Noguchi Memorial Institute for Medical Research
Strategies for the ENdgame: Targeting Infections among Non-compliants in the Elimination of Lymphatic filariasis (SENTINEL)
Non-compliance is a primary barrier to attaining elimination goals. This study aims to utilize data captured in MDA registers to address non-compliance in the Ahanta West District of Ghana, which has been identified as a hotspot of LF transmission with >1% microfilaria (mf) prevalence after 15-16 rounds of MDA. On the basis of information identified in the register, this study proposes to deploy two strategies:
- Engage and Treat individuals who were ill, missed treatment, or were unable to participate during the last MDA, and
- Test and Treat for individuals who might be systemically non-compliant or afraid of adverse events. The use of MDA registers to assist in locating non-compliant individuals is novel and would provide valuable evidence for other programs and represents an alternative strategy for countries struggling with the end game. It may also help provide insight as to whether systematically non-compliant individuals truly serve as a reservoir for LF in areas designated as hotspots. Qualitative data collection will aid in understanding reasons for systematic non-compliance and may lead to changes in social mobilization strategies.
Determination of the prevalence of LF infection in districts not included in LF control activities and of the basis for integrated implementation of LF - onchocerciasis elimination strategies in potentially co-endemic areas
Field validation of the diagnostic performance of the Wb123/Ov16 biplex rapid diagnostic test and Wb123 ELISA, compared to the filariasis test strip (FTS) in a setting initially found to be non-endemic for lymphatic filariasis, in which clinical cases have been identified.
Laboratory analysis of Ov16 ELISA and Skin snip PCR to support surveillance activities in National programs. Multi-country comparison of diagnostic tools to detect Onchocerca volvulus
To compare the performance of the diagnostic tools currently available for O. volvulus in terms of their relative sensitivity, species-specificity and practical use by countries. Comparison of the utility of these tools for mapping and surveillance in settings with different levels of endemicity for onchocerciasis (Oncho), lymphatic filariasis (LF) and/or loiasis.
Development and validation of Simulium damnosum genetic markers for surveillance of onchocerciasis in Ghana during the elimination phase of the disease
Are there distinct genetic differences between blackflies (Simulium spp) collected from different ecological zones in Ghana?
Developing a novel tool using miRNA for diagnosis of female genital schistosomiasis
We seek to find out if there are some specific miRNAs that are distinctive to FGS and could be used in prognosis and also grade the different stages of the disease progression.
Assessing schistosomiasis and soil-transmitted helminths (STH) infection in pregnant women: A basis for inclusion in routine antenatal care (ANC) screening
To screen pregnant women visiting ANC for helminth infections.
Field evaluation of newly developed urine dipstick for onchocerciasis diagnosis
A field evaluation of urine dipstick developed for monitoring active onchocerciasis.
Understanding areas of increased trachoma risk (hotspots) through the implementation of a post validation trachoma surveillance strategy
To determine if there is evidence of on-going or recent transmission in the “hotspot” communities of increased risk two years after they were identified during the pre-validation surveys (clinical, antibody and infection data).
Understanding areas of increased trachoma risk (hotspots) through the implementation of a post validation trachoma surveillance strategy
To determine if there is evidence of on-going or recent transmission in the “hotspot” communities of increased risk two years after they were identified during the pre-validation surveys (clinical, antibody and infection data).
Community implementation and comparison of Human landing and Non human landing collection methods for vectors of Wuchereria bancrofti and Onchocerca volvulus for entomological monitoring of transmission (Ghana)
To determine the feasibility of the use of entomological traps by community members for onchocerciasis and lymphatic filariasis entomological assessments.
Improving access to Lymphatic Filariasis MMDP services through an enhanced evidence-based, cascade training model for health worker capacity strengthening in Ghana
This social science study will address the following:
Formative question: What were the successes and challenges of the LF MMDP pilot in the Upper East region for increasing the capacity of health workers of all levels and improving the ability of patients to manage LF morbidity?
Intervention question: Can a modified capacity strengthening package, developed based on the formative research results, be effective at increasing the capacity of health workers of all levels and improving the ability of patients to manage LF morbidity?
Understanding areas of increased trachoma risk (hotspots) through the implementation of a post validation trachoma surveillance strategy
To determine if there is evidence of on-going or recent transmission in the “hotspot” communities of increased risk two years after they were identified during the pre-validation surveys (clinical, antibody and infection data).
Investigation of communities at increased risk of trachoma recrudescence & a model post-elimination surveillance strategy
Primary research question
Is there evidence of on-going or recent ocular Ct transmission in communities of northern Ghana felt to be at increased risk of recrudescence, at least two years since they were identified with Ct infection and or high anti-Pgp3 seroprevalence during pre-validation trachoma surveillance surveys?
Secondary research questions
What is the geographical extent of the boundaries of any persistent Ct infection and on-going transmission in the post-elimination setting?
What is the community-level (anti-Pgp3) prevalence of seropositivity for the multiplex bead array (MBA) (and possibly ELISA) as compared to the lateral flow assay (LFA)?