The Carter Center

The researchers propose taking a novel approach to increase coverage and reach previously neglected populations by engaging non-compliant individuals in devising a more effective strategy through a technique called knowledge co-production. The researchers plan to address the following questions:

1. Can an intervention package co-produced with systematically non-compliant individuals result in increased MDA coverage between the 2019 and 2020 LF MDA rounds?
2. Who and where are the systematic non-compliers in Leogane and Gressier?
3. What are the reasons motivating systematic non-compliance?
4. Is MDA non-compliance associated with hotspots of LF transmission?

The researchers plan the following activities:

1. A household cluster survey with 1300 individuals of all ages. This will define coverage in the past MDA and identify non-compliant individuals. In addition, ‘hidden’ non-compliers (NCs) will be located by a networking approach (respondent-driven sampling [RDS]).
2. All NCs will then be eligible to be selected into groups of 10 by age (18-25; 26-50; >50), sex (M, F) and demography (urban/rural). These 12 groups will each work with the national health team to devise new approaches to the non-compliance issue. These will be put into place for the 2020 MDA and then assessed by the co-production strategy groups. After the 2020 MDA a second survey will occur to assess impact.
3. The relationship between non-compliance and hotspots will be assessed using spatial analysis and defined serologically (FTS and DBS for antibodies) in collaboration with CDC.

Intervention: The primary aim of this project is to determine if the introduction of a Chronic Disease Self-Management curriculum into existing Hope Clubs in Léogâne, Haiti will result in improvements in symptoms of depression, self-rated health, chronic disease self-efficacy, social support, and disability.

Formative: What are the barriers that prevent people with LF from participating in Hope Clubs?

This study will address the characteristics of the ocular chlamydia trachomatis population structures within Amhara, a setting which has experienced repeated rounds of antibiotic for trachoma, and whether those circulating populations are different than known sequenced strains.

Are NTD programs in Anambra State, Nigeria, adopting and implementing prevention measures for COVID-19 in their drug delivery activities? What adaptations are required by staff and volunteers to adopt these measures? What are the barriers to doing so? What are the incremental costs associated with conducting MDA during a global pandemic?

What are the differences at 1 year post-baseline in the prevalence of trachoma and Ct infection in villages randomized to an enhanced antibiotic treatment regimen characterized by a routine community-wide MDA followed by two rounds of treatment targeted to children 6 months to 9 years in quick succession (1-2 weeks apart) compared to villages randomized to annual standard-of-care community-wide MDA?

Assess the performance of LF and Oncho diagnostic tools after stopping LF MDA but continuing Oncho MDA.

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.