USAID

1. Can the O-150 LAMP assay be established on whole blood? 2. Can the O-150 qPCR methodology be adapted for human sampling?

Secondary

1. How does the performance of the O-150 LAMP compare to the O-150 qPCR assay?

2. What threshold be used to define positive vs negative results for both assays?

3. Can deep sequencing reveal over potential biomarkers for further investigation?

• An Ov16/OVOC3261 biplex IgG4 test, whereby we are confident that we can provide > 60% sensitivity and 99.8% specificity, as required by the TPP for Onchocerciasis Elimination Mapping.
• Demonstration that the Ov16/OVOC3261 biplex IgG4 test behaves at least as good with blood as with plasma/serum samples (notably a perceived weakness of the SD Ov16 RDT)

Can geospatial algorithms be used by disease programs to help identify hotspots at community and Implementation Unit level?

Organize existing data for preparation of LF elimination dossiers based on the PacELF programs.

The overall goal of this research proposal is to prioritize the five novel Bancroftian antigen candidates with respect to their ease-of-use and practicability within the frame of a future Wb123/WbAgx biplex test, based on their biophysical properties, stability data and behavior in our lateral flow assay setup. Along with the concurrent biochemical/clinical validation by the Nutman group. This will allow an informed choice as to which candidate antigen(s) should be used for the biplex assay development.

1. Development of spatio-temporal models and associated statistical methods to enable forward projections of the geographical distribution of prevalence, and hence the risk of resurgence, by combining model-based geostatistical analysis with mechanistic predictive modelling of disease transmission dynamics, using the most recent available data on disease prevalence and environmental risk-factors.

2. To use the results from aim 1 to derive statistically efficient and affordable designs for networks of sentinel sites to enable continued monitoring of prevalence in areas at high risk of resurgence."

RQ1 - Reliability assessment: What is the intra- and inter-rater reliability of current qualitative F and novel quantitative hygiene metrics across study contexts?

RQ2 – Validity assessment: What is the validity of each metric of interest (i.e., quantitative hygiene and qualitative F metrics) with regard to recent personal hygiene practices and trachoma outcomes?

RQ3 – Utility assessment: What is the utility of each metric (i.e., qualitative and quantitative)?

RQ4 – Risk factor assessment: Do proxy facial and hand hygiene outcomes, as measured by the novel quantitative hygiene metric, represent risk factors of incident C. trachomatis infection?

A pilot study to identify meaningful and measurable targets for detecting the control of schistosomiasis-related morbidity in Africa. The overall study is designed to answer the following primary evaluation questions:

• What are the infection levels of Schistosoma mansoni and S. haematobium below which there is little, or no, detectable schistosomiasis-associated morbidity?
• What are the optimal morbidity markers for S. mansoni and S. haematobium?
• What are the optimal species-specific morbidity goals for which schistosomiasis control programs should be aiming?

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.

Innovative approach to exploit ongoing STH- SCH survey to conduct integrated surveillance for LF and oncho that will serve as a model for other programs

The primary aim of this study is a first evaluation (384 samples) of the DjinniChip in ocular clinical samples in a trachoma-endemic region in-country, but initially in the controlled environment of a research laboratory setting. The second aim is to determine the DjinniChips resilience and usability by evaluating its performance with a concentration series of positive control swabs in various environmental conditions (hot, dry, dusty, humid).

Identify the sampling strategy for tracking positive cases after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of active transmission, while saving program resources

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.

Can a smartphone-based app with an integrated image analysis algorithm be used to increase accuracy and yield of trachomatous trichiasis (TT) screening compared to standard TT case finder screening?

• What factors are associated with the availability, accessibility, and acceptability of MDA?
• What is the impact of an adapted and tailored intervention package on effective coverage?

This study builds on the methods developed for the operational studies ongoing in Ghana and Burkina Faso. The first two research questions are the same as those earlier studies with two new questions added here- question 3 on triple drug therapy (ivermectin, DEC, albendazole – IDA) and 4 on the use of a new rapid ethnography approach.

1. What factors are associated with effective (and lower) MDA coverage as defined as availability, accessibility, and acceptability in settings that have repeatedly failed Pre-TAS?
2. What is the impact of an adapted and tailored intervention package on achieving effective coverage?
3. What messages and community engagement approaches are needed to ensure the acceptability of IDA triple drug therapy in Nepal?
4. How does the rapid ethnography approach compare to more traditional qualitative analysis methods in terms of cost, timeliness, and ability to provide required information for programmatic decisions? Can local capacity for use of this approach be built rapidly?

