{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:55Z","timestamp":1772169175856,"version":"3.50.1"},"reference-count":25,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome","doi-asserted-by":"publisher","award":["226053"],"award-info":[{"award-number":["226053"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Center for Global Health and Social Responsibility, University of Minnesota"}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Mozambique has the 4\n                    <ns4:sup>th<\/ns4:sup>\n                    highest malaria incidence and mortality globally. Despite the existing malaria control strategies, malaria prevalence remains stagnant. These challenges have increased calls for innovative strategies in areas with the highest disease burden. Community mass treatment with anthelmintic agents have been used as an effective tool for the control of major helminth infections and has emerged as a potential tool for vector control in the fight against malaria.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    This was an analysis of data from a cross-sectional community-based survey designed to study malaria risk, prevention, and health seeking behaviors in Sussundenga, Mozambique. Using logistic regression models, we quantified the association between ever receiving anthelmintic treatment and\n                    <ns4:italic>P. falciparum<\/ns4:italic>\n                    infection. We also fit models to determine the association between recent anthelmintic treatment and malaria infection.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Two-hundred, seventy-seven (277) participants from 83 households were included in this analysis. The prevalence of\n                    <ns4:italic>P. falciparum<\/ns4:italic>\n                    infection measured by rapid diagnostic test (RDT) was 30%. 77% of participants reported having ever received anthelmintics. The prevalence of malaria was slightly higher among participants who reported ever taking anthelmintics. There was no statistically significant association between prior receipt of anthelmintic and\n                    <ns4:italic>P. falciparum<\/ns4:italic>\n                    malaria infection after adjusting for age, ITN use and head of household full-time employment (OR = 1.37, 95% CI, 0.70\u20132.70, p = 0.36). However, recent intake of anthelmintics was associated with lower odds of testing positive for in the adjusted models (OR = 0.35, 95% CI, 0.07\u20131.80, p = 0.21), but this was not statistically significant.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    Our findings show that the benefit of anthelmintics treatment as a control tool for\n                    <ns4:italic>P. falciparum<\/ns4:italic>\n                    malaria infection is likely tied to when it is administered rather than if it was ever administered. These findings offer evidence for making decisions in planning mass community deworming in sub-Saharan Africa.\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.19548.1","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T04:55:09Z","timestamp":1695185709000},"page":"417","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of anthelmintic treatment with malaria prevalence in Rural Sussundenga, Mozambique"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6230-9957","authenticated-orcid":false,"given":"Joseph A.","family":"Akambase","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o L.","family":"Ferr\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albino","family":"Francisco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valy","family":"Muhiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An\u00edsio","family":"Novela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique E.","family":"Earland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1316-9342","authenticated-orcid":false,"given":"Kelly M.","family":"Searle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2023,9,20]]},"reference":[{"key":"ref-1","article-title":"World malaria report 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Malaria in a Pre-Elimination Setting in Southern Zambia.","volume":"100","author":"T Kobayashi","year":"2019","journal-title":"Am J Trop Med Hyg."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"207-11","DOI":"10.1038\/nature15535","article-title":"The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015.","volume":"526","author":"S Bhatt","year":"2015","journal-title":"Nature."},{"key":"ref-7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002455","article-title":"malERA: An updated research agenda for diagnostics, drugs, vaccines, and vector control in malaria elimination and eradication.","volume":"14","year":"2017","journal-title":"PLoS Med."},{"key":"ref-8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001619","article-title":"The impact of pyrethroid resistance on the efficacy of insecticide-treated bed nets against African anopheline mosquitoes: systematic review and meta-analysis.","volume":"11","author":"C Strode","year":"2014","journal-title":"PLoS Med."},{"key":"ref-9","article-title":"High burden to high impact: A targeted malaria response","year":"2019"},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"e42-e48","DOI":"10.1016\/S1473-3099(16)30475-3","article-title":"Human schistosomiasis in the post mass drug administration era.","volume":"17","author":"F Mutapi","year":"2017","journal-title":"Lancet Infect Dis."