Tailoring Mass Drug Administration to Context: Implementation Research is Critical in Achieving Equitable Progress in the Control and Elimination of Helminth Neglected Tropical Diseases in sub-Saharan Africa


Control and elimination of neglected tropical diseases (NTDs) pose significant challenges to the health system, especially in low and middle income countries (LMICs).1 During a recent meeting, ‘The disease elimination agenda: the role of science and advocacy’ hosted by the Royal Society of Tropical Medicine and Hygiene, a session focused on ‘magic bullets’ and technological quick fixes that may change the landscape of NTDs. This commentary is based on a presentation given at that meeting, which contests the idea that a single ‘magic bullet’ approach would necessarily impact the NTD landscape, arguing that implementation research to understand how to maximise impact from existing NTD interventions is required.We do this through the example of preventive chemotherapy (PC) strategies, which offer expanded access to anthelminthics.

PC interventions, usually through mass drug administration (MDA), have become the primary public health intervention in meeting the NTD roadmap targets for control and elimination of helminth infections. The helminth diseases amenable to PC are lymphatic filariasis (LF), onchocerciasis, soil-transmitted helminthiasis (STH) and schistosomiasis. Trachoma (caused by the chlamydia infection) includes MDA as part of its broader SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvements). Recent reports of drug treatment coverage show that national MDA campaigns have been successful, reaching a signifi- cant proportion of those in need. (Read more...)


Full Reference:

Dean L, Page S, Hawkins K, Stothard R, Thomson R, Wanji S, Gyapong M, Anagbogu I, Molyneux D & Theobald S (2016; 8: 233–234) International Health