• To define a cost-effective and accurate method to map ivermectin-naïve districts for Onchocerciasis, Lymphatic Filariasis and Loiasis and identify districts eligible for safe treatment with ivermectin MDA.
• To validate a statistical model of Loiasis prevalence and intensity by comparing the model results to data from a prevalence assessment.

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Demonstrate the utility of a new mapping strategy based on school cluster random sampling Using PPES. A secondary objective is to assess the value of laboratory-based antibody assays as confirmatory tests and additional diagnostic tools for measuring LF transmission. 

To compare the performance of antigen (FTS) and antibody (Wb123 monoplex) tools in programmatic settings (TAS).

Preliminary Findings and Lessons Learned

The goal of this study is to compare the performance of antigen (FTS) and antibody (Wb123 monoplex, Wb123 ELISA, multiplex) tools in programmatic settings (TAS). In order to strengthen the existing TAS platform we need to better understand which diagnostic indicator(s) are best-suited for making programmatic decisions. The TAS was conducted in Trou de Nord and Plaisance EUs.  Both EUs passed the TAS, but positive FTS were identified (4 and 2, respectively). However the Wb123 RDT found ZERO positive children, of the over 2000 tested. While the Wb123 ELISA testing is still ongoing, this initial result agrees with findings from other studies, all of which suggest that the Wb123 RDT is too insensitive a tool to be of programmatic use.

Is there still LF transmission after successful TAS 3?

1. To evaluate strategies for the elimination of trachoma by evaluating potential makers that show interruption of transmission of C. trachomatis
2. To determine the prevalence of ocular chlamydial infection among children aged 1 – 9 years old in Mpwapwa and Kalambo District, Tanzania
3. To determine the associated risk factors of ocular Chlamydia infection among children aged 1 – 9 years old in Mpwapwa and Kalambo District, Tanzania
4. To determine the usability of antibody test to detect Chlamydia antigen pgp3 using lateral flow assay
5. To examine the longevity of the antibody response to trachoma antigens in a high and low-prevalence setting

To evaluate strategies to improve the sensitivity of the TAS for detecting evidence of recent lymphatic filariasis transmission in an evaluation unit (EU). The TAS Strengthening Study in Haiti is designed to assess additional indicators that may be added to the current TAS platform in order to strengthen the resulting stopping or surveillance decisions. A comprehensive analysis will be conducted to understand the correlation between antigen and antibody in adults and children with the mosquito data. A spatial analysis looking at microfoci of infection will also be conducted.  Xenomonitoring work to assess Culex mosquitoes will be conducted in the same sites as the human sampling. 

Preliminary Findings and Lessons Learned

The ultimate goal of this study is to strengthen the existing TAS platform so that the programs can be more confident with their stopping and surveillance decisions.   In order to strengthen the existing TAS platform we need to better understand which target population(s) and diagnostic indicator(s) are best-suited for identifying areas with persistent transmission that is not expected to cease on its own, knowing that the answer may vary according the primary vector and stage of the program.  In the selected sites a community-based TAS was conducted using the standard sampling of 6-7 year olds while a community TAS (individuals >8 years) was conducted concurrently.  All samples were tested via FTS and DBS (for Wb123 ELISA).  In these same communities a molecular xenomonitoring study will take place and the mosquitoes will be tested for filarial DNA to relate back to the human specimens.  To date human sampling has been completed in all sites and laboratory analysis of the specimens is complete. Mosquito collection has been completed in Haiti and Tanzania and the PCR analysis has been completed in Haiti and is planned for Tanzania (pending the arrival of a new PCR machine).  In American Samoa xenomonitoring has been delayed due to weather conditions and arbovirus outbreaks; work is expected to commence spring 2018.

How does the performance of the new Ov16/Ov3261 test strip compare to that of the SD Ov16 RDT and the SD Ov16 ELISA?

To identify the sampling strategy for positive case follow-up after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of ongoing transmission, while saving program resources.

To define a cost-effective and accurate method to map ivermectin-naïve districts for Onchocerciasis, Lymphatic Filariasis and Loiasis and identify districts eligible for safe treatment with ivermectin MDA.

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.

• Can the micro-stratification of lymphatic filariasis (LF) transmission assessment surveys positive case and clinical case data be used to identify, map and monitor transmission hotspots as part of an enhanced endgame surveillance strategy?
• Can targeted molecular xenomonitoring detect ongoing transmission [to the same extent as human surveillance] in defined LF transmission hotspots?

Comparison of different diagnostic tools during onchocerciasis mapping, including Ov16 ELISA, OV16 rapid diagnostic test (RDT) and skin snip test.

