Integrating Community Interventions to Eliminate Neglected Tropical Diseases

NCT03667079 | Completed

• 1 other identifier: 14674-001
• Study Type: interventional
• Target: 28,143
• Locations: 1 country
• Sites: 1

Brief Summary

The overarching goal of this project is the elimination of two neglected tropical diseases (NTD): soil-transmitted helminthiasis and rabies. The specific objective of this pilot study was: To determine whether the integrated delivery platform improved the cost-effectiveness and coverage of MDA targeting STH and rabies; The investigators integrated two public health initiatives: 1) a mass drug administration (MDA) effort to eliminate neglected tropical diseases (NTD) caused by soil-transmitted helminths (STH), with 2) a community-valued mass dog rabies vaccination (MDRV) intervention to eliminate human and animal rabies, also a priority NTD of the World Health Organisation. The goal of MDA efforts targeting STH is to reduce worm burdens to very low levels below which self-sustaining transmission, and the public health consequences of STH, cease. Existing school-based delivery programs fail to reach all affected age groups, however, which results in ineffective coverage levels and persistence of STH. The goal of MDRV is to immunize 70% of dog populations, after which canine-mediated rabies is eliminated. MDRV programs are typically very popular, with all human age groups participating. The objectives of this project were to determine whether supplementing a strictly school-based MDA NTD control program with a community-wide strategy that is coupled to an MDRV program will result in a synergism that (a) improves coverage, reach and cost-effective delivery of MDA targeting STH and (b) improves coverage and cost-effective delivery of dog vaccination. To achieve this, research activities, comprised of post-intervention household questionnaire surveys, were carried out. In addition detailed cost data was collected.

Conditions

Rabies in Animals; Worms; Intestine

Outcome Measures

Primary Outcomes (2)

• proportion of people in each village receiving deworming treatment

  The proportion of people in each village receiving deworming treatment was measured using household questionnaire surveys

  9 months

• proportion of dogs in each village receiving rabies vaccination

  The proportion of dogs in each village receiving rabies vaccination was measured using household questionnaire surveys

  9 months

Secondary Outcomes (3)

• cost of delivery

  9 months

• time people spent traveling

  9 months

• Comparison with the national school-based deworming program

  9 months

Study Arms (3)

Integrated

EXPERIMENTAL

Intervention 'integrated delivery of deworming and vaccination' will be delivered to this arm of the study

Other: integrated delivery of deworming and vaccination

Deworming only

ACTIVE COMPARATOR

Intervention 'Mass deworming only' will be delivered to villages in this arm of the study

Other: Mass deworming only

Rabies vaccination only

ACTIVE COMPARATOR

Villages assigned to this arm received mass vaccination of dogs against rabies only

Other: Mass vaccination of dogs

Interventions

integrated delivery of deworming and vaccination OTHER

integrated delivery of mass drug administrations, one targeting humans (deworming) and one targeting animals (rabies vaccination)

Integrated

Mass deworming only OTHER

Delivery of mass deworming to people only

Deworming only

Mass vaccination of dogs OTHER

Delivery of mass vaccination of dogs only

Rabies vaccination only

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All healthy non pregnant people

You may not qualify if:

• Children attending clinics alone
• Pregnant women

Sponsors & Collaborators

• Washington State University: lead
• University of Glasgow: collaborator
• National Institute for Medical Research, Tanzania: collaborator

Study Sites (1)

Washington State University

Spokane, Washington, 99202, United States

Location

Related Publications (1)

• Lankester F, Davis A, Kinung'hi S, Yoder J, Bunga C, Alkara S, Mzimbiri I, Cleaveland S, Palmer GH. An integrated health delivery platform, targeting soil-transmitted helminths (STH) and canine mediated human rabies, results in cost savings and increased breadth of treatment for STH in remote communities in Tanzania. BMC Public Health. 2019 Oct 28;19(1):1398. doi: 10.1186/s12889-019-7737-6.

  PMID: 31660915 DERIVED

MeSH Terms

Interventions

Vaccination

Intervention Hierarchy (Ancestors)

Immunotherapy, Active; Immunization; Immunotherapy; Immunomodulation; Biological Therapy; Therapeutics; Immunologic Techniques; Investigative Techniques; Primary Prevention; Preventive Health Services; Health Services; Health Care Facilities Workforce and Services; Communicable Disease Control; Public Health Practice; Public Health; Environment and Public Health

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Associate Professor

Model Details: Villages were allocated to one of three treatment arms: in Arm 1 villages people received deworming treatment and dogs rabies vaccination through an integrated delivery; in Arm 2 villages only deworming of people occurred; in Arm 3 only dog vaccination occurred. After the study, Arm 2 and 3 villages received rabies vaccination and deworming, respectively.

Study Record Dates

• First Submitted: September 7, 2018
• First Posted: September 12, 2018
• Study Start: February 1, 2016
• Primary Completion: October 30, 2016
• Study Completion: December 31, 2016
• Last Updated: May 1, 2023

Record last verified: 2023-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)