Impact of Alternative Treatment Strategies and Delivery Systems for Soil-transmitted Helminths in Kenya
Status:
Completed
Trial end date:
2017-07-01
Target enrollment:
Participant gender:
Summary
The mainstay of control of soil-transmitted helminths (STH) is school-based deworming but
recent modelling has highlights that in all but low very transmission settings, the treatment
of school-aged children is unlikely to interrupt transmission, and that new treatment
strategies are required. This study seeks to answer the question: is it possible to interrupt
the transmission of STH and if so, what is the most cost-effective treatment strategy and
delivery system to achieve this goal? In this study, two paired community cluster randomised
trials in different settings in Kenya will evaluate the impact and cost-effectiveness of
annual school-based deworming, annual community-based deworming, and biannual community-based
deworming. The interventions are (i) annual mass anthelmintic treatment delivered either to
pre-school and school-aged children, as part of a national school-based deworming programme,
or to the entire community delivered by community health workers. The primary outcome measure
is the prevalence of hookworm infection (the most common STH species), assessed by periodic
cross-sectional, age-stratified parasitological surveys. Secondary outcomes include intensity
of hookworm, prevalence and intensity of Ascaris lumbricoides, treatment coverage, and among
a randomly selected sub-sample of participants who will be followed longitudinally, worm
burden and proportion of eggs unfertilised. A nested process evaluation, using
semi-structured interviews, focus group discussions and a stakeholder analysis will
investigate the community acceptability, feasibility given the local and regional health
system structures and processes, and scale-up of the interventions.
Phase:
Phase 4
Details
Lead Sponsor:
London School of Hygiene and Tropical Medicine
Collaborators:
Emory University Imperial College London Kenya Medical Research Institute Kenya Ministry of Health