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.

Determine the Schistosoma prevalence in the Mekong River Basin on the border of Laos and Cambodia

To evaluate the utility of ongoing surveillance of adults in a post-treatment setting.

To determine if post-treatment surveillance of adults represents a more effective surveillance strategy than TAS or xenomonitoring.

To determine if PCR or serology techniques are better than TF for assessing Trachoma prevalence during the surveillance phase of Trachoma Elimination Programs.

To study the feasibility of LF and Oncho (Filariases) integrated transmission assessment survey (iTAS)  according to both LF and Onchocerciasis  WHO elimination guidelines

To compare results from Brugia Rapid tests (in 3 districts) and FTS (in 2 districts) with Wb123 rapid tests and Wb123 and Bm14 ELISA testing.

Preliminary Findings

• In March and April 2017, NIMPE had organized teams to go to the field to collect samples. In Duy Tien district, all of 20 primary schools were visited and 320 pupils were tested. In Quang Ninh district, all of 21 primary schools were visited and 323 students participated in the survey. In Le Thuy district, 35 of 38 primary schools were visited and 344 pupils had blood samples taken. 

• In total, 987 serum samples were collected but one sample was ran out of serum after doing quick tests (Brugia rapid and FTS). Finally, 986 samples were collected for the antibodies test. The serum samples were kept in frieze (-20 0 C) until analysis. Base on the cut–off 0.096 that was calculated by CDC, no positive case was found by this technique.

• Wb123 testing was applied in all three districts to detect W. bancrofti antibody. All 986 samples were tested, but no positive case was found. This result did not indicate that the Wb123 testing accuracy is equivalent to FTS but did show that no cross action with B. malayi and other parasites was found within the study. 

• All 986 serum samples that collected from the three districts in the Mini TAS were tested by Bm14 to detect B.malayi antibody. No positive case was recorded and this result was comparable to the result from Brugia rapid test.

• Following these data, the researchers supposed that the ELISA testing could be comparable to the quick testing with regards to accuracy. However, since no positive case was found and we could not conclude about the sensitivity and the specificity of the test. Therefore, a further study should be continued especially in endemic areas in which possibly can find some positive cases for assessment and conclusion.

To investigate the presence and epidemiology of Schistosoma hybrids in Nigeria. The acquisition of new genes through hybridization may generate new phenotypes that might differ in virulence, drug resistance, pathology, and host use, ultimately leading to the emergence of new diseases. Hybrids can develop into a new emerging pathogen, necessitating new control strategies in zones where both parental species overlap, an intense and rapid control response is required to minimize further spread of the hybrid and possible escalation of human schistosomiasis.

To assess if introducing point-of-care Circulating Cathodic Antigen rapid test to community health workers will increase access, compliance and coverage to treatment among adult individuals at Kome Island in North-Western Tanzania, an area on the Lake Victoria highly endemic for schistosomiasis

To investigate the utility of an antibody test as a tool for surveillance during the elimination phase of trachoma programmes

To determine whether there is LF transmission in Cotonou and Porto-Novo, which are the two main urban locations of Benin where the LF status is undetermined. A study will be conducted to evaluate the prevalence of LF using antigenemia and antibody testing (FTS and Wb123). An entomological survey will be implemented to understand the dynamic of LF transmission and potential barriers to LF MDA in urban settings. 

Determine whether school-based TAS results in the same programmatic conclusion as a community-based TAS in EUs where school attendance is poor.

Preliminary Findings and Lessons Learned

This USAID project represents an innovative approach to resolve critical questions about the performance of the TAS and in particular, the question of how important 75% school attendance is to a valid TAS result.  At its core, this study addresses the concern that LF (specifically antigenemia) could be associated with school attendance, which leads to the programmatic research question: does a school-based TAS result in the same programmatic conclusion as a community-based TAS in EUs where school attendance is poor? This study will lead to a better understanding of the validity of the TAS in programmatic settings where school attendance and/or reporting of school enrollment may be poor.  It will also generate important results for the Haitian program that is looking to the TAS for guidance on stopping MDA in several EUs. The school- and community-based TAS were both conducted in a commune considered to be highly endemic (‘zone rouge’) at baseline.  Both surveys passed the TAS, with only 1 ICT positive child identified in the school TAS and 4 ICT-positive children in the community-based TAS.  The conclusion is that there appears to be no meaningful difference between school- and community-based TAS for stopping MDA decisions, even where school attendance is poor. This is the third LFSC/NTDSC study to return a null result -- perhaps it can now be considered a "non-issue" for LF.

