To assess if transmission assessment surveys (TAS) for lymphatic filariasis (LF) are a feasible platform to integrate transmission assessment for onchocerciasis, using the same age group (6-7 years old) and the same prevalence threshold (<2%) that the LF programs utilize.
1. To perform the TAS for stopping LF MDA and use it as platform for Oncho impact assessment.
2. To assess the level of endemicity of Oncho following at least five rounds of MDA in hypo, meso and hyper endemic districts.
3. To study the performance of the Wb123/Ov16 Biplex rapid diagnostic test (RDT) to assess Oncho and LF transmission interruption.
The success of MDA programs requires effective planning, community engagement, and delivery by community drug distributors. This proposal seeks to assess barriers and facilitators of effective coverage. Using in depth interviews, focus group discussions, and surveys, they will investigate factors related to acceptance, availability, and accessibility of MDA from the perspectives of drug distributors, healthcare workers, community leaders, the NTD program, and community members. Using the findings from the formative phase, an intervention package will be developed and implemented during MDA, followed by an evaluation of the impact of the intervention on coverage.
This project is part of a larger series of four studies that use a mixed methods approach to understand why particular districts that have undergone 5+ years of MDA are failing or are likely to fail transmission assessment surveys (TAS). Other studies include 169.1D Ghana, 169.2U Burkina Faso, and 177U Nepal. This study in Uttar Pradesh also provides a second opportunity to deploy the rapid ethnographic approach that will be first tested in Nepal. Team members from HERD Nepal will be traveling to India to train their team on the technique and assist with roll out.
This study will pilot the Slash and Clear methodology in an oncho-Loa loa co-endemic setting. Previous pilots in Uganda and Nigeria have demonstrated that this simple strategy of removing breeding sites can result in significant black fly reductions that last for several months. This study will provide important data on the impact of Slash and Clear on black fly biting, and consequently its impact on oncho elimination. Two intervention and one control community will be compared for two years, with repeated measurements being taken of biting rates.
Evaluate the current status of transmission of onchocerciasis in a hyperendemic area treated for many years and in a hypoendemic area treated for lymphatic filariasis for 5 years using the Ov16 ELISA and supplemented by entomology results from a previous study
Is mobile outreach with a doxycycline test and treat strategy (TTd) an effective strategy in reducing onchocerciasis prevalence and intensity of infection amongst hard-to-reach nomadic groups in Massangam health area (HA)?
What is the variation in prevalence of onchocerciasis and intensity of infection (community microfilaria load (CML)) in the different age and sex groups of hard-to-reach nomad community in the Massangam HA?
What was the coverage of ivermectin mass drug administration in the nomad population with respect to the last round of ivermectin MDA?
What is the cost of the mobile outreach strategy in this context, per person screened and treated?