The overarching research question for this project was: “What is the impact of mainstreaming on the deworming program in four districts in Nigeria?” The question was addressed through three objectives:

1. Objective 1: Transition schistosomiasis and soil-transmitted helminth treatment programs to the primary health care system or routine health services in select districts currently supported by The Carter Center.
2. Objective 2: Evaluate the effects of transitioning the program to full government ownership by comparing treatment coverage among the target population before and after the transition to the primary health care system or routine health services to evaluate the success of the transition, supplementing the results with qualitative data. 
3. Objective 3: Develop recommendations based on study findings to inform schistosomiasis and soil-transmitted helminths transition plans for other districts and states in Nigeria.

What is the effectiveness of appropriately dosed IDA in clearing microfilariae (Mf) from Mf positive people who (i) reported taking triple drug therapy with ivermectin, diethylcarbamazine, and albendazole (IDA) in August 2018, and (ii) did not report recently taking IDA.

This will be investigated by:

• assessing the baseline (current) Mf presence and density before re/treatment with IDA, against which post-treatment Mf presence and density can be compared
• assessing the peak plasma concentration levels of ivermectin, DEC and albendazole in treated Mf positive individuals to identify whether the recommended dosages of medications are sufficient for achieving effective plasma concentrations
• assessing Mf clearance one week following directly observed IDA re/treatment