This study will include comparing 1) MDA as usual 2) double treatment with two closely-spaced MDAs (consistent with the recommendation based on mathematical models) 3) twice yearly MDA and 4) double MDA plus snail control.
(1) Is it possible to eliminate schistosomiasis as a public health problem on Unguja in three years and to interrupt transmission in five years? (2) Is it possible to control schistosomiasis throughout Pemba (prevalence <10%) in three years and to eliminate it as a public health problem in five years? (3) What are the costs, successful strategies, barriers, etc. associated with three different interventions (MDA, vector control, and behavior change)?
The DeWorm3 Project is a series of hybrid trials testing the feasibility of interrupting the transmission of soil transmitted helminths (STH), while conducting implementation science research that contextualizes clinical research findings and provides guidance on opportunities to optimize delivery of STH interventions.
The purpose of DeWorm3 implementation science studies is to ensure rapid and efficient translation of evidence into practice. Research methods include: (1) stakeholder mapping and network analysis, (2) qualitative research, (3) structural readiness surveys, (4) process mapping, and (5) economic evaluation (costing and cost-effectiveness).
Implementation science research aims include:
1)To systematically identify stakeholders influencing standard of care targeted and community-wide MDA and map their potential role and involvement in scale-up of community-wide MDA for STH.
2)To identify implementation-related barriers and facilitators to community-wide MDA for STH from the perspective of various stakeholders.
3)To quantify the readiness of the health system to deliver community-wide MDA for STH programs.
4)To map the intervention delivery process and identify any discrepancies between planned and implemented activities in order to optimize the trial intervention.
5)To compare the financial and economic costs and incremental cost-effectiveness of community-wide and targeted MDA for STH in the short- and long-term.