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Trop. Med. Infect. Dis. 2018, 3(1), 10; doi:10.3390/tropicalmed3010010

The COUNTDOWN Study Protocol for Expansion of Mass Drug Administration Strategies against Schistosomiasis and Soil-Transmitted Helminthiasis in Ghana

1
Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
2
Department of Environmental Biology and Health, Council for Scientific and Industrial Research—Water Research Institute, P.O. Box M 32, Accra 102001, Ghana
3
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
4
Neglected Tropical Diseases Control Programme, Ghana Health Service, Accra 102001, Ghana
5
Dodowa Health Research Centre, Ghana Health Service, Dodowa 116001, Ghana
6
Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
Joint first authorship.
*
Author to whom correspondence should be addressed.
Received: 25 October 2017 / Revised: 3 January 2018 / Accepted: 4 January 2018 / Published: 22 January 2018
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Abstract

(1) Background: Current international policy for schistosomiasis and soil-transmitted helminthiasis (STH) control emphasises mass administration of deworming drugs in school-based programmes. However, this approach is insufficient to control the transmission of these diseases, and their burden in non-school cohorts is recognised, albeit under-researched. This research will investigate the feasibility and acceptability of expanding access to praziquantel (PZQ) against schistosomiasis, and albendazole (ALB) against STH, to communities in selected transmission settings in Ghana. (2) Methods: A three-site longitudinal study will be implemented to investigate the effectiveness of expanding treatment strategies for PZQ and ALB to community members. In the context of community mass drug administration (to preschool children, school non-attending children, and adults, including pregnant women), the intervention will be assessed in a random sample of community members, at baseline with follow-up at 6, 12, and 18 months. In each community, 658 participants will be enrolled, and 314 followed up at each time point. The primary outcome measure is the prevalence of infection of Schistosoma haematobium and/or S. mansoni at study endpoint, as assessed by longitudinal surveys. Secondary outcomes are to quantify the infection of schistosomiasis and STH infections in non-treated cohorts, reductions in prevalence of STH, and intensity of schistosomiasis and STH, and treatment coverage. Nested within this study will be qualitative, cost-benefit, and cost-effectiveness evaluations that will explore accessibility, feasibility, and economic impact of expanded treatment from different complementary perspectives. (3) Discussion: Using a multidisciplinary approach, this study will generate evidence for improved availability, acceptability, affordability, and accessibility to deworming drugs against schistosomiasis and STH to individuals and communities in Ghana. This is likely to have considerable research, programmatic, and political value to contribute evidence for national programme policy development within Ghana, and, more broadly, World Health Organization policy development. View Full-Text
Keywords: schistosomiasis; haematobium; mansoni; soil-transmitted helminthiasis; access; chemotherapy; praziquantel; albendazole; Ghana schistosomiasis; haematobium; mansoni; soil-transmitted helminthiasis; access; chemotherapy; praziquantel; albendazole; Ghana
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Campbell, S.J.; Osei-Atweneboana, M.Y.; Stothard, R.; Koukounari, A.; Cunningham, L.; Armoo, S.K.; Biritwum, N.-K.; Gyapong, M.; MacPherson, E.; Theobald, S.; Woode, M.E.; Khan, J.; Niessen, L.; Adams, E.R. The COUNTDOWN Study Protocol for Expansion of Mass Drug Administration Strategies against Schistosomiasis and Soil-Transmitted Helminthiasis in Ghana. Trop. Med. Infect. Dis. 2018, 3, 10.

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