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. 2016 May 26:16:229.
doi: 10.1186/s12879-016-1575-2.

Gaining and sustaining schistosomiasis control: study protocol and baseline data prior to different treatment strategies in five African countries

Amara E Ezeamama  1 , Chun-La He  2 , Ye Shen  2 , Xiao-Ping Yin  2 , Sue C Binder  3 , Carl H Campbell Jr  3 , Stephen Rathbun  2 , Christopher C Whalen  2 , Eliézer K N'Goran  4   5 , Jürg Utzinger  6   7 , Annette Olsen  8 , Pascal Magnussen  8 , Safari Kinung'hi  9 , Alan Fenwick  10 , Anna Phillips  10 , Josefo Ferro  11 , Diana M S Karanja  12 , Pauline N M Mwinzi  12 , Susan Montgomery  13 , W Evan Secor  13 , Amina Hamidou  14 , Amadou Garba  14 , Charles H King  15 , Daniel G Colley  3   16
Affiliations

Gaining and sustaining schistosomiasis control: study protocol and baseline data prior to different treatment strategies in five African countries

Amara E Ezeamama et al. BMC Infect Dis. .

Abstract

Background: The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in 2008 to answer strategic questions about schistosomiasis control. For programme managers, a high-priority question is: what are the most cost-effective strategies for delivering preventive chemotherapy (PCT) with praziquantel (PZQ)? This paper describes the process SCORE used to transform this question into a harmonized research protocol, the study design for answering this question, the village eligibility assessments and data resulting from the first year of the study.

Methods: Beginning in 2009, SCORE held a series of meetings to specify empirical questions and design studies related to different schedules of PCT for schistosomiasis control in communities with high (gaining control studies) and moderate (sustaining control studies) prevalence of Schistosoma infection among school-aged children. Seven studies are currently being implemented in five African countries. During the first year, villages were screened for eligibility, and data were collected on prevalence and intensity of infection prior to randomisation and the implementation of different schemes of PZQ intervention strategies.

Results: These studies of different treatment schedules with PZQ will provide the most comprehensive data thus far on the optimal frequency and continuity of PCT for schistosomiasis infection and morbidity control.

Conclusions: We expect that the study outcomes will provide data for decision-making for country programme managers and a rich resource of information to the schistosomiasis research community.

Trial registration: The trials are registered at International Standard Randomised Controlled Trial registry (identifiers: ISRCTN99401114 , ISRCTN14849830 , ISRCTN16755535 , ISRCTN14117624 , ISRCTN95819193 and ISRCTN32045736 ).

Keywords: Control; Côte d’Ivoire; Kenya; Mozambique; Niger; Praziquantel; Preventive chemotherapy; Schistosoma haematobium; Schistosoma mansoni; Schistosomiasis; Tanzania.

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Figures

Fig. 1
Fig. 1
a Study arms and timeline for the studies of gaining control of schistosomiasis in Africa. CWT, community-wide treatment; SBT, school-based treatment; Sm2, gaining control study in S. mansoni endemic villages; Sh2, gaining control study in S. haematobium endemic villages. b Study arms and timeline for the studies of sustaining control of schistosomiasis in Africa. SBT, school-based treatment; Sh1, sustaining control study in S. haematobium endemic villages; Sm1, sustaining control study in S. mansoni endemic villages
Fig. 2
Fig. 2
Baseline infection prevalence and intensity for gaining control of schistosomiasis studies, by study arm. Figures depict box plots. Horizontal lines in box interiors indicate medians. Box lengths represent the interquartile range (i.e. amount of data between the 75th and 25th percentile), + signs in boxes represent mean infection intensity (in eggs per gram of faeces (for S. mansoni) or per 10 ml of urine (for S. haematobium)) or prevalence in the respective arms 1–6 and the whiskers represent the minimum and maximum infection prevalence or intensity. Sh2, gaining control study in S. haematobium villages; Sm2, gaining control study in S. mansoni endemic villages
Fig. 3
Fig. 3
Infection prevalence and intensity for sustaining control of schistosomiasis studies, by study arm. Figures depict box plots. Horizontal lines in box interiors indicate medians. Box lengths represent the interquartile range (i.e. amount of data between the 75th and 25th percentile), + signs in boxes represent mean infection intensity (eggs per gram of faeces (for S. mansoni) or eggs per 10 ml of urine (for S. haematobium)) or prevalence in the respective arms 1–3 and the whiskers represent the minimum and maximum infection prevalence or intensity. Sh1, sustaining study in S. haematobium endemic villages; Sm1, sustaining study in S. mansoni endemic village
Fig. 4
Fig. 4
Revised study design for Niger. CWT, community-wide treatment; SBT, school-based treatment
See this image and copyright information in PMC

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