Optimizing the survey design for assessing schistosomiasis at the sub-district for treatment decision making.

Autor: Phillips AE; Family Health International (FHI) 360, Washington, DC, USA. Electronic address: aphillips@fhi360.org., Klein L; Family Health International (FHI) 360, Washington, DC, USA., Dorkenoo M; Faculté des Sciences de la Santé (FSS), University of Lomé, Togo., Opare J; Neglected Tropical Disease Program, Department of Public Health, Ghana Health Service, Accra, Ghana., Gnossike P; Programme National de Lutte contre les Maladies Tropicales Négligées, Ministère de la santé et hygiène publique, Togo., Knowles S; Department of Biology, Oxford University, UK., Stukel DM; Family Health International (FHI) 360, Washington, DC, USA., Zhang Y; Helen Keller International, New York City, USA., Kabore A; Family Health International (FHI) 360, Washington, DC, USA., Bougouma C; Programme National de Lutte contre les Maladies Tropicales Négligées, Ministère de la Santé, Ouagadougou, Burkina Faso., Kargbo-Labor I; Neglected Tropical Disease Program, Ministry of Health and Sanitation, Sierra Leone., Kane NM; Programme National de Lutte contre les Maladies Tropicales Négligées, Ministère de la Santé, Dakar, Senegal., Traoré M; Programme National de Lutte contre les Maladies Tropicales Négligées, Ministère de la Santé, Bamako, Mali., Shott J; U.S. Agency for International Development (USAID), Washington DC, USA., Evans DS; U.S. Agency for International Development (USAID), Washington DC, USA.
Jazyk: angličtina
Zdroj: Acta tropica [Acta Trop] 2024 Dec; Vol. 260, pp. 107422. Date of Electronic Publication: 2024 Oct 18.
DOI: 10.1016/j.actatropica.2024.107422
Abstrakt: Background: Schistosomiasis control programs typically launch with district-level, school-based preventive chemotherapy (PC). Recent World Health Organization recommendations are to shift to community-wide treatment where schistosomiasis prevalence is >10%. Simultaneously there is a push to move to sub-district PC to prioritize communities in need of treatment and alleviate the pressure on global praziquantel need, but few countries have sub-district prevalence data and no guidelines on how to collect this information.
Methods/principal Findings: Data collected from 57,161 school-aged children (SAC) across six countries (Burkina Faso, Ghana, Mali, Senegal, Sierra Leone, and Togo) to generate spatially realistic gold standard datasets that were used to evaluate different numbers of schools per sub-district (1-10) and district (5-30), number of SAC sampled per school (10-50), on accuracy of prevalence estimates. Sampling fewer children in more schools maximized accuracy of prevalence at the sub-district and district level. Surveying three schools per sub-district or 15 schools per district gave precise prevalence estimates. Increasing the number of SAC beyond 30 per school led to negligible improvements in reliably detecting schistosomiasis. Failure to detect schistosomiasis occurred more frequently in low (1-10%) prevalence and larger districts/sub-districts.
Conclusion: This study provides guidelines for evaluating sub-district schistosomiasis in a range of transmission settings. Among two-stage cluster surveys for schistosomiasis, our simulations show surveying three schools per sub-district and 20-30 SAC per school optimized cost-efficiency and minimized risk of mistreatment. Population size and endemicity influenced survey estimates, with the probability of misclassification being greater as populations increased or prevalence decreased.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Anna Phillips reports financial support was provided by FHI 360 Washington. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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