03008nas a2200277   4500000000100000008004100001653003900042653002000081653003000101653002500131100001100156700001300167700001500180700001400195700001600209700001500225700001300240700001100253700001500264245016800279856009900447300001300546490000700559520215000566022001402716       2018                            d10aNeglected tropical diseases (NTDs)10aschistosomiasis10aMonitoring and evaluation10aTreatment strategies1 aToor J1 aTurner H1 aTruscott J1 aWerkman M1 aPhillips AE1 aAlsallaq R1 aMedley G1 aKing C1 aAnderson R00aThe design of schistosomiasis monitoring and evaluation programmes: The importance of collecting adult data to inform treatment strategies for Schistosoma mansoni.  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006717&type=printable  ae00067170 v123 a<p>Monitoring and evaluation (M&amp;E) programmes are used to collect data which are required to assess the impact of current interventions on their progress towards achieving the World Health Organization (WHO) goals of morbidity control and elimination as a public health problem for schistosomiasis. Prevalence and intensity of infection data are typically collected from school-aged children (SAC) as they are relatively easy to sample and are thought to be most likely to be infected by schistosome parasites. However, adults are also likely to be infected. We use three different age-intensity profiles of infection for Schistosoma mansoni with low, moderate and high burdens of infection in adults to investigate how the age distribution of infection impacts the mathematical model generated recommendations of the preventive chemotherapy coverage levels required to achieve the WHO goals. We find that for moderate prevalence regions, regardless of the burden of infection in adults, treating SAC only may achieve the WHO goals. However, for high prevalence regions with a high burden of infection in adults, adult treatment is required to meet the WHO goals. Hence, we show that the optimal treatment strategy for a defined region requires consideration of the burden of infection in adults as it cannot be based solely on the prevalence of infection in SAC. Although past epidemiological data have informed mathematical models for the transmission and control of schistosome infections, more accurate and detailed data are required from M&amp;E programmes to accurately determine the optimal treatment strategy for a defined region. We highlight the importance of collecting prevalence and intensity of infection data from a broader age-range, specifically the inclusion of adult data at baseline (prior to treatment) and throughout the treatment programme if possible, rather than SAC only, to accurately determine the treatment strategy for a defined region. Furthermore, we discuss additional epidemiological data, such as individual longitudinal adherence to treatment, that should ideally be collected in M&amp;E programmes.</p>
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