Awards

Hussein Abdullahi of Wajir County Government in Kenya will combine a mass drug administration effort to treat soil-transmitted helminth (parasitic worm) infections in Wajir County with a survey of the number of cases of visceral leishmaniasis, which is transmitted by sand flies. Visceral leishmaniasis can be lethal and has recently become endemic in this poor Kenyan county, but the actual disease burden is unknown. They will compile community data on mapped settlements in two subcounties, and recruit and train local health workers to distribute questionnaires to help identify past and present cases of visceral leishmaniasis, which will help identify risk factors. In parallel, these workers will distribute deworming drugs, which has been difficult in the area due to low attendance rates at schools where mass deworming efforts normally take place.

Rebecca Katz of George Washington University in the U.S. will identify the most cost-efficient and effective way to integrate the existing mass drug administration program for the parasitic disease schistosomiasis with the control program for malaria in Yemen. Both diseases are widespread in Yemen, but control efforts are currently separate, so combining them would pool financial and human resources. They will build a framework to model the health systems and structures in the current individual control programs and use it to quantify the relative strengths of different modes of integration. The chosen integration method will be assessed for cost and coverage by comparing it against other methods.

Jane Whitton of Schistosomiasis Control Initiative in the United Kingdom will test whether grouping treatments for three neglected tropical diseases alongside motivating people to come for the treatments by offering incentives such as free shoes or free school meals can increase coverage and better reduce disease incidence. Current treatment campaigns for different diseases run in parallel, requiring multiple clinic visits, which is inconvenient. They will perform a clustered randomized control trial with 75 villages to test whether administering the treatments during one visit, and offering an additional incentive, increases coverage.

Louis-Albert Tchuem Tchuente of the Centre for Schistosomiasis and Parasitology in Cameroon will work to eliminate one species of the parasitic flatworm Schistosoma that causes severe disease in certain regions of Cameroon. They will intensify current school-based mass drug administration efforts in the Litteral region to increase treatment coverage to individuals of all ages. They will integrate the existing control program with maternal and child health weeks to reach children under school age, and community-based interventions for other diseases to reach children not attending school and adults. Their approach will be evaluated by measuring infection levels in the population after two Rounds of treatment.

Jessa Gitaka of Mount Kenya University in Kenya will work to integrate surveillance and control of three diseases - malaria, schistosomiasis and soil-transmitted helminths - in five Lake Victoria islands where these diseases are highly prevalent. This should improve cost-effectiveness and promote greater participation. They have already established facilities and systems to semi-annually survey malaria in the region, which includes a 30-person motorboat to access the islands, a parasitology laboratory and trained personnel. They will exploit this setup to first collect general data and identify those who are infected during clinic visits and household surveys, and then perform mass drug administration for schistosomiasis and soil-transmitted helminths using standard treatments.

Glenn Morris of the University of Florida in the U.S. will evaluate different strategies for integrating three national disease elimination programs against lymphatic filariasis, malaria and cholera, which are currently being run in parallel in Haiti. These campaigns involve improving water, sanitation and hygiene, and providing insecticide-treated bed nets. They are funded and coordinated by different departments and each target a specific disease. Integrating them could improve their effectiveness and reduce associated costs. They will perform pilot studies in two villages and one town in Haiti to evaluate four different integration scenarios and model their potential for scale-up including assessing the degree of acceptance by the community.

Miriam Laufer of the University Maryland in the U.S. will boost malaria treatment and control in Malawi by linking it with a school-based mass drug administration program for other neglected tropical diseases, and improve uptake by engaging school children to reach those not attending school. School-aged children carry one of the highest burdens of malaria infection so disease campaigns should also directly target schools. However, there is a high frequency of school absence in Malawi. They will perform a pilot study on ten primary schools, and use the mass drug administration program to conduct a health day for the testing and treatment of malaria. They will also recruit older children at the school to act as health scouts to communicate between health care workers and children who are not in school.

Felix Lankester of Washington State University in the U.S. will determine whether integrating a mass drug administration campaign targeting soil-transmitted helminth infections with a mass dog rabies vaccination campaign reduces costs and extends treatment coverage for these diseases, which are endemic in Tanzania. Collaborators include: Safari Kinunghi - National Institute of Medical Research, Tanzania, Sarah Cleaveland - University of Glasgow and Deborah Watson Jones - London School of Hygiene and Tropical Medicine. Current mass drug administration efforts mostly target schools, neglecting the young, adult and elderly populations, and often lack community support. They are also difficult to extend to rural communities. However, many people in rural communities own dogs, and are willing to participate in rabies vaccination campaigns. They will perform a randomized cluster controlled trial involving 60 villages receiving either integrated or non-integrated control strategies, and evaluate their effect on disease prevalence and treatment uptake.

Gilbert Saint Jean of the University of Notre Dame in the U.S. will promote the consumption of salt fortified with both iodine, which is essential for child and maternal health, and the drug DEC, which is used to treat the parasitic disease lymphatic filariasis, in Haiti. Haitian emigrants residing in the U.S. frequently purchase food vouchers via money transfer company websites for their families in Haiti. The researchers will partner with food remittance companies to build on this system and offer vouchers for their tested DEC-iodized cooking salt. They will pilot test the approach in Florida by educating a group of emigrants on the health benefits of the salt, and evaluate uptake and the effect on iodine levels and disease incidence in their families back in Haiti.

Romeo Montoya of OPS/OMS Honduras in Honduras will test an integrated approach of deworming, education, vitamin A supplements, and improved water quality and sanitation to decrease the incidence and effects of intestinal parasites in school children in Honduras. Intestinal worms are highly prevalent in Honduras and a significant cause of morbidity and mortality. By integrating several treatment strategies together with national vaccination campaigns they hope to broaden coverage to the entire population and reduce costs.