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"1825-35","DOI":"10.1017\/S0031182009000493","article-title":"Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs.","volume":"136","author":"M Doenhoff","year":"2009","journal-title":"Parasitology."},{"key":"ref-12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002745","article-title":"The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: A cluster randomised trial.","volume":"16","author":"L von Seidlein","year":"2019","journal-title":"PLoS Med."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"231-40","DOI":"10.1080\/14787210.2017.1271713","article-title":"Ivermectin: a complimentary weapon against the spread of malaria?","volume":"15","author":"H Alout","year":"2017","journal-title":"Expert Rev Anti Infect Ther."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12936-017-1825-9","article-title":"Ivermectin and malaria control.","volume":"16","author":"S \u014cmura","year":"2017","journal-title":"Malar J."},{"key":"ref-15","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/1475-2875-12-153","article-title":"Ivermectin to reduce malaria transmission: a research agenda for a promising new tool for elimination.","volume":"12","author":"C Chaccour","year":"2013","journal-title":"Malar J."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"113-6","DOI":"10.1086\/653208","article-title":"Effect of ivermectin on Anopheles gambiae mosquitoes fed on humans: the potential of oral insecticides in malaria control.","volume":"202","author":"C Chaccour","year":"2010","journal-title":"J Infect Dis."},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"119-26","DOI":"10.1016\/j.actatropica.2010.06.001","article-title":"The effect of oral anthelmintics on the survivorship and re-feeding frequency of anthropophilic mosquito disease vectors.","volume":"116","author":"K Kobylinski","year":"2010","journal-title":"Acta Trop."},{"key":"ref-18","doi-asserted-by":"publisher","first-page":"1517-1526","DOI":"10.1016\/S0140-6736(18)32321-3","article-title":"Efficacy and risk of harms of repeat ivermectin mass drug administrations for control of malaria (RIMDAMAL): a cluster-randomised trial.","volume":"393","author":"B Foy","year":"2019","journal-title":"Lancet."},{"key":"ref-19","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2021.106213","article-title":"Association of anthelmintic treatment with malaria prevalence, incidence, and parasitemia: A systematic review and meta-analysis.","volume":"225","author":"K Dila","year":"2022","journal-title":"Acta Trop."},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"266-75","DOI":"10.1093\/infdis\/jiv382","article-title":"Effect of Repeated Anthelminthic Treatment on Malaria in School Children in Kenya: A Randomized, Open-Label, Equivalence Trial.","volume":"213","author":"S Kepha","year":"2016","journal-title":"J Infect Dis."},{"key":"ref-21","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-614728\/v1","article-title":"Modelling Sociodemographic Factors That Affect Malaria Prevalence in Sussundenga, Mozambique.","author":"J Ferrao","year":"2021","journal-title":"Res Sq."},{"key":"ref-22","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/1475-2875-3-43","article-title":"Increase of malaria attacks among children presenting concomitant infection by Schistosoma mansoni in Senegal.","volume":"3","author":"C Sokhna","year":"2004","journal-title":"Malar J."},{"key":"ref-23","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/913696","article-title":"Helminth Parasites Alter Protection against Plasmodium Infection.","volume":"2014","author":"V Salazar-Casta\u00f1on","year":"2014","journal-title":"Biomed Res Int."},{"key":"ref-24","doi-asserted-by":"publisher","first-page":"194-8","DOI":"10.4269\/ajtmh.2006.75.194","article-title":"Parasitic co-infections: does Ascaris lumbricoides protect against Plasmodium falciparum infection?","volume":"75","author":"L Brutus","year":"2006","journal-title":"Am J Trop Med Hyg."},{"key":"ref-25","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/1471-2334-10-277","article-title":"Impact of 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.21654.r71938, R Matthew Chico, Wilfred F Mbacham, Associate Professor in the Department of Disease Control, London School of Hygiene & Tropical Medicine, London, 20 Feb 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-71938","order":0,"name":"referee-response-71938","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21654.r75739, Adilson DePINA, CCS-SIDA, Minist\u00e9rio da Sa\u00fade e da Seguran\u00e7a Social, Praia, 08 Apr 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-75739","order":1,"name":"referee-response-75739","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21654.r75724, Manju Rahi, Srikanth S, ICMR- Vector Control Research Centre, Puducherry, Puducherry, 08 Apr 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-75724","order":2,"name":"referee-response-75724","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21654.r78473, Zachary R Popkin-Hall, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 09 Apr 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-78473","order":3,"name":"referee-response-78473","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21654.r71268, Olawunmi Oyerinde, Department of Biological Sciences, Mountain Top University, Ibafo, Ogun State, 09 Apr 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-71268","order":4,"name":"referee-response-71268","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Kelly Searle<\/b>; \n<i>Posted: 24 Apr 2024<\/i>; However, the results and discussion sections should be reviewed. 