Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2019 Sep 18;19(1):822.
doi: 10.1186/s12879-019-4449-6.

A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol

Naomi E Clarke  1 , Dinh Ng-Nguyen  2 , Rebecca J Traub  3 , Archie C A Clements  4   5 , Kate Halton  6 , Roy M Anderson  7 , Darren J Gray  8 , Luc E Coffeng  9 , John M Kaldor  10 , Susana Vaz Nery  10
Affiliations
Randomized Controlled Trial

A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol

Naomi E Clarke et al. BMC Infect Dis. .

Abstract

Background: Current guidelines and targets for soil-transmitted helminth (STH) control focus on school-based deworming for school-age children, given the high risk of associated morbidity in this age group. However, expanding deworming to all age groups may achieve improved STH control among both the community in general and school-age children, by reducing their risk of reinfection. This trial aims to compare school-based targeted deworming with community-wide mass deworming in terms of impact on STH infections among school-age children.

Methods: The CoDe-STH (Community Deworming against STH) trial is a cluster-randomised controlled trial (RCT) in 64 primary schools in Dak Lak province, Vietnam. The control arm will receive one round of school-based targeted deworming with albendazole, while in the intervention arm, community-wide mass deworming with albendazole will be implemented alongside school-based deworming. Prevalence of STH infections will be measured in school-age children at baseline and 12 months following deworming. The primary outcome is hookworm prevalence in school-age children at 12 months, by quantitative PCR. Analysis will be intention-to-treat, with outcomes compared between study arms using generalised linear and non-linear mixed models. Additionally, cost-effectiveness of mass and targeted deworming will be calculated and compared, and focus group discussions and interviews will be used to assess acceptability and feasibility of deworming approaches. Individual based stochastic models will be used to predict the impact of mass and targeted deworming strategies beyond the RCT timeframe to assess the likelihood of parasite population 'bounce-back' if deworming is ceased due to low STH prevalence.

Discussion: The first large-scale trial comparing mass and targeted deworming for STH control in South East Asia will provide key information for policy makers regarding the optimal design of STH control programs.

Trial registration: ACTRN12619000309189 .

Keywords: Albendazole; Hookworm; Mass drug administration; Soil-transmitted helminths.

PubMed Disclaimer

Conflict of interest statement

RMA is non-Executive Chairman of Oriole Global Health Ltd. All other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the trial
Fig. 2
Fig. 2
Map of Vietnam showing Dak Lak province and its second-tier administrative units (districts, town and city)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization . Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases. Geneva: WHO; 2010.
    1. Hall A, Hewitt G, Tuffrey V, De Silva N. A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Matern Child Nutr. 2008;4(Suppl 1):118–236. doi: 10.1111/j.1740-8709.2007.00127.x. - DOI - PMC - PubMed
    1. Smith JL, Brooker S. Impact of hookworm infection and deworming on anaemia in non-pregnant populations: a systematic review. Tropical Med Int Health. 2010;15:776–795. doi: 10.1111/j.1365-3156.2010.02542.x. - DOI - PMC - PubMed
    1. Stoltzfus RJ, Chwaya HM, Tielsch JM, Schulze KJ, Albonico M, Savioli L. Epidemiology of iron deficiency anemia in Zanzibari schoolchildren: the importance of hookworms. Am J Clin Nutr. 1997;65:153–159. doi: 10.1093/ajcn/65.1.153. - DOI - PubMed
    1. World Health Organization . Crossing the billion. Lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases and trachoma: preventive chemotherapy for neglected tropical diseases. Geneva: WHO; 2017.

Publication types

LinkOut - more resources