02243nas a2200229 4500000000100000008004100001260001600042653002100058653001600079653003900095653001400134653002900148653004300177100001300220700001600233245012400249856011900373300000600492490000800498520149300506022001401999 2025 d bElsevier BV10aSchistosomiasis 10aSchistosoma10aNeglected tropical diseases (NTDs)10aModelling10aMass drug administration10aElimination as a public health problem1 aEllis JR1 aAnderson RM00aPreschool age participation in mass drug administration: Analyzing the impact on community-wide schistosomiasis control uhttps://www.sciencedirect.com/science/article/pii/S1201971225001420?via%3Dihub&mc_cid=d9d90b7da0&mc_eid=4c83d0322d a70 v1563 a

Objectives

Schistosome infection in childhood is common and can lead to morbidity. A formulation of praziquantel to treat preschool-aged children (PSAC) has been developed recently. This paper assesses the impact of including PSAC in mass drug administration (MDA) on transmission and morbidity at a community-wide level.

Methods

We used a model of schistosome transmission to simulate the probability of a community reaching elimination as a public health problem (EPHP) and the reduction in morbidity of children resulting from infections until the age of 5 years, measured by a “worm years” metric as a score of morbidity.

Results

Including PSAC in MDA will almost always lead to a reduction in morbidity. However, it does not necessarily result in a substantial increase in the probability of EPHP. The proportion of schistosome infections in each age group is a key factor in determining the effectiveness of MDA programs, which prioritize different age groups for treatment.

Conclusions

Policymakers should be aware that including PSAC in MDA may not help to reach the World Health Organization target of EPHP. However, a reduction in the average summed worm infection burden at the age children typically start attending school is highly desirable in increasing the long-term benefit of MDA in early childhood.

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