1. Table 1 can be more detailed to include the significance in proportion of those who had taken de-worming tablets and those who had not by running chi-square test.&nbsp; \n<b>Response<\/b>: This has been included. 2. Figure 2 may not be required as the information provided is already in Table 1.&nbsp; 3. For a more robust data, the authors could obtain the malaria diagnosis result by microscopy from the Sussundenga RHC since RDT positive patients were referred to the clinic. \n<b>Response<\/b>: in this case the RHC also primarily uses RDTs instead of microscopy. 4. The interpretation of the association between deworming and prevalence of malaria by RDT should be with caution since no significant association was found. Hence, the conclusion of the abstract and the discussion section should be reviewed. \n<b>Response<\/b>: This has been revised.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-comment-5684","order":5,"name":"referee-comment-5684","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21654.r69481, Nkemngo Francis Nongley, PhD, Infection and Disease Control Unit, Centre for Infection Biology and Tropical Health (CIBITH), Forzi Institute, Buea, Southwest, 09 Apr 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-69481","order":6,"name":"referee-response-69481","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Kelly Searle<\/b>; \n<i>Posted: 24 Apr 2024<\/i>; \n<b>Introduction:<\/b> First paragraph: Please update the morbidity and mortality data from the recently published world malaria report (WHO, malaria report 2023) \n<b>Response<\/b>: We have corrected this.  Third paragraph: Modify the statement to \u201cincreasing vector and parasite resistance to insecticides and antimalarial drugs, respectively.\u201d. Also, the last statement is incomplete. Correct it to develop new and easy &quot;strategies&quot; to \u201ccomplement\u201d control methods \n<b>Response:<\/b> We have corrected these statements.  \n<b>Method section:<\/b> Data collection: Please could you comment if 100 is the total number of individuals sampled or the number of households included in the study. I find it difficult to understand because if 100 is the overall number of 5-6 residents per household, then the sample size is small and weakens the overall study design and data generated. \n<b>Response:<\/b> One hundred households was our target sample size from the 125 randomly selected household with the assumption that there would be approximately 5-6 residents per household that would be eligible to be included in the study.  What was the antimalarial treatment history of the 83 household members? Noting that Sussundenga has a high community prevalence of malaria, it suggests that individuals will frequently be sick of malaria and, as such, will take treatment to alleviate symptoms. Therefore, it is important to unbiasedly rule out the effect of previously antimalarial treatment intake as a confounder relative to the independent, measurable impact of anthelminthic on malaria burden in this locality. Data collectors administered a questionnaire. The questionnaire failed to include a history of antimalarial medication. \n<b>Response<\/b>: We collected information on recent malaria treatment as this impacts the validity of the RDT due to the prophylactic effect of ACTs for approximately 2-4 after completing the treatment. Our study was conducted prior to the rainy season and as such, none of our participants reported recent treatment (in the past month) for malaria. If they would have reported recent treatment they would have been excluded from the analysis as they are not at risk of having the outcome.  \n<b>Results section:<\/b> Prevalence of malaria: Specify the prevalence in relation to the diagnostic method used (in this case, RDT). Please, can the authors\u2019 comment explain why the gold standard microscopy was not employed? \n<b>Response<\/b>: The RDT was used as we conducted study visits in participants\u2019 household making the RDT the most logistically feasible. Additionally, RDTs are the standard diagnostic used in rural health centers in Mozambique as microscopy can have varied sensitivity and specificity depending on the microscopist which isn\u2019t a factor with an RDT. Table 1: The numerical difference between dewormers is 3x larger than that between non-dewormers. This is a significant bias, as it is difficult to pair-wise compute the effect of deworming on malaria infection and parasitemia. \n<b>Response<\/b>: This is likely due to our small sample size and semi-frequent deworming campaigns in this region.  Secondly, looking at the age indicator, why did the authors not mainly focus on school-age children (3\u201315 years) for both subject categories (dewormers and ND). Indeed, MDA-based preventive chemotherapy (Mebendazole for STH) often targets this age group, and where certainty exists on deworming history for a 6-month interval period (at least by DOTS),. Including individuals over 15 years old in your study is a weakness, as a verbal record of taking anthelminthic may not be a true indication of a deworming history. Also, the minimum age range of dewormers (11-27) is far higher than the minimum for non-dewormers (3-35), and this is a potential confounder. \n<b>Response<\/b>: We didn\u2019t want to restrict the analysis to younger ages due to an already low sample size. We included age as a confounder in our final models to account for the age differences in both the exposure and the outcome. We also asked participants if they did not recall if they had ever received dewormers to no force a response that they could not remember.  