Determine whether current or historic C. trachomatis (Ct) infection can be detected, and whether it is associated with clinical signs of ‘trachomatous inflammation – follicular’ (TF) in Vanuatu and Kiribati

Determine the utility of infection testing as a tool for operational surveillance and impact assessment in trachoma-endemic environments.

To improve STH detection by developing a reliable and easy to perform molecular diagnostic test for epidemiological surveillance and post-elimination monitoring of STH

To increase onchocerciasis treatment coverage and to optimize service delivery through community mobilization, disease sensitization, training and strengthening of community health extension workers (CHEW), and community control advocates

In March 2016, the Republic of Togo submitted an application for validation of the elimination of LF as a public health problem. However, healthcare facility managers in some health regions – especially in the Savanes Region, have reported the presence of migrant groups from neighboring countries which are still endemic to LF – i.e. Ghana, Burkina Faso, Nigeria. Migrants arrive and reside temporarily but recurrently in some localities of these regions. They constitute hotspots that can be source of resurgence, mainly because the nationwide passive surveillance has been stopped in 2016. 

In order to track all population movements that constitute a potential risk to the Republic of Togo, the country proposes to set up a strategy for the identification of these groups, with the contribution of Neglected Tropical Disease (NTD) Focal Points, followed by the research of potential parasite carriers. Isolated cases discovered will be investigated in order to track all imported W. bancrofti. They will be treated, but if an effective hotspot is discovered, rounds of Albendazole and Ivermectin MDA will be implemented a follow up of infected individuals will be maintained. 

The purpose of this study is to contribute maintaining the end of LF transmission across the country.

To field-test the Pgp3 lateral flow assay to compare data obtained in the field on the rapid test to that from DBS collected from the same individual tested on the Pgp3 multiplex bead array.

Mass drug administration (MDA) programs have dramatically reduced lymphatic filariasis (LF) incidence in many areas around the globe, including Bangladesh. Post-treatment surveillance activities as recommended by WHO include repeated transmission assessment surveys (TAS) among children and ongoing surveillance to detect new foci of transmission and collect data on infection trends in the general population. The contribution of molecular xenomonitoring (MX, or detection of filarial DNA in mosquitoes) to confirm the interruption of transmission during the post-treatment surveillance phase has not been well defined. There is also a need to better understand the relationship between the prevalence of W. bancrofti DNA in mosquitoes and infection in humans.

To determine the feasibility and best practices of using the Supervisor's Coverage Tool to monitor community and school-based distribution and integrated MDA.

The Supervisor’s Coverage Tool (SCT) is a rapid, simple, and inexpensive tool designed for use in Neglected Tropical Diseases (NTD) programs mass drug administration (MDA) to monitor drug coverage and compliance, to supervise community drug distributors (CDD), and to identify areas that may need mop-up. After successfully piloting the SCT in Ethiopia and Nigeria in 2015, additional testing of the tool was suggested to assess the feasibility of the tool in different regions and new settings. Therefore, the SCT was implemented in the Philippines in July 2016.

After the completion of training, the field work was conducted in two provinces, in six Supervision Areas (SA) consisting of one or more puroks (subdivisions) per barangay (village). Two survey populations were represented in the SCT implementation covering a community-based distribution for Lymphatic Filariasis (LF), excluding children aged 5-18 years and a school-based distribution for LF for all children aged 5-18 years. 

Findings and lessons learned:

• The most common reasons for not swallowing drugs were fear of side effects, not feeling well, forgetting, being too busy, and the taste of the medicine.
• When an accurate register of all the households in the SA exists, it is possible to complete the SCT in each SA in less than a day because the registers greatly aid the random selection process.
• Implementing the SCT during the last week or two of the MDA was advantageous as it enabled the program to implement the action plan to improve the current MDA using the personnel, budget, and infrastructure that was already in place for the MDA.
• It is important to consider whether or not Community Drug Distributors (CDD) should accompany the SCT teams during interviews, as their presence may influence the answers of the respondents.
• It is strongly recommended that when possible, CDDs use directly observed treatment (DOT). If DOT is not possible, CDDs should remind participants that there is no advantage in delaying swallowing the drugs, and that it is actually better when everyone swallows the drugs at the same time.
• Overall, the Philippines SCT pilot was a success, as it was the first time it was implemented in the Western Pacific region, and it was also used to monitor multiple distributions (both school- and community-based). 

What is the optimal sampling strategy for SCH impact assessments to enable sub-implementation unit decisions? 

How is the epidemiological distribution of Schistosoma haematobium in school aged children (5 to 14 years) after multiple rounds of preventive chemotherapy across three districts in Togo.

