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Brady MA, Toubali E, Baker M, Long E, Worrell C, Ramaiah K, Graves P, Hollingsworth TD, Kelly-Hope L, Stukel D, Tripathi B, Rubin Means A, Hadley Matendechero S, Krentel A. Persons 'never treated' in mass drug administration for lymphatic filariasis: identifying programmatic and research needs from a series of research review meetings 2020-2021. Int Health 2023:ihad091. [PMID: 37846645 PMCID: PMC11021373 DOI: 10.1093/inthealth/ihad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
As neglected tropical disease programs rely on participation in rounds of mass drug administration (MDA), there is concern that individuals who have never been treated could contribute to ongoing transmission, posing a barrier to elimination. Previous research has suggested that the size and characteristics of the never-treated population may be important but have not been sufficiently explored. To address this critical knowledge gap, four meetings were held from December 2020 to May 2021 to compile expert knowledge on never treatment in lymphatic filariasis (LF) MDA programs. The meetings explored four questions: the number and proportion of people never treated, their sociodemographic characteristics, their infection status and the reasons why they were not treated. Meeting discussions noted key issues requiring further exploration, including how to standardize measurement of the never treated, adapt and use existing tools to capture never-treated data and ensure representation of never-treated people in data collection. Recognizing that patterns of never treatment are situation specific, participants noted measurement should be quick, inexpensive and focused on local solutions. Furthermore, programs should use existing data to generate mathematical models to understand what levels of never treatment may compromise LF elimination goals or trigger programmatic action.
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Affiliation(s)
- Molly A. Brady
- Department of Global Health, RTI International, Washington, DC 20008, USA
| | - Emily Toubali
- Neglected Tropical Diseases Division, Office of Infectious Disease, Bureau for Global Health, United States Agency for International Development, Washington, DC 20547, USA
| | - Margaret Baker
- Department of Global Health, RTI International, Washington, DC 20008, USA
- Georgetown University, Washington, DC 20057, USA
| | - Elizabeth Long
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Caitlin Worrell
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
- Department of Epidemiology, Swiss Tropical and Public Health Institute, Basel 4051, Switzerland
- Faculty of Science, University of Basel, Basel 4001, Switzerland
| | - Kapa Ramaiah
- Consultant, Lymphatic Filariasis Epidemiologist, Pondicherry, India
| | - Patricia Graves
- College of Public Health, Medical and Veterinary Sciences and WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Nguma-bada Campus, Cairns, QLD 4870, Australia
| | - T. Deirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, OX3 7LF, UK
| | - Louise Kelly-Hope
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
- University of Liverpool, Institute of Infection, Veterinary and Ecological Sciences, Brownlow Hill, Liverpool, L2 5RF, UK
| | - Diana Stukel
- Act to End Neglected Tropical Diseases West, Department of Global Health and Population, FHI 360, Washington, DC 20009, USA
| | - Bhupendra Tripathi
- Bill and Melinda Gates Foundation, India Country Office, New Delhi 110067, India
| | | | | | - Alison Krentel
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Drive, Ottawa, ON K1G 5Z3, Canada
- Bruyère Research Institute, Ottawa, ON K1N 5C8, Canada
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Woodhall DM, Mkwanda S, Dembele M, Lwanga H, Drexler N, Dubray C, Harris J, Worrell C, Mathieu E. Exploring innovative ways to conduct coverage surveys for neglected tropical diseases in Malawi, Mali, and Uganda. Acta Trop 2014; 132:119-24. [PMID: 24462795 DOI: 10.1016/j.actatropica.2014.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 10/18/2013] [Accepted: 01/09/2014] [Indexed: 11/29/2022]
Abstract
Currently, a 30-cluster survey to monitor drug coverage after mass drug administration for neglected tropical diseases is the most common methodology used by control programs. We investigated alternative survey methodologies that could potentially provide an estimation of drug coverage. Three alternative survey methods (market, village chief, and religious leader) were conducted and compared to the 30-cluster method in Malawi, Mali, and Uganda. In Malawi, drug coverage for the 30-cluster, market, village chief, and religious leader methods were 66.8% (95% CI 60.3-73.4), 74.3%, 76.3%, and 77.8%, respectively. In Mali, results for round 1 were 62.6% (95% CI 54.4-70.7), 56.1%, 74.8%, and 83.2%, and 57.2% (95% CI 49.0-65.4), 54.5%, 72.2%, and 73.3%, respectively, for round 2. Uganda survey results were 65.7% (59.4-72.0), 43.7%, 67.2%, and 77.6% respectively. Further research is needed to test different coverage survey methodologies to determine which survey methods are the most scientifically rigorous and resource efficient.
