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Background: This paper documents changes in the prevalence and intensity of soil-transmitted helminth (STH) infections in the Geshiyaro project in the Wolaita zone of Southern Ethiopia. Methods: The Geshiyaro project comprises three intervention arms. Arm 1 is subdivided into the Arm 1 pilot (one district) and Arm 1 (four other districts), both receiving integrated community-wide mass drug administration MDA (cMDA) with intensive water, sanitation, and hygiene (WaSH) interventions. Arm 2 involves 18 districts with cMDA interventions plus the existing government-led One WaSH program, while Arm 3 serves as a control with school-based MDA (sMDA) interventions plus the existing government-led One WaSH program in three districts. The study is designed as a cohort investigation over time, with the establishment of longitudinal sentinel sites where infection levels are assessed annually. A total of 45 longitudinal parasitological surveillance sentinel sites are being used across all three intervention arms to monitor STH prevalence and intensity of infection. From each of the 45 sentinel sites, 150 individuals were randomly selected, stratified by age and gender. The t-test and analysis of variance (ANOVA) were employed to compare infection prevalence and intensity across the three study arms over time. Results: The prevalence of STH decreased significantly from 34.5% (30.6%, 38.5%) in 2019 to 10.6% (8.3%, 13.4%) in 2022/2023 (df = 1, P < 0.0001) in the Arm 1 pilot, from 27.4% (25.2%, 29.7%) in 2020 to 5.5% (4.4%, 6.7%) in 2023 (df = 1, P < 0.0001) in Arm 1, from 23% (21.3%, 24.8%) in 2020 to 4.5% (3.7%, 5.3%) in 2023 (df = 1, P < 0.001) in Arm 2, and from 49.6% (47.4%, 51.7%) in 2021 to 26.1% in 2023 (df = 1, P < 0.0001) in Arm 3. The relative reduction in the prevalence of any STH was the highest in the arms employing cMDA, namely Arm 2, with a decrease of 82.5% (79.3%, 84.2%), followed by Arm 1 with a reduction of 80.1% (75.3%, 84.6%), and then the Arm 1 pilot with a decrease of 69.4% (60.1%. 76.6%). Arm 3 employing sMDA had the lowest decrease, with a reduction of 46.9% (43.6%, 51%). The mean intensity of infection (based on Kato–Katz egg count measures) for Ascaris lumbricoides species, which was the dominant STH species present in the study area, decreased significantly in Arms 1 and 2, but only slightly in Arm 3. The prevalence of hookworm and Trichuris trichiura infections were found to be very low in all arms but also decreased significantly. Conclusions: The reduction in the prevalence and intensity of STH in Arms 1 and 2 revealed steady progress towards transmission interruption based on cMDA intervention, but additional efforts with MDA coverage and WaSH interventions are needed to achieve a prevalence threshold < 2% based on the quantitative polymerase chain reaction (qPCR) diagnostic method. [ABSTRACT FROM AUTHOR]

Background: This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions. Methods: The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms. Results: The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = −5.2, df = 8780, P = 0.0004). Conclusions: The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores. [ABSTRACT FROM AUTHOR]

Background: This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions. Methods: The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms. Results: The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = −5.2, df = 8780, P = 0.0004). Conclusions: The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores. [ABSTRACT FROM AUTHOR]

Background: This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions. Methods: The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms. Results: The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = −5.2, df = 8780, P = 0.0004). Conclusions: The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores. [ABSTRACT FROM AUTHOR]