Smith College will serve as a repository for skin snip, serum, and urine samples collected as part of randomized, double-blind, parallel trials conducted in both Congo, and the Democratic Republic of Congo (DRC).

In addition to providing a valuable resource for the onchocerciasis community, a secondary objective of the establishment of this biobank will be to facilitate biomarker discovery for other pathogens.  Accordingly, these samples will be made available to researchers working in academia, industry, or government, who are interested in advancing biomarker research, regardless of their particular disease discipline.  Additionally, this biobank will serve as a foundational resource, establishing a repository to which additional samples, generated during future studies and spanning multiple diseases, can be added.

To identify the sampling strategy for positive case follow-up after TAS 2 and TAS 3 that optimizes the chances of correctly identifying evidence of ongoing transmission, while saving program resources.

Can the new recPOC-CCA test provide more accurate monitoring of Schistosoma mansoni infection prevalence in low and high endemicity settings compared to the current POC-CCA and Kato-Katz tests?

Can the Schistosoma haematobium Recombinase Polymerase Amplification (Sh-RPA) assay be optimized for field use to support monitoring and evaluation of Schistosomiasis control programs?

1. What are the socioeconomic conditions, cultural and local health system challenges impacting MDA implementation strategies?
2. What are the factors hindering sustainable delivery of MDA to control and eliminate STH and schistosomiasis in persons living in hard-to-reach communities?
3. What are the opportunities available to improve uptake and adoption of existing MDA strategies for achieving STH and schistosomiasis control and elimination targets?
 

To generate data that will determine if the QFAT is at least equivalent to the current gold standard FTS, in GPELF settings. and to determine if the QFAT is a suitable tool to be added to the GPELF diagnostic portfolio.

1. What is the microbiota in S. damnosum in northern Uganda?
2. Is there spatial variation in microbiomes sampled from different locations in northern Uganda?
3. What are the infection rates of S. damnosum with O. volvulus in different areas of northern Uganda?
4. Is there a relationship between infection status of S. damnosum and the composition of the blackfly gut microbiome?
5. Are there specific members of the S. damnosum gut microbiome that are significantly over/under-represented in O. volvulus infected/uninfected individuals?
6. Are there specific members of the S. damnosum gut microbiome that can potentially be manipulated to control the vector?
 

Are the identified antigens, CABDOU 1 and CABDOU 2 suitable markers for diagnosis of onchocerciasis in urine?

1. What are the optimal conditions for developing a simple and efficient DUS collection method that yields reliable results in diagnosing schistosomiasis using the Schistosoma CCA cassette test in resource-limited settings?
2. What are the optimal conditions for developing a simple and efficient DUS-based Schistosoma circulating antigens extraction method for detection in the Schistosoma CCA cassette test method?
3. Does the DUS-based Schistosoma CCA cassette test method give reproducible results?
4. Is the DUS-based Schistosoma CCA cassette test method produce clinically valid result?
5. What are the optimal storage conditions for DUS for maximum Schistosoma circulating antigen stability in resource-limited environments?
 

1. Has LF transmission resumed after the cessation of mass treatment with ivermectin plus albendazole in the cross-border areas of the Sikasso region which borders Guinea Conakry?

2. Are the new LF evaluation based on routine blood sample collection and detection of infection by qPCR in mosquito vectors captured in cross-border villages in the Sikasso region more sensitive than the TAS strategy?

1. Can snail eDNA be used to detect and monitor schistosome snail hosts in freshwater environments in Nigeria?

2. How do prevailing environmental factors affect sensitivity of this snail eDNA method for schistosomiasis monitoring?
 

Does lymphatic filariasis transmission interrupt or resurge after the MDA has stopped base on the TAS in the evaluation units of Hauts-Bassins region since 2011?

1. What is the prevalence of FGS among women attending reproductive health services at public health facilities in schistosomiasis hotspots in Eastern Uganda?
2. What are the patient barriers and facilitators for the integration of FGS screening using digital colposcopy in reproductive clinics at public reproductive health facilities in schistosomiasis hotspots in Eastern Uganda?
3. What are the provider barriers and facilitators for the integration of FGS screening using digital colposcopy in reproductive health clinics at public reproductive health facilities in schistosomiasis hotspots in Eastern Uganda?
 

Are there distinct genetic differences between blackflies (Simulium spp) collected from different ecological zones in Ghana?

1. What is the comparative prevalence of STH among children and adults in settings where IVM and ALB/MBZ-based MDA have been implemented for at least 10 years in comparison to settings where only ALB/MBZ-based MDA have been used with similar baseline prevalence?

