Dataset from Field Studies on the Feasibility of Interrupting the Transmission of Soil-transmitted Helminths (STH) DeWorm3 Project

Over 1.5 billion people are infected with soil-transmitted helminths (STH). Global STH guidelines recommend MDA (mass drug administration) of albendazole or mebendazole to targeted populations, including pre-school age children and school-age children. However mathematical models suggests that current MDA strategies are not sufficient for interrupting disease transmission in most areas. Meanwhile many lymphatic filariasis (LF) programs have successfully treated entire populations with albendazole (in combination with ivermectin or diethylcarbamazine) and are transitioning to a state of post-MDA surveillance. This project will conduct a series of community-based cluster randomized trials in India, Malawi, and Benin to determine if maintaining three years of MDA with albendazole to entire communities following the cessation of LF programs can interrupt STH transmission in focal geographic areas. Additionally, this study aims to compare the efficacy of community-wide MDA versus targeted MDA of children in interrupting the transmission of STH. Nested implementation science research will be used to optimize the intervention, identify contextual factors influencing trial efficacy, and evaluate the feasibility of sustaining and scaling community-wide MDA for STH. These data will provide evidence necessary to inform future guidelines, policies, and operational plans as country partners engage in intensified approaches to eliminate these disabling diseases.

全球已有超过15亿人感染土源性蠕虫（soil-transmitted helminths, STH）。全球土源性蠕虫防治指南推荐对目标人群——包括学龄前儿童与学龄儿童——实施阿苯达唑或甲苯咪唑的大规模药物投放（mass drug administration, MDA）。但数学模型显示，当前的大规模药物投放策略在多数地区均不足以阻断疾病传播。与此同时，诸多淋巴丝虫病（lymphatic filariasis, LF）项目已成功联合伊维菌素或乙胺嗪，使用阿苯达唑对全体人群开展治疗，目前正转向大规模药物投放后的监测阶段。本项目将在印度、马拉维与贝宁开展一系列基于社区的整群随机试验，以明确在淋巴丝虫病项目终止后，对全体社区持续三年实施阿苯达唑大规模药物投放，是否能够在特定地理区域阻断土源性蠕虫的传播。此外，本研究旨在对比全民大规模药物投放与针对儿童的靶向大规模药物投放在阻断土源性蠕虫传播方面的效果差异。本研究将采用嵌套式实施科学研究方法，用于优化干预措施、识别影响试验效果的情境因素，并评估维持与推广全民大规模药物投放以防治土源性蠕虫的可行性。上述研究数据将为各国合作伙伴强化消除这类致残性疾病的相关举措，提供制定未来指南、政策及实施方案所需的循证依据。