03093nas a2200397   4500000000100000008004100001260003400042653002400076653005700100653002100157653001700178653002000195653003900215653002900254653003900283653001800322653003100340653002300371100001400394700001400408700001600422700002000438700001200458700001300470700001300483700001300496700001300509700001500522700001400537700001600551245018700567856010400754300000800858520180400866022002502670       2023                            d  bOxford University Press (OUP)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aParasitology10acontrol program10aindividual longitudinal compliance10aMass drug administration10aNeglected tropical diseases (NTDs)10anever treated10asoil-transmitted helminths10atransmission break1 aMaddren R1 aCollyer B1 aPhillips AE1 aRayment Gomez S1 aAbtew B1 aAnjulo U1 aTadele D1 aSharma A1 aTamiru A1 aFirdawek E1 aChernet M1 aAnderson RM00aPatterns of individual compliance with anthelmintic treatment for soil-transmitted helminth infections in southern Ethiopia over six rounds of community-wide mass drug administration  uhttps://academic.oup.com/trstmh/advance-article-pdf/doi/10.1093/trstmh/trad079/53408000/trad079.pdf  a1-93 a<p><strong>Background:&nbsp;</strong>The mainstay of soil-transmitted helminth (STH) control is repeated mass drug administration (MDA) of anthelmintics to endemic populations. Individual longitudinal compliance treatment patterns are important for identifying pockets of infected individuals who remain untreated and serve as infection reservoirs.</p>

<p><strong>Methods:</strong> The Geshiyaro Project censused the study population in Wolaita, Ethiopia at baseline in 2018. Individual longitudinal compliance was recorded for six rounds of community-wide MDA (cMDA). The probability distribution of treatment frequency was analysed by age and gender stratifications. Probabilities of transmission interruption for different compliance patterns were calculated using an individual-based stochastic model of Ascaris lumbricoides transmission.</p>

<p><strong>Results:</strong> The never-treated (0.42%) population was smaller than expected from a random positive binomial distribution. The observed compliance frequency was well described by the beta-binomial distribution. Preschool-age children (odds ratio [OR] 10.1 [95% confidence interval {CI} 6.63 to 15.4]) had the highest never-treated proportion of the age groups. Conversely, school-age children (SAC) and adults (OR 1.03 [95% CI 0.98 to 1.09]) had the highest always-treated proportion of the age groups.</p>

<p><strong>Conclusions:</strong> The study reports the largest dataset of individual longitudinal compliance to cMDA for STH control. Clear pattens are shown in the age-dependent distribution of individual compliance behaviour. The impact of compliance on the probability of elimination is significant, highlighting the importance of recording the full frequency distribution, not just the never-treated proportion.</p>
  a0035-9203, 1878-3503