2. What is the estimated time to elimination of STH in settings where IVM and ALB/MBZ-based MDA have been implemented for at least 10 years in comparison to settings where only ALB/MBZ-based MDA have been used with similar baseline prevalence using mathematical modeling?
 

Can OvMANE1 chimeric antigen specifically recognize O. volvulus antigens in human body fluids?

1. Can we identify and characterize protein-based biomarkers for schistosomiasis and schistosomiasis induced bladder pathologies using urine samples?

2. Can we identify urine antibodies to, or antigens of, S. bovis and determine their utility for diagnosis and risk of schistosomiasis haematobium and schistosomiasis-associated bladder pathologies?

3. Can we validate the identified biomarkers for consistency and reliability and inclusion in an RDT?

Will the rational selection of targets for onchocerciasis diagnosis lead to the generation of more robust, specific, and sensitive diagnostic tools?

How effective and reliable are aptamers when implemented in functional 3D µPAD, for a multiplex detection of malaria and schistosomiasis from blood samples?

1. What is the positivity rate of STH among pregnant mothers attending the ANC?
2. What is the difference in the STH burden in women who receive DOT and those who receive standard of care?
3. How acceptable is the DOT strategy in administering mebendazole among health care providers?
4. What is the information gap on STH preventive measures experienced by expectant mothers attending ANC clinics in Kilifi county?
 

- Can the co-endemicity of S. mansoni and S. haematobium in the north region of Cameroon induce a modification of the genetic structure of the parasites?
- Can the co-endemicity of S. mansoni and S. haematobium in the north region of Cameroon has an impact to the control of the disease through preventive chemotherapy?
 

1. Will the traps collect a similar daily number of host-seeking S.damnosum females than the HLC?
2. Will the physiological stage and infectivity rates of the blackflies collected by the traps be similar to those of the vector collectors?
3. Could the development of a standard and effective trap support the decision to stop MDAs by facilitating xenomonitoring of onchocerciasis?
 

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.

1. Why are communities not accepting the intervention in spite of the presence of the infections in their communities?
2. What are the causes for lack of cooperation from school teachers, and how can these be addressed?
3. What are the factors responsible for lack of communication between the stakeholders responsible for integrated control programs in the state?
4. How are the health workers remunerated, and how can the remuneration be scaled-up to encourage their active participation and success of the program?
5. How can capacity for supervision, monitoring and evaluation of the integrated program be strengthened in the state?
 

1. What is the integrated knowledge of skin NTDs among affected and unaffected households in rural endemic communities?
2. What are community perceptions on stigma, stigma drivers and strategies to prevent stigma against women with skin NTDs in selected rural endemic communities?
3. How do women with skin NTDs cope with stigma in rural endemic communities?
4. What is the health service utilization patterns of women with skin NTDs in selected rural endemic communities?
5. What is the effect of community-level multi-component intervention on health seeking, de-stigmatization and social integration of women with skin NTDs in rural endemic communities?

1. What are the community health system barriers that affect the manner in which morbidity management and disability prevention services can be made accessible to hydrocele patients from migrant and mobile fishing populations?
2. What processes and actors at community level are crucial for the integration of morbidity management and disability prevention services so as to make them accessible to hydrocele patients from migrant and mobile fishing populations?
3. What community health system strategies can be used to increase the uptake of morbidity management and disability prevention services among hydrocele patients from migrant and mobile fishing populations?
 

1. What are the supply-side health systems enablers and constraints to equitable delivery of NTD program interventions for Onchocerciasis & LF in hard-to-reach rural areas?

2. Which demand-side (socioeconomic and disability status) factors hinder equitable access to NTD program interventions for Onchocerciasis & LF in hard-to-reach rural areas?

3. What is the prevalence of disability among health facility attendees vs. persons affected by NTDs within the community in hard-to-reach rural areas?

4. What factors hinder disability-inclusion for NTD program interventions for Onchocerciasis & LF in hard-to-reach rural areas?

1. What are the temporal trends in onchocerciasis in the study communities from the commencement of interventions until the interruption of CDTi due to COVID-19?
2. What is the impact of a 12-month interruption of CDTi on such trends?
3. What is the difference between the expected and empirical trends?
4. What are the best mitigation strategies and how can they safely be implemented to minimize the impact of the interruption and/or to accelerate progress towards EOT?
 

1.What are the perceptions of community members in school deworming exercise?
2. What are the operational difficulties health workers and teachers encounter in school deworming exercise?
3. What are the barriers affecting school deworming exercise among community members?
4. What strategies can be identified to improve coverage in school deworming exercise?
 

