title: The coverage and frequency of mass drug administration required to eliminate persistent transmission of soil-transmitted helminths.
abstract: A combination of methods, including mathematical model construction, demographic plus epidemiological data analysis and parameter estimation, are used to examine whether mass drug administration (MDA) alone can eliminate the transmission of soil-transmitted helminths (STHs). Numerical analyses suggest that in all but low transmission settings (as defined by the magnitude of the basic reproductive number, R0), the treatment of pre-school-aged children (pre-SAC) and school-aged children (SAC) is unlikely to drive transmission to a level where the parasites cannot persist. High levels of coverage (defined as the fraction of an age group effectively treated) are required in pre-SAC, SAC and adults, if MDA is to drive the parasite below the breakpoint under which transmission is eliminated. Long-term solutions to controlling helminth infections lie in concomitantly improving the quality of the water supply, sanitation and hygiene (WASH). MDA, however, is a very cost-effective tool in long-term control given that most drugs are donated free by the pharmaceutical industry for poor regions of the world. WASH interventions, by lowering the basic reproductive number, can facilitate the ability of MDA to interrupt transmission.
authors.affiliation: London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, , St Marys Campus, Norfolk Place, London W2 1PG, UK.
authors.forename: Roy
authors.initials: R
authors.lastname: Anderson
authors.forename: James
authors.initials: J
authors.lastname: Truscott
authors.forename: T Deirdre
authors.initials: TD
authors.lastname: Hollingsworth
mesh_terms: D000328:Adult; D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D006373:Helminthiasis / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control*; D006376:Helminths / Q000187:drug effects*; D006801:Humans; D008954:Models, Biological; D012987:Soil / Q000469:parasitology*
chemical_list: D000890:Anti-Infective Agents; D012987:Soil
keywords: chemotherapy; elimination; modelling; school-based intervention; soil-transmitted helminths