The Schistosomiasis Consortium for Operational Research and Evaluation 2008–2020: Approaches, Experiences, Lessons, and Recommendations

Abstract

For the past 10 years, the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), funded by the Bill & Melinda Gates Foundation, has been supporting operational research to provide a stronger evidence base for controlling and moving toward elimination of schistosomiasis. The SCORE portfolio was developed and implemented with engagement from many stakeholders and sectors. Particular efforts were made to include endemic country neglected tropical disease program managers. Examples of the challenges we encountered include the need to balance rigor (e.g., conducting large cluster-randomized trials) with ensuring relevance to real-world settings, allowing for local contexts while standardizing key study aspects, adjusting to evolving technologies, and incorporating changing technologies into multiyear studies. The Schistosomiasis Consortium for Operational Research and Evaluation's findings and data and the collected specimens will continue to be useful in the years to come. Our experiences and lessons learned can benefit both program managers and researchers conducting similar work in the future.

Impact of Different Mass Drug Administration Strategies for Gaining and Sustaining Control of Schistosoma mansoni and Schistosoma haematobium Infection in Africa

“…1 This field research was implemented on a much larger scale than any previous trials and under circumstances that would closely mirror implementation of MDA in national control programs. Although there were limitations to the study designs 39 and performance, 34 the results from all studies confirm the following:…”

“…Similarly, we had concerns about reported treatment coverage data, which were not found to be helpful in explaining the overall results or the emergence of persistent hot spots. Details about these data are found in articles by Binder et al, 34,35 in this supplement.…”

Challenges in Protocol Development and Interpretation of the Schistosomiasis Consortium for Operational Research and Evaluation Intervention Studies

“…This article provides a critical review of the issues of study design and interpretation for such large-scale operational research. Recommendations for future studies are offered, with a more detailed list provided in Binder et al 13 in this supplement.…”

SCORE Operational Research on Moving toward Interruption of Schistosomiasis Transmission

“…These included implementation of MDA, implementation of behavior change interventions in Zanzibar, and implementation of snail control in both Zanzibar and Côte d'Ivoire. 17,18 Achieving regular, high-quality MDA coverage can be challenging, impacted not only by NTD programmatic issues but also by events external to NTD programs, such as school schedules and political events. Developing and implementing behavior change programs with a high degree of community acceptance in Zanzibar took a long time and required more resources than were available.…”

“…These included delays in program funding and difficulty coordinating MDAs with school schedules and local events. 17,18 Nevertheless, coverage among students in study schools on Pemba was above 75% in all years. On Unguja, coverage was below 75% in years 1 and 2, but reached 97% in year 3.…”