02915nas a2200385   4500000000100000008004100001260001200042653001000054653002500064100001500089700001300104700001100117700001200128700001600140700001300156700001400169700001200183700001500195700001000210700001000220700001300230700001500243700001400258700001300272700001500285700001600300700001700316700001300333700001300346700001300359245009400372856016200466520188700628022001402515       2020                            d  c05/202010aSCORE10aOperational research1 aCampbell C1 aBinder S1 aKing C1 aKnopp S1 aRollinson D1 aPerson B1 aWebster B1 aAllan F1 aUtzinger J1 aAme S1 aAli S1 aKabole F1 aN'Goran EK1 aTediosi F1 aSalari P1 aOuattara M1 aDiakité NR1 aHattendorf J1 aAndros T1 aKittur N1 aColley D00aSCORE Operational Research on Moving toward Interruption of Schistosomiasis Transmission.  uhttp://www.ajtmh.org/docserver/fulltext/10.4269/ajtmh.19-0825/tpmd190825.pdf?expires=1589990273&id=id&accname=guest&checksum=B86891580E40781B2188A0A62924A4653 a<p>As part of its diverse portfolio, the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) included two cluster-randomized trials evaluating interventions that could potentially lead to interruption of schistosomiasis transmission (elimination) in areas of Africa with low prevalence and intensity of infection. These studies, conducted in Zanzibar and Côte d'Ivoire, demonstrated that multiyear mass drug administration (MDA) with praziquantel failed to interrupt the transmission of urogenital schistosomiasis, even when provided biannually and/or supplemented by small-scale implementation of additional interventions. Other SCORE activities related to elimination included a feasibility and acceptability assessment of test-treat-track-test-treat (T5) strategies and mathematical modeling. Future evaluations of interventions to eliminate schistosomiasis should recognize the difficulties inherent in conducting randomized controlled trials on elimination and in measuring small changes where baseline prevalence is low. Highly sensitive and specific diagnostic tests for use in very low-prevalence areas for schistosomiasis are not routinely available, which complicates accurate measurement of infection rates and assessment of changes resulting from interventions in these settings. Although not encountered in these two studies, as prevalence and intensity decrease, political and community commitment to population-wide MDA may decrease. Because of this potential problem, SCORE developed and funded the T5 strategy implemented in Egypt, Kenya, and Tanzania. It is likely that focal MDA campaigns, along with more targeted approaches, including a T5 strategy and snail control, will need to be supplemented with the provision of clean water and sanitation and behavior change communications to achieve interruption of schistosome transmission.</p>  a1476-1645