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 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.

Effects of deworming medication on anaemia among children aged 6–59 months in sub-Saharan Africa

“…However, many DM programmes in SSA utilize school settings, typically because SAC are thought to be a group with the highest intensity of worm infection [ 54 ]. Additionally, it has been proven that school-based targeted deworming programmes provide an opportunity for STH control efforts while utilizing an existing school-based infrastructure to reach a large proportion of SAC, with teachers acting as drug distributors [ 55 ]. Moreover, research has demonstrated that when older children are treated with DM, worm infections become less prevalent not only for them, but also for household contacts who reside in the same environment as treated children [ 56 , 57 ].…”

Impact of DNA Extraction Method on Variation in Human and Built Environment Microbial Community and Functional Profiles Assessed by Shotgun Metagenomics Sequencing

“…Our data also highlights the unique challenges when working with non-fecal samples, including the larger proportion of human reads that effectively decrease sequencing depth and the lower biomass which accentuates signal from potential contamination. Petrof et al, 2013;Levin et al, 2016;Sinha et al, 2017;Chapagain et al, 2019;Clarke et al, 2019 Qiagen MagAttract PowerSoil DNA KF Kit (Earth Microbiome Protocol) Easson and Thacker, 2014;McDonald et al, 2016;Halfvarson et al, 2017;Marotz et al, 2017;McDonald et al, 2018 ZymoBIOMICS Terranova et al, 2018;Wurm et al, 2018;Zabat et al, 2018;Gibson et al, 2019;Reinhart et al, 2019 *This list is not exhaustive. Example references include five studies from a variety of journals, study types, and sample types.…”

Wasting, Stunting, and Anemia in Angolan Children after Deworming with Albendazole or a Test-and-Treat Approach for Intestinal Parasites: Binary Longitudinal Models with Temporal Structure in a Four-Arm Randomized Trial

“…Current national guidelines for STH control are focused on school-based deworming [ 17 ]. Expanding deworming to all age groups has been noted as a benefit to communities in general and, in particular, to school-age children, by reducing their risk of reinfection [ 32 ]. Our study included a particular age group not included in the eligible priority age group established by national guidelines to receive the low-cost single dose [ 17 ].…”