Objectives: Deworming programmes of soil-transmitted helminths are generally monitored and evaluated by aggregating drug coverage and infection levels at a district level. However, heterogeneity in drug coverage at finer spatial scales means indicators may remain above thresholds for elimination as a public health problem or of transmission in some areas. This paper aims to highlight the misleading information that aggregating data at larger spatial scales can have for programme decision making. Methods: Drug coverage data from the Geshiyaro project were compared at two spatial scales with reference to the World Health Organisation's targets. District (woreda) and village (kebele) level were compared. The association between infection levels and drug coverage was analysed by fitting a weighted least-squares function to the mean intensity of infection (eggs per gram of faeces) against drug coverage. Results: The data show clearly that when the evaluation of coverage is aggregated to the district level, information on heterogeneity at a finer spatial scale is lost. Infection intensity decreases significantly (p = 0.0023) with increasing drug coverage. Conclusion: Aggregating data at large spatial scales can result in prematurely ceasing deworming, prompting rapid infection bounce-back. There is a strong need to define context-specific spatial scales for monitoring and evaluating intervention programmes. Author summary: For soil-transmitted helminths (STH), control is centred around mass drug administration (MDA) of eligible subgroups without prior diagnosis, aiming to achieve 75% drug coverage. MDA programmes are monitored by assessing whether drug coverage and infection prevalence and intensity, aggregated to a spatial scale, typically an administrative unit such as a district, have met programmatic targets. Spatial heterogeneity in drug coverage, prevalence, and intensity is commonplace and well documented. However, little attention has been paid to the spatial scales of this heterogeneity and the implications it has on providing the basis to inform the cessation or continuation of prophylactic mass treatment. We present a clear analysis showing that fine scale spatial heterogeneity in drug coverage is commonplace even in well implemented MDA programmes. We show that aggregating data at the district level, which is routine for deworming programmes, can give misleading information on which to base future treatment decisions, specifically the premature reduction in frequency, or cessation of MDA, because fine scale heterogeneity is not captured by larger aggregations. This work highlights the critical need to define context specific spatial scales for monitoring and evaluating interventions implemented in different transmission settings. [ABSTRACT FROM AUTHOR]

Twenty neglected tropical diseases (NTDs) are currently prioritised by the World Health Organization for eradication, elimination as a public health problem, elimination of transmission or control by 2030. This issue celebrates progress made since the 2012 London Declaration on NTDs and discusses challenges currently faced to achieve these goals. It comprises 14 contributions spanning NTDs tackled by intensified disease management to those addressed by preventive chemotherapy. Although COVID-19 negatively affected NTD programmes, it also served to spur new multisectoral approaches to strengthen school-based health systems. The issue highlights the needs to improve impact survey design, evaluate new diagnostics, understand the consequences of heterogeneous prevalence and human movement, the potential impact of alternative treatment strategies and the importance of zoonotic transmission. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'. [ABSTRACT FROM AUTHOR]

This study explores how an undercover sting that targeted men soliciting sex with other men around public park toilets in Fresno, California, led to an increase in resources for local law enforcement, including a surveillance system that stretched beyond the park and into poor Black and Brown neighborhoods. We use the literature on policy entrepreneurship to make sense of the power of police both to quell opposition to unpopular public safety initiatives and to make the case for administrative expansion. This case study demonstrates that creating panic about public same-sex erotic activity can be utilized without appearing homophobic or drawing the wrath of LGBTQ+ rights groups, especially when focusing on the dangers to children. We argue that the men arrested for lewd conduct were simply collateral damage and not seen worthy of defense. [ABSTRACT FROM AUTHOR]

