Effects, equity, and cost of school-based and community-wide treatment strategies for soil-transmitted helminths in Kenya: a cluster-randomised controlled trial

Publication date: Available online 18 April 2019Source: The LancetAuthor(s): Rachel L Pullan, Katherine E Halliday, William E Oswald, Carlos Mcharo, Emma Beaumont, Stella Kepha, Stefan Witek-McManus, Paul M Gichuki, Elizabeth Allen, Tom Drake, Catherine Pitt, Sultani H Matendechero, Marie-Claire Gwayi-Chore, Roy M Anderson, Sammy M Njenga, Simon J Brooker, Charles S MwandawiroSummaryBackgroundSchool-based deworming programmes can reduce morbidity attributable to soil-transmitted helminths in children but do not interrupt transmission in the wider community. We assessed the effects of alternative mass treatment strategies on community soil-transmitted helminth infection.MethodsIn this cluster-randomised controlled trial, 120 community units (clusters) serving 150 000 households in Kenya were randomly assigned (1:1:1) to receive albendazole through annual school-based treatment targeting 2–14 year olds or annual or biannual community-wide treatment targeting all ages. The primary outcome was community hookworm prevalence, assessed at 12 and 24 months through repeat cross-sectional surveys. Secondary outcomes were Ascaris lumbricoides and Trichuris trichiura prevalence, infection intensity of each soil-transmitted helminth species, and treatment coverage and costs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02397772.FindingsAfter 24 months, prevalence of hookworm changed from 18·6% (95% CI 13·9–23·2) to 13·8% (10·5â...
Source: The Lancet - Category: General Medicine Source Type: research