1. What are the roots of stigma and social isolation of people living with LF?
2. What are the perceptions of people unaffected with LF, community and religious leaders, and health workers in these communities about LF?
3. Will educational interventions using various media platforms contribute to alleviating the purported social isolation by LF patients?
 

What strategic innovative alternatives could be developed for the control of onchocerciasis?

1. Is the multiplex peptide microarray effective in diagnosing schistosomiasis, lymphatic filariasis, trachoma and the STHs (roundworm, whipworm and hookworm) in Zimbabwe?
2. Is the peptide microarray effective in screening Chagas disease, guinea worm disease, sleeping sickness and visceral leismaniasis?
 

1. Can Community-Led Total Sanitation (CLTS) and WASH improve the control of schistosomiasis and soil transmitted helminthiasis among school children in a rural area?

2. Can Community-Led Total Sanitation (CLTS) facilitate the achievement of open defecation free (ODF) status in a rural community which to improve the control of schistosomiasis and soil transmitted helminthiasis among school children in a rural area?
 

1. Which combination of clinical, demographical, and behavioral variables best predict urogenital schistosomiasis diagnosis in individuals living in communities around the Mapé dam?

2. How this combination of clinical, demographical, and behavioral variables can help to establish a diagnostic score for urogenital schistosomiasis diagnosis in individuals living in communities around the Mapé dam?
 

1. What social factors contribute to non-compliance in community directed treatment with Ivermectin?
2. Are there programmatic factors that can contribute for non-compliance and impact the program?
 

Can we identify diagnostic markers of Schistosoma mansoni in environmental water samples?

1. How sensitive and specific are the antigens in the urine of onchocerciasis patients?
2. What are the structures of the onchocerca specific antigens?
 

Does the SmCTF-RDT have high sensitivity to be potentially used in the screening, disease surveillance and routine diagnosis of schistosomiasis for people in co-endemic areas in Zambia?

Could the dynamics of schistosome populations be different in children subjected to MDA of PZQ and presenting different worm burdens?

1. What are the barriers and facilitators of access to Preventive Chemotherapy among the physically disabled in Osun State viz a viz tailor-made sensitization, mobilization, and proper drug distribution to meet their peculiarity?

2. What is the capacity of the health system and NTD programme of the state to provide these services?

3. What strategies can be adapted or developed to improve access to drugs among these demography?
 

1. What is the perception of Trachoma among women who refused to have the Trachoma Trichiasis surgery in North Pokot Sub County in West Pokot County, Kenya?

2. What are the social based barriers associated with Trachoma Trichiasis Surgery refusals among women in North Pokot Sub County of West Pokot County, Kenya?

3. What are the institutional based barriers associated with Trachoma Trichiasis Surgery refusals among women in North Pokot Sub County of West Pokot County, Kenya?
 

· Is LF associated with any disease related stress in affected Ghanaian communities?
· What are the predictors of LF related stress and depressive mental illness in LF endemic communities in Ghana?
· Is LF disease related stress independent of gender, disease stage, and age in affected Ghanaian communities?
· What is the impact of lymphatic filariasis on quality of life?
 

Will assessing key functions of the existing integrated disease surveillance and response systems improve neglected tropical diseases surveillance and response at the sub-national level in Kenya?

1. What cultural and household factors influence the uptake of PC among people living in selected communities?

2. How do the communities perceive or feel about the interventions they receive?

3. What are the barriers impeding the implementation of preventive chemotherapy for helminthic-NTDs in the study area?

4. What other health-service related factors affect the delivery of preventive chemotherapy intervention for helminthic-NTDs?

A formative study to quantify and describe implementation challenges in integrating NTD data into a data warehouse using the national DHIS2 platform and make recommendations for program improvements

To identify and describe multilevel barriers to equitable and effective implementation and delivery of Schistosomiasis interventions and make recommendations.

Can a reliable molecular diagnostic test for STHs be developed and serve in the current epidemiological context of elimination and post-elimination of STHs?

Does infection data add anything to our understanding of trachoma prevalence in low endemic areas?

i) identifying all the groups migrating in districts, especially those of the northern countryside,
ii) determining LF transmission status among these migrant groups,
iii) investigating any positive cases following the algorithm of the passive surveillance.

Understanding if training and strengthening the capacity of CHEW and application of simple technology such as use of mobile SMS as reminders could amplify CDTI?

Will integrating point-of-care Circulating Cathodic Antigen in Community Directed Mass Drug Administration campaign increases the uptake, compliance and coverage of schistosomiasis treatment among adult?