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Affiliation(s)
- Dana M Woodhall
- Parasitic Diseases Branch Centers for Disease Control Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States.
| | - Square Mkwanda
- Ministry of Health, P.O. Box 30377, Capital City, Lilongwe 3, Malawi.
| | | | - Harriet Lwanga
- RTI Uganda, P.O. Box 1661, Buganda Road, Kampala, Uganda.
| | - Naomi Drexler
- Parasitic Diseases Branch Centers for Disease Control Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States
| | - Christine Dubray
- Parasitic Diseases Branch Centers for Disease Control Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States
| | - Jennifer Harris
- Parasitic Diseases Branch Centers for Disease Control Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States
| | - Caitlin Worrell
- Parasitic Diseases Branch Centers for Disease Control Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States
| | - Els Mathieu
- Parasitic Diseases Branch Centers for Disease Control Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States
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Suchdev PS, Davis S, Ruth L, Worrell C, Wiegand R, Montgomery JM, Foxe L. Soil‐transmitted helminthic infection and nutritional status among urban slum children in Kenya. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.357.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Mass drug administration is one of the public health strategies recommended by the World Health Organization for the control and elimination of seven neglected tropical diseases (NTDs). Because adequate coverage is vital to achieve program goals, periodically conducting surveys to validate reported coverage to guide NTD programs is recommended. Over the past decade, the Centers for Disease Control and Prevention (CDC) and collaborators conducted more than 30 two-stage cluster household surveys across three continents. The questionnaires gathered coverage data and information relevant to improving NTD programs including NTD-related attitudes and practices. From the 37 coverage survey estimates obtained in those surveys, 73.3% indicated an over reporting of coverage, including all three that assessed school-based distributions. It took an average of 1 week to conduct a survey. Our experiences led us to conclude that coverage surveys are useful and feasible tools to ensure NTD elimination and control goals are reached.
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Affiliation(s)
- Caitlin Worrell
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Worrell C, Xiao N, Vidal JE, Chen L, Zhong B, Remais J. Field detection of Schistosoma japonicum cercariae in environmental water samples by quantitative PCR. Appl Environ Microbiol 2011; 77:2192-5. [PMID: 21278276 PMCID: PMC3067307 DOI: 10.1128/aem.01561-10] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 01/20/2011] [Indexed: 01/21/2023] Open
Abstract
A species-specific quantitative PCR (qPCR) assay was combined with two novel water-sampling methods and compared with the mouse bioassay for the quantitative detection of S. japonicum in surface waters. The novel methods were capable of capturing cercariae and, with subsequent analysis through qPCR, detecting the presence of a minimum of 1 cercaria.
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Affiliation(s)
- Caitlin Worrell
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322, Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 61004, People's Republic of China, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322
| | - Ning Xiao
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322, Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 61004, People's Republic of China, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322
| | - Jorge E. Vidal
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322, Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 61004, People's Republic of China, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322
| | - Lin Chen
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322, Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 61004, People's Republic of China, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322
| | - Bo Zhong
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322, Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 61004, People's Republic of China, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322
| | - Justin Remais
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322, Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 61004, People's Republic of China, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322
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Dieterich DT, Chachoua A, Lafleur F, Worrell C. Ganciclovir treatment of gastrointestinal infections caused by cytomegalovirus in patients with AIDS. Rev Infect Dis 1988; 10 Suppl 3:S532-7. [PMID: 2847290 DOI: 10.1093/clinids/10.supplement_3.s532] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Ganciclovir (DHPG) treatment of 69 AIDS patients with gastrointestinal infection due to cytomegalovirus (CMV) was studied. Sites of infection included the colon (46 patients, 67%), esophagus and stomach (15 patients, 22%), rectum (five patients, 7%), liver (two patients, 3%), and small bowel (one patient, 1.4%). Ganciclovir was given in a dose of 5 mg/kg intravenously every 12 hours for 14 days. Maintenance therapy consisted of 6 mg/kg daily. Positive clinical responses were seen in 52 (75%) of the 69 patients, stable responses in 9 (13%), and worsening in eight (11%). The virologic response was positive in 47 patients (68%), while virologic findings did not change in three patients (4%) and could not be evaluated in 19 patients (28%). Toxicity was mainly hematologic, with moderate leukopenia (1,000-1,900 leukocytes/mm3) in seven patients and severe leukopenia (less than 1,000 leukocytes/mm3) in three patients. The median survival time was 18 weeks (range, 1-68 weeks). Forty-seven patients survived for 4 weeks; of these, 22 (47%) relapsed. The median time to relapse was 9 weeks. Despite the uncontrolled nature of this study, ganciclovir is probably an effective and safe agent for the treatment of gastrointestinal CMV infections. The high probability of relapse (50%) should be considered and maintenance therapy offered to most patients.
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Affiliation(s)
- D T Dieterich
- Kaplan Cancer Center, New York University Medical Center, New York 10016
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Worrell C. Alcoholic or Non-Alcoholic Treatment of Typhoid Fever. West J Med 1884. [DOI: 10.1136/bmj.1.1202.81-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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