for soil-transmitted helminths in Benin, India, and Malawi: findings from the DeWorm3 project.
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Means Arianna Rubin, Ásbjörnsdóttir Kristjana Hrönn, Sharrock Katherine C, Galagan Sean R, Aruldas Kumudha, Avokpaho Euripide, Chabi Félicien, Halliday Katherine E, Houngbegnon Parfait, Israel Gideon John, Kaliappan Saravanakumar Puthupalayam, Kennedy David, Legge Hugo, Oswald William E, Palanisamy Gokila, Rogers Elliott, Timothy Joseph, Pearman Emily, Ramesh Rohan Michael, Simwanza James, Sheik-Abdullah Jasmine Farzana, Sheikh Mariyam, Togbevi Comlanvi Innocent, Witek-McManus Stefan, Pullan Rachel L, Bailey Robin, Kalua Khumbo, Ibikounlé Moudachirou, Luty Adrian J F, Ajjampur Sitara S R, Walson Judd L
Аннотация
METHODS: From 2018-2020, DeWorm3 delivered six rounds of cMDA with 400 mg albendazole at sites in Benin, India, and Malawi. We report coverage, treatment uptake, and directly observed therapy across all rounds. Factors associated with coverage at the cluster level were identified using binomial generalized estimating equations, while factors associated with non-treatment at the individual level were identified using binomial mixed-effects models.
RESULTS: Coverage was high across all clusters and rounds, exceeding the WHO target of 75% in all sites and across all rounds (78% to 95%); cluster-level coverage tended to increase over time. Younger, unmarried, and migratory adults were more likely to be untreated at all sites; adult males were more likely to be untreated in Benin and Malawi. Among children, girls were more likely to be untreated, as were non-school-attending and migratory children. Higher adult education was associated with greater odds of non-treatment among adults, but lower odds among children in the household. Belonging to a less wealthy or minority language-speaking household was associated with non-treatment among both adults and children.
CONCLUSIONS: It is possible to deliver community-wide MDA with high coverage. Unique individual and community-level factors influence treatment across settings, and these may be addressed through targeted programming.
TRIAL REGISTRATION: Field Studies on the Feasibility of Interrupting the Transmission of Soil-transmitted Helminths (STH), NCT03014167.