The Carter Center
A knowledge co-production strategy to address systematic non-compliance with MDA for Lymphatic Filariasis in Leogane, Haiti
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:
- Can an intervention package co-produced with systematically non-compliant individuals result in increased MDA coverage between the 2019 and 2020 LF MDA rounds?
- Who and where are the systematic non-compliers in Leogane and Gressier?
- What are the reasons motivating systematic non-compliance?
- Is MDA non-compliance associated with hotspots of LF transmission?
The researchers plan the following activities:
- 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]).
- 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.
- 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.
Addressing the Mental Health of Persons Living with Lymphatic Filariasis in Léogâne, Haiti: Effectiveness of a Chronic Disease Self-Management Program
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?
Whole genome sequencing of ocular Chlamydia trachomatis in Amhara region, Ethiopia, an area with persistent hyperendemic trachoma.
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.
Evaluating the adoption of COVID-19 prevention measures during mass drug administration in Anambra State, Nigeria
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?
The Impact of an Enhanced Antibiotic Treatment Regimen on Trachoma in Amhara, Ethiopia
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?
Community-wide Surveys for Evaluation of LF transmission Interruption, Oncho Transmission Assessment and Comparison of Diagnostic Tools in LF-Onchocerciasis Areas
Assess the performance of LF and Oncho diagnostic tools after stopping LF MDA but continuing Oncho MDA.
Evaluating a Transition to Government Ownership of Schistosomiasis and Soil-Transmitted Helminth Control Programs
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:
- 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.
- 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.
- Objective 3: Develop recommendations based on study findings to inform schistosomiasis and soil-transmitted helminths transition plans for other districts and states in Nigeria.
Evaluating the adoption of COVID-19 prevention measures during mass drug administration in Anambra State, Nigeria
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?
Community-wide Surveys for Evaluation of LF transmission Interruption, Oncho Transmission Assessment and Comparison of Diagnostic Tools in LF-Onchocerciasis Areas
Assess the performance of LF and Oncho diagnostic tools after stopping LF MDA but continuing Oncho MDA.
The Impact of WASH on Re-infection with STH
Study the impact of WASH on Trachoma by adding an STH intervention and post-treatment evaluation. WASH intervention and control communities will be treated with albendazole and STH burden will be assessed pre-treatment and at annual intervals thereafter.
Trachomatous Trichiasis and Mental Health: a comparative impact study
This study aims to understand the relationship between trachomatous trichiasis (TT) and mental health disorders over an 18-month study period, by answering the following questions:
- What is the impact of the blinding stage of trachoma (Trachomatous Trichiasis) on common mental disorders such as depression, anxiety and suicidality?
- Will the validation of the 5-Question Stigma Indicators (5-QSI) generic stigma tool help to measure and monitor stigma in trachomatous trichiasis patients in Ethiopia
- What are the drivers for mental disorders in TT patients
- Is there a difference in depression, anxiety and suicidality prevalence between TT cases accepting vs declining TT surgery; and un-operated vs postoperative TT cases? The research team will be trained on good clinical practice through the WHO Mental Health Gap Action Programme (mhGAP). Following interviews, any patient with TT will be referred for surgery and patients found with a mental health disorder will be referred for care. If a negative impact of blinding trachoma on mental health is noted, the researchers plan to use the results of the study to advocate for additional funding for the trachoma program and highlight the need to address mental health in Ethiopia.
Long term outcome of the two most commonly used surgical procedures to treat trachomatous trichiasis (TT): PLTR vs BLTR
Ascertain whether the difference in outcome (measured in rate of post-operative trachomatous trichiasis, or TT), between the posterior lamellar tarsal rotation (PLTR) and bilamellar tarsal rotation (BLTR) is sustained at four years or whether they give different results from what has been found at 1 year.
Field testing the use of 3D photographs of trachomatous trichiasis to train trachoma field graders
To evaluate 3D photographs of trachomatous trichiasis (TT) in the training and assessment of trachoma graders.