Patterns of individual non-treatment during multiple rounds of mass drug administration for control of soil-transmitted helminths in the TUMIKIA trial, Kenya: a secondary longitudinal analysis

Oswald, William E.; Kepha, Stella; Halliday, Katherine E.; Mcharo, Carlos; Safari, Th’uva; Witek-McManus, Stefan; Hardwick, Robert J.; Allen, Elizabeth; Matendechero, Sultani; Brooker, Simon; Njenga, Sammy M.; Mwandawiro, Charles; Anderson, Roy M.; Pullan, Rachel L.

doi:10.1016/s2214-109x(20)30344-2

Cited by 21 publications

(31 citation statements)

References 28 publications

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“…In order to demonstrate the application of our probability model, we applied it to the recently collected adherence data from the TUMIKIA project in Kenya, which aims to control STH infections by repeated drug treatment, in Sec 3. Findings from the analyses presented here extend and support previous work [ 13 ], which include past behaviour-independent adherence or non-adherence for school-aged children (SAC) and the detection of past behaviour-dependent non-adherence to treatment in nearly all other age groups and both sexes. A full description of our results and analysis is given in S2 Appendix .…”

Section: Discussionsupporting

confidence: 86%

“…We can see quite clearly from Table 2 by the values of the conditional probabilities that a degree of past behaviour-dependent non-adherence is indeed present in all the age groups, with the exception of the final round ω 4 values for those in the pre-SAC (which have mostly aged into SAC by this point) and SAC categories. This effect is explained in more detail by Ref [ 13 ]. Table 2 also shows that the most past behaviour-dependent non-adherent age group and sex appears to be males aged 30+ (they have the largest conditional probability values across all rounds of treatment).…”

Section: Resultsmentioning

confidence: 88%

“…The validity of interpreting the inferences made in Sec 3 as directly due to individual behaviour patterns using the TUMIKIA project adherence data [ 13 ] should be considered carefully. An important caveat to this interpretation is that, for various reasons, some individuals were not offered treatment and were hence automatically accounted for as ‘non-adherent’ within the data, and as such we cannot discriminate between refusing, and not being offered, treatment.…”

Section: Discussionmentioning

confidence: 99%

“…This also involves employing, for example, models of parasite transmission and control by MDA. To illustrate how our methodology may be implemented and interpreted in practice, we apply it to data collected during the TUMIKIA project: a recent cluster randomised, controlled trial of the impact of MDA on the transmission of STH infections in Kwale County, Kenya [ 11 – 13 ]. A statistical analysis has already been performed on this dataset, as described in Ref [ 13 ], and so the analysis we present here is to illustrate the application of our probability model only.…”

Section: Introductionmentioning

confidence: 99%

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Individual adherence to mass drug administration in neglected tropical disease control: A probability model conditional on past behaviour

et al. 2021

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We present a general framework which describes the systematic (binary) scenario of individuals either taking treatment or not for any reason, over the course of mass drug administration (MDA)—which we refer to as ‘adherence’ and ‘non-adherence’. The probability models developed can be informed by observed adherence behaviour as well as employed to explore how different patterns influence the impact of MDA programmes, by the use of mathematical models of transmission and control. We demonstrate the interpretative value of the developed probability model employing a dataset collected in the TUMIKIA project, a randomised trial of deworming strategies to control soil-transmitted helminths (STH) by MDA conducted in coastal Kenya. We stratify our analysis by age and sex, although the framework which we introduce here may be readily adapted to accommodate other stratifications. Our findings include the detection of specific patterns of non-adherence in all age groups to varying extents. This is particularly apparent in men of ages 30+. We then demonstrate the use of the probability model in stochastic individual-based simulations by running two example forecasts for the elimination of STH transmission employing MDA within the TUMIKIA trial setting with different adherence patterns. This suggested a substantial reduction in the probability of elimination (between 23-43%) when comparing observed adherence patterns with an assumption of independence, with important implications for programmes. The results here demonstrate the considerable impact and utility of considering non-adherence on the success of MDA programmes to control neglected tropical diseases (NTDs).

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Section: Discussionsupporting

confidence: 86%

Section: Resultsmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Individual adherence to mass drug administration in neglected tropical disease control: A probability model conditional on past behaviour

et al. 2021

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“…In order to demonstrate the application of our probability model, we applied it to the recently collected adherence data from the TUMIKIA project in Kenya, which aims to control STH infections by repeated drug treatment, in Sec 3. Findings from the analyses presented here extend and support previous work [13], which include past behaviour-independent adherence or non-adherence for school-aged children (SAC) and the detection of past behaviour-dependent non-adherence to treatment in nearly all other age groups and both sexes. A full description of our results and analysis is given in Appendix S2.…”

Section: Discussionsupporting

confidence: 86%

Individual adherence to mass drug administration in neglected tropical disease control: a probability model conditional on past behaviour

Hardwick

Truscott

Oswald

et al. 2020

Preprint

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We present a comprehensive framework which describes the systematic (binary) choice of individuals to either take treatment, or not for any reason, over the course of multiple rounds of mass drug administration (MDA) - which we here here refer to as ‘adherence’ and ‘non-adherence’. This methodology can be fitted to (or informed by) program data as well as manipulated to reproduce the same adherence behaviours of past analyses, and can go beyond past analyses to describe new behaviours that have yet to be considered in the literature. Our model also has a straightforward interpretation and implementation in simulations of mass drug trials for disease transmission studies and forecasts for control through MDA. We demonstrate how our analysis may be implemented to statistically infer adherence behaviour from a dataset by applying our approach to the recent adherence data from the TUMIKIA project, a recent trial of deworming strategies in Kenya. We stratify our analysis according to age and sex, though the framework which we introduce here may be readily adapted to accommodate other categories. Our findings include the detection of past behaviour dependent non-adherence in all age groups to varying degrees of severity and particularly strong non-adherent behaviour of men of ages 30+. We then demonstrate the use of our model in stochastic individual-based simulations by running two example forecasts for elimination in TUMIKIA with the learned adherence behaviour implemented. Our results demonstrate the impact and utility of including non-adherence from real world datasets in simulations.

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Community views on mass drug administration for soil-transmitted helminths: a qualitative evidence synthesis

Fox,

Shrestha,

Kuehn

et al. 2024

Cochrane Database of Systematic Reviews

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Patterns of individual non-treatment during multiple rounds of mass drug administration for control of soil-transmitted helminths in the TUMIKIA trial, Kenya: a secondary longitudinal analysis

Cited by 21 publications

References 28 publications

Individual adherence to mass drug administration in neglected tropical disease control: A probability model conditional on past behaviour

Individual adherence to mass drug administration in neglected tropical disease control: A probability model conditional on past behaviour

Individual adherence to mass drug administration in neglected tropical disease control: a probability model conditional on past behaviour

Community views on mass drug administration for soil-transmitted helminths: a qualitative evidence synthesis

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