Strongyloides Stercoralis Public Health Control in Rwanda

NCT07009613 | Completed

• 1 other identifier: No477/RNEC/2024
• Study Type: observational
• Target: 1,415
• Locations: 1 country
• Sites: 1

Brief Summary

The World Health Organization (WHO) recently issued guideline for the public health control of Strongyloides stercoralis in endemic areas. We aimed to evaluate the feasibility of implementing the WHO recommendations in Rwanda, specifically to intergrate the activities for the public health control of strongyloidiasis in the ongoing national programme for the control of the other soil-transmitted helminths and schistosomiasis, that has been in place for several years. As additional objective, we aimed to estimate the prevalence of S. stercoralis in two districts of Rwanda (Gisagara and Rubavu). To evaluate the feasibility, we asked lab technicians to evaluate challenges emerged during the implementation of the laboratory procedures with a structured questionnaire. Also, we evaluated the costs needed to perform these tests. We estimated the prevalence of S. stercoralis by calculating the number of positive cases out of all people tested. The lab technicians participated to a training session, where they were taught the S. stercoralis-specific lab techniques, and to a two-day pilot study where they could practice. The tests used were parasitological techniques (agar stool culture, (APC) and Baermann method) and an antibody rapid diagnostic test (RDT). Duration of training, with a specific focus on larvae differentiation, was identified as pivotal for a successful implementation of the parasitological techniques. The use of the RDT was instead considered easy to apply at all evaluation time points. Raw cost (i.e. not including staff salaries and transport costs) of materials and equipment was below 2 euros/test for each assay. In both districts, Strongyloides prevalence was below the threshold recommended by the WHO for the implementation of mass treatment, hence this aspect was not evaluated.

Conditions

Strongyloides Stercoralis Infection; Strongyloides

Outcome Measures

Primary Outcomes (1)

• Evaluation of the tests based on technicians' perception (through questionnaire) and costs

  Technicians' previous experience with each S. stercoralis-specific assay, along with their perceptions regarding the ease of each of the procedural steps and associated safety concerns were assessed using a structured questionnaire. Each procedural step was rated as "Very easy", "Easy", "Neutral", "Difficult" and "Very difficult". For the steps marked "difficult" or "very difficult", respondents could specify the reasons for the difficulty from a predefined non-mutually-exclusive list of options. The per-test costs were calculated from the procurement records of each S. stercoralis-specific assay.

  The data will be collected at baseline, during the pilot study (two - three days from baseline) and during field work (after two to three weeks from baseline)

Secondary Outcomes (1)

• Prevalence

  through study completion

Interventions

Parasitological tests DIAGNOSTIC_TEST

The primary outcome was reported based on the technicians' answers collected with a structured questionnaire. The individuals screened underwent testing with the tests detailed above

Questionnaire OTHER

The primary outcome was based on the technicians' evaluation, based on their answers collected in a questionnaire. The individuals screened were tested with assays used for the national control programmes

Eligibility Criteria

• Age: 5 Years+
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

People living in two districts in Rwanda

You may qualify if:

• People living in the selected districts and households
• Obtainment of written informed consent (for children's participation, consent was sought from parents/guardians).

You may not qualify if:

• Inability to supply an adequate stool sample

Sponsors & Collaborators

• IRCCS Sacro Cuore Don Calabria di Negrar: lead
• University of Rwanda: collaborator
• Rwanda Biomedical Centre: collaborator

Study Sites (1)

School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda

Kigali, 737, Rwanda

Location

MeSH Terms

Interventions

Surveys and Questionnaires

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of infectious disease Clinical Research Unit

Study Record Dates

• First Submitted: May 17, 2025
• First Posted: June 6, 2025
• Study Start: September 23, 2024
• Primary Completion: October 11, 2024
• Study Completion: October 14, 2024
• Last Updated: June 6, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

RW (1)