1. Spatial heterogeneity in mass drug administration from a longitudinal epidemiological study assessing transmission interruption of soil transmitted helminths in the Wolaita zone of southern Ethiopia (Geshiyaro Project).
- Author
-
Rayment Gomez S, Maddren R, Liyew EF, Chernet M, Anjulo U, Tamiru A, Tollera G, Tasew G, Mengistu B, Collyer B, Forbes K, and Anderson R
- Subjects
- Animals, Humans, Mass Drug Administration, Soil parasitology, Ethiopia epidemiology, Epidemiologic Studies, Prevalence, Helminthiasis drug therapy, Helminthiasis epidemiology, Helminthiasis prevention & control, Anthelmintics therapeutic use, Helminths
- Abstract
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., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rayment Gomez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
- Full Text
- View/download PDF