Repeated distribution of preventative chemotherapy (PC) by mass drug administration forms the mainstay of transmission control for five of the 20 recognised neglected tropical diseases (NTDs); soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. The efficiency of such programmes is reliant upon participants swallowing the offered treatment consistently at each round. This is measured by compliance, defined as the proportion of eligible participants swallowing treatment. Individually linked longitudinal compliance data is important for assessing the potential impact of MDA-based control programmes, yet this accurate monitoring is rarely implemented in those for NTDs. Longitudinal compliance data reported by control programmes globally for the five (PC)-NTDs since 2016 is examined, focusing on key associations of compliance with age and gender. PubMed and Web of Science was searched in January 2022 for articles written in English and Spanish, and the subsequent extraction adhered to PRISMA guidelines. Study title screening was aided by Rayyan, a machine learning software package. Studies were considered for inclusion if primary compliance data was recorded for more than one time point, in a population larger than 100 participants. All data analysis was conducted in R. A total of 89 studies were identified containing compliance data, 57 were longitudinal studies, of which 25 reported individually linked data reported by varying methods. The association of increasing age with the degree of systematic treatment was commonly reported. The review is limited by the paucity of data published on this topic. The varying and overlapping terminologies used to describe coverage (receiving treatment) and compliance (swallowing treatment) is reviewed. Consequently, it is recommended that WHO considers clearly defining the terms for coverage, compliance, and longitudinal compliance which are currently contradictory across their NTD treatment guidelines. This review is registered with PROSPERO (number: CRD42022301991). Author summary: Neglected tropical diseases (NTDs) are estimated to affect 1.74 billion people globally, often those in low socio-economic communities in tropical and sub-tropical regions. Five NTDs can be effectively treated using repeated administration of preventative chemotherapy (PC), delivered to communities with endemic infection. This is described as mass-drug administration (MDA). Repeated treatment is necessary due to re-infection of treated people by those untreated in these endemic communities, and the absence of strong acquired immunity in the human host to many of the NTDs despite repeated exposure to infection. Increasing the number of people treated at each round is critical to increase the number of parasite-free individuals. As a result, this will reduce the amount of re-infection to the community and therefore increases the chance of reaching the goal of transmission elimination. Currently, the measurement of MDA success is focused upon coverage defined as the receiving of treatment. However, not everyone who receives treatment swallows the treatment, which defines compliance. Reviewing patterns of compliance over time in the population targeted for treatment, such as the proportion of the population which always takes treatment, or conversely never takes treatment, will help predict the impact of MDA on disease prevalence and intensity. This review summarises the results of recent studies recording compliance data for the five NTDs controllable by MDA, soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. [ABSTRACT FROM AUTHOR]

Background Current WHO strategies for reaching soil-transmitted helminths (STH) elimination as a public health problem excludes treating certain adult populations in endemic areas, creating infection reservoirs that drive 'bounce back' of STH infection to pretreatment levels post-mass drug administration (MDA). Predisposition is a widespread, but poorly understood phenomena among helminth infections where individuals are predisposed to reinfection after repeated treatments. Methods This analysis uses Geshiyaro project data, an STH control programme exploring transmission interruption by community-wide MDA and enhanced water, sanitation and hygiene during 2019–2023. Parasitological survey data from longitudinal cohorts are analysed using Kendall's Tau-b rank correlation to assess the evidence for predisposition to light or heavy infection between four consecutive rounds of MDA. Results Correlation analyses revealed the strongest evidence for predisposition to heavy or light Ascaris lumbricoides infection was between survey 1 and 2 (Tau-b 0.29; p<0.001). Overall patterns were not observed for Trichuris trichiura or hookworm infections, however, some significant and notable correlations were recorded for some stratifications and time points. Conclusions Evidence for predisposition in endemic settings in southern Ethiopia with low STH prevalence suggests that more targeted approaches to MDA in those predisposed to infection may be a sensible control strategy if cheap, point of care diagnostics are available. [ABSTRACT FROM AUTHOR]

Mass drug administration (MDA), targeted at school-aged children (SAC) is recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds, and research suggests that only treating SAC will not be sufficient to interrupt transmission of STH. In countries with endemic infection, such as Ethiopia, the coverage, community-groups targeted, and rates of reinfection will determine how effective MDA is in suppressing transmission in the long-term. In this paper, individually-linked longitudinal data from three epidemiological STH surveys conducted between November 2018 and November 2020 in the Wolaita region of Ethiopia are analysed to determine how STH prevalence and intensity changes according to individual level treatment data collected over two rounds of MDA. This study demonstrates that while community-wide MDA successfully reduces overall infection intensity across the villages treated, the observed levels of non-compliance to treatment by individuals acts to maintain levels of parasite abundance whereby transmission interruption is not possible at to, despite reasonable levels of MDA coverage in the communities studied (ranging from 65% to 84% of the village populations). This quantifies with substantial data the often-postulated difference between coverage (accepting treatment) and compliance (swallowing of treatment), the latter impacting the former to a previously unquantified level. The paper highlights the need to focus treatment to partially treated, or never treated groups of individuals within existing community wide MDA control activities to interrupt the transmission of STH, and to reduce the basic reproductive number, R0, of the parasites to less than unity in value. Author summary: Soil-transmitted helminths (STH) are a group of parasites that remain a public health challenge across developing countries. The high number of global infections is ongoing despite significant financial investment in reducing the disease burden in endemic countries. In recent years WHO recommendations have shifted morbidity reduction to the possibility of transmission elimination through MDA and WaSH measures. One concern with attempting this route towards transmission interruption remains the impact that compliance and coverage has on effectiveness of community-wide treatment. The problem of STH reinfection means that a sustainable break in transmission remains difficult to achieve across an entire community. Despite repeated rounds of treatment, non-compliant individuals can shed infective eggs into the environment, essentially exposing treated individuals to become re-infected. This study highlights this problem, despite the overall effectiveness in reducing infection intensity across communities in the study area, prevalence remains at levels that would not indicate transmission interruption. This in part is due to the non-compliant individuals remaining viable reservoirs for infection that will lead to reinfection of that community before repeated round of MDA. This study indicates the importance of understanding treatment compliance and tools to combat the problem in settings where transmission interruption is being sought. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Progress in controlling the transmission of schistosome parasites in Southern Ethiopia: the Geshiyaro Project in the Wolaita Zone." The correction addresses an error in the spelling of the first author's family name, which was incorrectly spelled as 'Mengsitu' instead of 'Mengistu'. The correction has been made in the article, and the authors apologize for any inconvenience caused. The document also includes the names of all the authors involved in the article. [Extracted from the article]

