Pre-school age participation in mass drug administration: analysing the impact on community-wide schistosomiasis control
File(s)
Published version
Author(s)
Ellis, John
Anderson, Roy
Type
Journal Article
Abstract
Objectives
Schistosome infection in childhood is common and can lead to morbidity. A formulation of praziquantel to treat preschool-aged children (PSAC) has been developed recently. This paper assesses the impact of including PSAC in mass drug administration (MDA) on transmission and morbidity at a community-wide level.
Methods
We used a model of schistosome transmission to simulate the probability of a community reaching elimination as a public health problem (EPHP) and the reduction in morbidity of children resulting from infections until the age of 5 years, measured by a “worm years” metric as a score of morbidity.
Results
Including PSAC in MDA will almost always lead to a reduction in morbidity. However, it does not necessarily result in a substantial increase in the probability of EPHP. The proportion of schistosome infections in each age group is a key factor in determining the effectiveness of MDA programs, which prioritize different age groups for treatment.
Conclusions
Policymakers should be aware that including PSAC in MDA may not help to reach the World Health Organization target of EPHP. However, a reduction in the average summed worm infection burden at the age children typically start attending school is highly desirable in increasing the long-term benefit of MDA in early childhood.
Schistosome infection in childhood is common and can lead to morbidity. A formulation of praziquantel to treat preschool-aged children (PSAC) has been developed recently. This paper assesses the impact of including PSAC in mass drug administration (MDA) on transmission and morbidity at a community-wide level.
Methods
We used a model of schistosome transmission to simulate the probability of a community reaching elimination as a public health problem (EPHP) and the reduction in morbidity of children resulting from infections until the age of 5 years, measured by a “worm years” metric as a score of morbidity.
Results
Including PSAC in MDA will almost always lead to a reduction in morbidity. However, it does not necessarily result in a substantial increase in the probability of EPHP. The proportion of schistosome infections in each age group is a key factor in determining the effectiveness of MDA programs, which prioritize different age groups for treatment.
Conclusions
Policymakers should be aware that including PSAC in MDA may not help to reach the World Health Organization target of EPHP. However, a reduction in the average summed worm infection burden at the age children typically start attending school is highly desirable in increasing the long-term benefit of MDA in early childhood.
Date Issued
2025-07-01
Date Acceptance
2025-04-29
Citation
International Journal of Infectious Diseases, 2025, 156
ISSN
1201-9712
Publisher
Elsevier
Journal / Book Title
International Journal of Infectious Diseases
Volume
156
Copyright Statement
© 2025 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
License URL
Identifier
10.1016/j.ijid.2025.107919
Publication Status
Published
Article Number
107919
Date Publish Online
2025-05-03