A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol
Abstract Background Current guidelines and targets for soil-transmitted helminth (STH) control focus on school-based deworming for school-age children, given the high risk of associated morbidity in this age group. However, expanding deworming to all age groups may achieve improved STH control among...
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doaj-a9c1bfd12eb248e0acec28fb797bf6be2020-11-25T03:50:56ZengBMCBMC Infectious Diseases1471-23342019-09-0119111010.1186/s12879-019-4449-6A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocolNaomi E. Clarke0Dinh Ng-Nguyen1Rebecca J. Traub2Archie C. A. Clements3Kate Halton4Roy M. Anderson5Darren J. Gray6Luc E. Coffeng7John M. Kaldor8Susana Vaz Nery9The Kirby Institute for Infection and Immunity in Society, University of New South WalesFaculty of Animal Sciences and Veterinary Medicine, Tay Nguyen UniversityFaculty of Veterinary and Agricultural Sciences, University of MelbourneFaculty of Health Sciences, Curtin UniversityInstitute of Health and Biomedical Innovation, Queensland University of TechnologyDepartment of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonResearch School of Population Health, Australian National UniversityDepartment of Public Health, Erasmus MC, University Medical Center RotterdamThe Kirby Institute for Infection and Immunity in Society, University of New South WalesThe Kirby Institute for Infection and Immunity in Society, University of New South WalesAbstract Background Current guidelines and targets for soil-transmitted helminth (STH) control focus on school-based deworming for school-age children, given the high risk of associated morbidity in this age group. However, expanding deworming to all age groups may achieve improved STH control among both the community in general and school-age children, by reducing their risk of reinfection. This trial aims to compare school-based targeted deworming with community-wide mass deworming in terms of impact on STH infections among school-age children. Methods The CoDe-STH (Community Deworming against STH) trial is a cluster-randomised controlled trial (RCT) in 64 primary schools in Dak Lak province, Vietnam. The control arm will receive one round of school-based targeted deworming with albendazole, while in the intervention arm, community-wide mass deworming with albendazole will be implemented alongside school-based deworming. Prevalence of STH infections will be measured in school-age children at baseline and 12 months following deworming. The primary outcome is hookworm prevalence in school-age children at 12 months, by quantitative PCR. Analysis will be intention-to-treat, with outcomes compared between study arms using generalised linear and non-linear mixed models. Additionally, cost-effectiveness of mass and targeted deworming will be calculated and compared, and focus group discussions and interviews will be used to assess acceptability and feasibility of deworming approaches. Individual based stochastic models will be used to predict the impact of mass and targeted deworming strategies beyond the RCT timeframe to assess the likelihood of parasite population ‘bounce-back’ if deworming is ceased due to low STH prevalence. Discussion The first large-scale trial comparing mass and targeted deworming for STH control in South East Asia will provide key information for policy makers regarding the optimal design of STH control programs. Trial registration ACTRN12619000309189.http://link.springer.com/article/10.1186/s12879-019-4449-6Soil-transmitted helminthsHookwormMass drug administrationAlbendazole |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Naomi E. Clarke Dinh Ng-Nguyen Rebecca J. Traub Archie C. A. Clements Kate Halton Roy M. Anderson Darren J. Gray Luc E. Coffeng John M. Kaldor Susana Vaz Nery |
spellingShingle |
Naomi E. Clarke Dinh Ng-Nguyen Rebecca J. Traub Archie C. A. Clements Kate Halton Roy M. Anderson Darren J. Gray Luc E. Coffeng John M. Kaldor Susana Vaz Nery A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol BMC Infectious Diseases Soil-transmitted helminths Hookworm Mass drug administration Albendazole |
author_facet |
Naomi E. Clarke Dinh Ng-Nguyen Rebecca J. Traub Archie C. A. Clements Kate Halton Roy M. Anderson Darren J. Gray Luc E. Coffeng John M. Kaldor Susana Vaz Nery |
author_sort |
Naomi E. Clarke |
title |
A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol |
title_short |
A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol |
title_full |
A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol |
title_fullStr |
A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol |
title_full_unstemmed |
A cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the CoDe-STH trial protocol |
title_sort |
cluster-randomised controlled trial comparing school and community-based deworming for soil transmitted helminth control in school-age children: the code-sth trial protocol |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2019-09-01 |
description |
Abstract Background Current guidelines and targets for soil-transmitted helminth (STH) control focus on school-based deworming for school-age children, given the high risk of associated morbidity in this age group. However, expanding deworming to all age groups may achieve improved STH control among both the community in general and school-age children, by reducing their risk of reinfection. This trial aims to compare school-based targeted deworming with community-wide mass deworming in terms of impact on STH infections among school-age children. Methods The CoDe-STH (Community Deworming against STH) trial is a cluster-randomised controlled trial (RCT) in 64 primary schools in Dak Lak province, Vietnam. The control arm will receive one round of school-based targeted deworming with albendazole, while in the intervention arm, community-wide mass deworming with albendazole will be implemented alongside school-based deworming. Prevalence of STH infections will be measured in school-age children at baseline and 12 months following deworming. The primary outcome is hookworm prevalence in school-age children at 12 months, by quantitative PCR. Analysis will be intention-to-treat, with outcomes compared between study arms using generalised linear and non-linear mixed models. Additionally, cost-effectiveness of mass and targeted deworming will be calculated and compared, and focus group discussions and interviews will be used to assess acceptability and feasibility of deworming approaches. Individual based stochastic models will be used to predict the impact of mass and targeted deworming strategies beyond the RCT timeframe to assess the likelihood of parasite population ‘bounce-back’ if deworming is ceased due to low STH prevalence. Discussion The first large-scale trial comparing mass and targeted deworming for STH control in South East Asia will provide key information for policy makers regarding the optimal design of STH control programs. Trial registration ACTRN12619000309189. |
topic |
Soil-transmitted helminths Hookworm Mass drug administration Albendazole |
url |
http://link.springer.com/article/10.1186/s12879-019-4449-6 |
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