03026nas a2200373   4500000000100000008004100001260003700042653002400079653005700103100001600160700001400176700002000190700001600210700001300226700001400239700001500253700001400268700001500282700001600297700001100313700001300324700001300337700001500350700001200365700001600377700001500393700001600408245022400424856009900648300001300747490000700760520187100767022001402638       2022                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health1 aLanderyou T1 aMaddren R1 aRayment Gomez S1 aKalahasti S1 aLiyew EF1 aChernet M1 aMohammed H1 aWuletaw Y1 aTruscott J1 aPhillips AE1 aOwer A1 aForbes K1 aAnjulo U1 aMengistu B1 aTasew G1 aSalasibew M1 aAnderson R1 aSantiago HC00aLongitudinal monitoring of prevalence and intensity of soil-transmitted helminth infections as part of community-wide mass drug administration within the Geshiyaro project in the Bolosso Sore district, Wolaita, Ethiopia  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0010408&type=printable  ae00104080 v163 a<p>Mass drug administration (MDA), targeted at school-aged children (SAC) is recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds, and research suggests that only treating SAC will not be sufficient to interrupt transmission of STH. In countries with endemic infection, such as Ethiopia, the coverage, community-groups targeted, and rates of reinfection will determine how effective MDA is in suppressing transmission in the long-term. In this paper, individually-linked longitudinal data from three epidemiological STH surveys conducted between November 2018 and November 2020 in the Wolaita region of Ethiopia are analysed to determine how STH prevalence and intensity changes according to individual level treatment data collected over two rounds of MDA. This study demonstrates that while community-wide MDA successfully reduces overall infection intensity across the villages treated, the observed levels of non-compliance to treatment by individuals acts to maintain levels of parasite abundance whereby transmission interruption is not possible at to, despite reasonable levels of MDA coverage in the communities studied (ranging from 65% to 84% of the village populations). This quantifies with substantial data the often-postulated difference between coverage (accepting treatment) and compliance (swallowing of treatment), the latter impacting the former to a previously unquantified level. The paper highlights the need to focus treatment to partially treated, or never treated groups of individuals within existing community wide MDA control activities to interrupt the transmission of STH, and to reduce the basic reproductive number, R0, of the parasites to less than unity in value.</p>
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