03552nas a2200397   4500000000100000008004100001260004400042653001800086653001700104653001600121653003300137653002900170653001300199653002000212653003200232653001900264653002600283653001900309100001500328700001300343700001100356700001300367700001400380700001700394700001100411700001100422700001300433700001100446700001200457245011200469856008600581300000900667490000700676520245700683022001403140       2024                            d  bSpringer Science and Business Media LLC10aInterventions10aCase finding10aElimination10ainterruption of transmission10aMass drug administration10aZanzibar10aSchistosomiasis10atest-treat-track-test-treat10aTest-and-treat10aSurveillance-response10aS. haematobium1 aTrippler L1 aTaylor L1 aAli MN1 aNajim SO1 aKhamis KS1 aHattendorf J1 aJuma S1 aAme SM1 aKabole F1 aAli SM1 aKnopp S00aTest-treat-track-test-treat (5T) approach for Schistosoma haematobium elimination on Pemba Island, Tanzania  uhttps://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/s12879-024-09549-w.pdf  a1-160 v243 a<p><strong>Background:</strong> After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania.</p>

<p><strong>Methods:</strong> School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area.</p>

<p><strong>Results:</strong> The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive.</p>

<p><strong>Conclusions: </strong>The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination.&nbsp;</p>
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