How could surveillance and treatment efforts be optimized to control and eliminate NTDs in Ghana?

What is the persistence of Trichuris trichiura infection in a high transmission setting?

What is the diagnostic potential of Ov-17-IRP and Ov-MANE-1 antigens for diagnosis of individual patients or for mapping or monitoring onchocerciasis elimination programs?

To determine the current prevalence and morbidity of Male Genital Schistosomiasis (MGS) due to S. haematobium and the potential risk of HIV transmission through viral load shedding in semen, particularly of fishermen in schistosomiasis-endemic areas along shores of Lake Malawi in Mangochi district.

Use of molecular xenomonitoring, an entomological method to assess the impact of MDA on LF transmission and characterize the vector role of mosquitoes in maintaining transmission in selected endemic areas in order to improve vector control strategies and reach elimination

1. What is the baseline prevalence of STH in the Baka community?
2. What is the level of knowledge of the Baka people with respect to STH
3. What is the impact of health education on reinfection rates and parasite loads of STHs in the Baka community?
 

To screen pregnant women visiting ANC for helminth infections.

Evaluate the field applicability of a real time Recombinase Polymerase Amplification assay for the rapid diagnosis of Schistosoma haematobium infection among school children in Ashanti region, Ghana
 

To assess equitable access to PCT distribution and use, identify its barriers and facilitators to recommend possible solutions for equitable access to PCT at South Omo, Southern Ethiopia

A field evaluation of urine dipstick developed for monitoring active onchocerciasis.
 

To assess the risk of emergence of schistosomiasis in the communities of indigenous people 8 years after modification of their environment for rubber cultivation in North of Gabon.
 

Can Ov-16 Enzyme-linked immunosorbent assay (ELISA) sero-prevalence in children aged 5-9 years equal to or less than 2% at the upper bound of the 95% confidence interval be safely applied to stop Mass Drug Administration of ivermectin in onchocerciasis endemic areas without the risk of resurgence?

1.    What is the acceptability of the test and treat approach to the school kids in the hot spot areas within the two leading high prevalent districts in Unguja?
2.    How would the test and treatment, followed by vector control and behavior change impact the prevalence of schistosomiasis in the two leading districts and overall prevalence in Unguja?
3.    How feasible is the scalability of the test and treatment method in the present status of the health system? 
4.    Does the test and treat method improve therapeutic coverage within the geographical hotspots’ areas?

What is the status of lymphatic filariasis transmission eight (8) years after the cessation of mass drug administration in border areas, gold panning sites, among refugees and internally displaced persons of the country?

Could the multiplicity of gold panning sites and the security context marked by a strong movement of people have an impact on the re-emergence of lymphatic filariasis infection?

●Les données sérologiques (prévalence ou force de l’infection à l’aide de pgp3) indiquent-elles que la transmission du trachome est en cours ?

●Y a-t-il concordance entre les conclusions tirées du TF, des données PCR ? sur les infections et les données sérologiques au niveau de l’UE ?

To investigate the relationship between clinical signs of trachoma (TF), C. trachomatis infection and pgp3 antibody responses in EUs previously with recrudescent active trachoma.

1)To determine the prevalence of ocular Chlamydial infection and pgp3 serology among children aged 1 – 9 years in Nebbi East and Nebbi West EUs.

2)To determine if the Ct infection and serology data suggest ongoing transmission of trachoma within the EU. 

3)To investigate geographic, demographic, behavioral or WASH factors that are correlated with chlamydial infection, pgp3 and/or TF positivity that could inform more effective program interventions.

Is there concordance in the TF, infection and serology data (at EU level) in confirming persistence and/or recrudescence of trachoma and the need for on-going interventions?

(1)    How does TF, anti-Ct antibody and infection data correlate at cluster level and what implications does this have for targeting programmatic interventions? 

(2)    Are there treatment coverage, geographic, demographic, and WASH factors that are correlated with higher pgp3 antibody, Ct infection and/or TF prevalence that could inform more effective program interventions? 

(3)    Are there sociocultural and behavioural factors that are associated with higher TF prevalence that could inform more effective program interventions?

What are the Ct transmission dynamics in Binji and Silame LGAs, of Sokoto State and does this confirm persistence of trachoma (and need for continued MDA) as indicated in the latest impact survey?

1.    Are there any particular geographical locations or groups that have higher Ct infection and therefore driving persistence of infection and /or on-going transmission?

2.    What are the underlying (epidemiological, programmatic, contextual, and socio-behavioral) factors contributing to persistent active trachoma despite delivery of the recommended SAFE intervention strategies in Binji and Silame districts of Sokoto state?