Based on four years of participatory action research, this case study examines feminist grassroots organizing in response to three gender discrimination lawsuits in an athletic department at a US university. Students and community activists formed a multigenerational, multiracial, cross-class coalition to support the plaintiffs and to pressure university officials to remedy other institutional gender inequities. Our organizing efforts revealed that we did not similarly assess the potential of lawsuits to make substantive changes nor did we share a vision of how the university should be restructured to better serve women. Examining the fault-lines in our activism reveals how the articulation of difference fosters new forms of political consciousness that use more expansive understandings of equity than those in legal narratives, and leads to more radical forms of social justice work outside the narrow confines of normative rights-based aspirations. The findings are positioned in the feminist legal studies and feminist activism literature. This research contributes to our understanding of the impact of court cases on feminist political mobilization and sheds light on the contributions diverse groups of women make to the everyday interpretations of law and localized public understandings of gender equality. [ABSTRACT FROM AUTHOR]

In an era of waning public funding and growing assumptions within the academy that gender has been integrated into curricula, Women's Studies Programs work under the monitoring eye of a corporate model of budget-slicing, bureaucratic, audit-culture accountability. Programs come under increasing assault on the grounds of obsolescence and cost-effectiveness. This article documents the institutional setting of a Women's Studies Program under threat and traces how program faculty have attempted to counter antifeminist obsolescence and individualist rhetoric, using as an example the struggle over institutional sexual harassment policy and its successor at the authors' state university. In participating in re-writing policy, the authors discovered possibilities and blockades in professors' and students' attempts to position the Program as more than a curricular remedy. We reveal the limitations of valuing departments solely on quantitative grounds and insist that feminist work in transforming academic culture is far from complete. [ABSTRACT FROM AUTHOR]

Focuses on the consideration of volunteerism as part of women's studies in the United States. Significance of integrating volunteerism into feminist perspectives; Difficulties encountered in promoting the program; Relevance of the program in building public awareness and creating social change.

The article discusses about children and adolescents living with HIV (human immunodeficiency virus) disease in Great Britain.Topics include myths spread regarding transmission of this virus, impact and consequences of HIV on a child's life, and social awareness of disease. Additional topics include psychosocial impact of HIV, health professionals role in supporting patients, and stress on these children lead to negative health effects like compromising nervous and immune system function.

The article presents a narrative of a teenage girl's experience with her first intimate kiss and her friend's rape on the same night. The author explains her excitement in wanting to share her experience with her friend, only to find that her friend is not in school that day. She learns the events of her friend's rape, how she saved her younger sister, and the factors that allowed her to live after her rapist tried to slit her throat. She learns, at the same time but incidentally, of her neighborhood's displeasure at her friend's interracial dating. She explains the hospital's unwillingness to admit that her friend was there, in protection of her privacy. And she tries to imagine the innocence of her kiss turning into the violence of her friend's rape.