@article{101215,
  keywords = {Soil-transmitted helminths, Mass drug administration, Albendazole, Community, Coverage},
  author = {Means AR and Ásbjörnsdóttir KH and Sharrock KC and Galagan SR and Aruldas K and Avokpaho E and Chabi F and Halliday KE and Houngbégnon P and Israel GJ and Kaliappan SP and Kennedy D and Legge H and Oswald WE and Palanisamy G and Rogers E and Timothy J and Pearman E and Ramesh RM and Simwanza J and Sheik-Abdullah JF and Sheikh M and Togbevi CI and Witek-McManus S and Pullan RL and Bailey R and Kalua K and Ibikounlé M and Luty AJF and Ajjampur SSR and Walson JL},
  title = {Coverage of community-wide mass drug administration platforms for soil-transmitted helminths in Benin, India, and Malawi: findings from the DeWorm3 project},
  abstract = {<p><strong>Background: </strong>Soil-transmitted helminths (STH) affect approximately 1.5 billion people globally. The current STH control strategy is annual or twice-annual preventive chemotherapy, typically school-based deworming targeting children and women of reproductive age. Mathematical modeling suggests that it may be possible to interrupt STH transmission through high-coverage community-wide mass drug administration (cMDA). DeWorm3 is a cluster randomized trial testing cMDA for prevalence reduction and transmission interruption. The purpose of this study is to describe coverage of cMDA in study clusters over time and correlates of coverage at individual and cluster levels.</p>

<p><strong>Methods:</strong>&nbsp;From 2018–2020, DeWorm3 delivered six rounds of cMDA with 400&nbsp;mg albendazole at sites in Benin, India, and Malawi. We report coverage, treatment uptake, and directly observed therapy across all rounds. Factors associated with coverage at the cluster level were identified using binomial generalized estimating equations, while factors associated with non-treatment at the individual level were identified using binomial mixed-effects models.</p>

<p><strong>Results:</strong> Coverage was high across all clusters and rounds, exceeding the WHO target of 75% in all sites and across all rounds (78% to 95%); cluster-level coverage tended to increase over time. Younger, unmarried, and migratory adults were more likely to be untreated at all sites; adult males were more likely to be untreated in Benin and Malawi. Among children, girls were more likely to be untreated, as were non-school-attending and migratory children. Higher adult education was associated with greater odds of non-treatment among adults, but lower odds among children in the household. Belonging to a less wealthy or minority language-speaking household was associated with non-treatment among both adults and children.</p>

<p><strong>Conclusions: </strong>It is possible to deliver community-wide MDA with high coverage. Unique individual and community-level factors influence treatment across settings, and these may be addressed through targeted programming. Trial Registration: Field Studies on the Feasibility of Interrupting the Transmission of Soil-transmitted Helminths (STH), NCT03014167.</p>
},
  year = {2024},
  journal = {Infectious Diseases of Poverty},
  volume = {13},
  pages = {1-14},
  publisher = {Springer Science and Business Media LLC},
  issn = {2049-9957},
  url = {https://link.springer.com/content/pdf/10.1186/s40249-024-01241-0.pdf},
  doi = {10.1186/s40249-024-01241-0},
  language = {ENG},
}