This weakness strongly reflects on the malaria prevalence by RDT, where dewormers document a similar prevalence than their counterpart, posing a weakness on the MS title and overall conclusion of the manuscript itself. Please, critically, provide a convincing response to address these remarks. \n<b>Response<\/b>: We have edited the title and conclusions of the study to more accurately reflect the results found.  Does this imply that anthelminthic treat\/clear P. falciparum infection? RDT is a less sensitive method to diagnose malaria, particularly in low parasite loads (as may coincide with the recent intake of anthelminthic drugs). Moreover, what was the antimalaria treatment history? \n<b>Response<\/b>: We are not implying that anthelminthic treat or clear malaria infections. The impact that they have on malaria is indirect through killing the vectors that feed on individuals who have been treated with anthelminthic.  Figure 2: I am certain that recent deworming will exhibit additional effects both on reducing STH egg burden and on lessening malaria incidence and prevalence. However, the data reported in this study is largely weakened by the study design and randomization. Indeed, by focusing on individuals who had been dewormed for at least 6 months prior to the study, would the deworming have any effect on malaria incidence after 6 months of deworming? This is clearly seen in Fig. 2, as I may be of the opinion that the malaria positivity status (of dewormed participants) could be attributed to recent infection that would not have been prevented by the 6-month post-deworming effect. Timing of dewormer administration and&nbsp;\n<i>P. falciparum&nbsp;<\/i>malaria infection: How was the modelling done? Please provide enough details on this. This aspect of this study is of major interest as it constitutes the basis of your manuscript title and abstract. However, very limited information is provided. Furthermore, the authors indicated the unadjusted model considered in account a &lt;6-month interval of anthelminthic treatment. Please could the authors provide additional analysis to show the varied impact of recent intake of anthelminthic on malaria infection (with highlights on the anthelminthic malaria reduction effects of 1 week, 2 weeks, 1 month, 2 months, 3 months, or 5 of treatment). Also, I will be interested to see a logistic regression plot that depicts the impact of these varied anthelminthic treatment periods on malaria prevalence levels. This will provide strong evidence to replicate the data and also consider the validity of the results \n<b>Response<\/b>: This was a cross-sectional study so there was no randomization of the exposure just observation. We have included additional information on the model building and selection process. The survey asked whether the participant was ever treated with anthelminthics and when their last treatment was. As this was not a trial we were not able to collect information longitudinally after administration of anthelminthics. Also, this was a secondary analysis of the data that was collected to determine community malaria prevalence and risk factors.  \n<b>Discussion section:<\/b> Second paragraph: Please clarify if the Sokhna et al. study reported on the status of anthelminthic treatment as well or if the study only focused on the association between both infections. This will strengthen the following statement, where you are implying that helminthic treatment enhances the risk of malaria infection. Clarify appropriately \n<b>Response<\/b>: We have clarified this.  Last paragraph: Although the authors highlighted this as a limitation, it will nevertheless be worthwhile to know what type of anthelminthic drugs were administered for deworming programs in this community. Was deworming done annually or biannually? Aside from programmatic deworming campaigns, did participants document just receiving anthelminthic randomly to treat worm infections? Please comment on this. \n<b>Response<\/b>: This information was not collected during our study.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-comment-5685","order":7,"name":"referee-comment-5685","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.21654.r71262, Poe Poe Aung, CAPHRI, Maastricht University Medical Center, Maastricht University, Maastricht, 09 Apr 2024, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-response-71262","order":8,"name":"referee-response-71262","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Kelly Searle<\/b>; \n<i>Posted: 24 Apr 2024<\/i>; Introduction: 2\n<sup>nd<\/sup>&nbsp;paragraph: iCCM is meant for \u201cintegrated community case management\u201d I think. Pls double check you are mentioning \u201cintegrated community care management\u201d. &nbsp;Response: It should be integrated community case management.  World Malaria Report data should be updated with the latest version of the report, which is 2023. Response: We have corrected this.  Methods - none  Results: P-value should be added in table 1 and figure 2. Response: We have added these to Table 1.  Discussion - none  Conclusion - none","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-417\/v1#referee-comment-5686","order":9,"name":"referee-comment-5686","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This study was funded by a SEED grant from the University of Minnesota Center for Global Health and Social Responsibility. KMS is supported by Wellcome [226053]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":10,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}