{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T16:07:58Z","timestamp":1793203678098,"version":"4.5.0"},"reference-count":33,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,4]]},"abstract":"<jats:p>Control of schistosomiasis presently relies largely on preventive chemotherapy with praziquantel through mass drug administration (MDA) programs. The Schistosomiasis Consortium for Operational Research and Evaluation has concluded five studies in four countries (C\u00f4te d\u2019Ivoire, Kenya, Mozambique, and Tanzania) to evaluate alternative approaches to MDA. Studies involved four intervention years, with final evaluation in the fifth year. Mass drug administration given annually or twice over 4 years reduced average prevalence and intensity of schistosome infections, but not all villages that were treated in the same way responded similarly. There are multiple ways by which responsiveness to MDA, or the lack thereof, could be measured. In the analyses presented here, we defined persistent hotspots (PHS) as villages that achieved less than 35% reduction in prevalence and\/or less than 50% reduction in infection intensity after 4 years of either school-based or community-wide MDA, either annually or twice in 4 years. By this definition, at least 30% of villages in each of the five studies were PHSs. We found no consistent relationship between PHSs and the type or frequency of intervention, adequacy of reported MDA coverage, and prevalence or intensity of infection at baseline. New research is warranted to identify PHSs after just one or a few rounds of MDA, and new adaptive strategies need to be advanced and validated for turning PHSs into responder villages.<\/jats:p>","DOI":"10.4269\/ajtmh.19-0193","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T03:00:29Z","timestamp":1562641229000},"page":"617-627","source":"Crossref","is-referenced-by-count":65,"title":["Persistent Hotspots in Schistosomiasis Consortium for Operational Research and Evaluation Studies for Gaining and Sustaining Control of Schistosomiasis after Four Years of Mass Drug Administration of Praziquantel"],"prefix":"10.4269","volume":"101","author":[{"given":"Nupur","family":"Kittur","sequence":"first","affiliation":[{"name":"Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"King","sequence":"additional","affiliation":[{"name":"Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl H.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safari","family":"Kinung\u2019hi","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline N. M.","family":"Mwinzi","sequence":"additional","affiliation":[{"name":"Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana M. S.","family":"Karanja","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliezer K.","family":"N\u2019Goran","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Formation et de Recherche Biosciences, Universit\u00e9 F\u00e9lix Houphou\u00ebt-Boigny, Abidjan, C\u00f4te d\u2019Ivoire;"},{"name":"Centre Suisse de Recherches Scientifiques en C\u00f4te d\u2019Ivoire, Abidjan, C\u00f4te d\u2019Ivoire;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro H.","family":"Gazzinelli-Guimaraes","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Schistosomiasis Control Initiative, Imperial College London, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Olsen","sequence":"additional","affiliation":[{"name":"Section for Parasitology and Aquatic Pathobiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Magnussen","sequence":"additional","affiliation":[{"name":"Centre for Medical Parasitology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Evan","family":"Secor","sequence":"additional","affiliation":[{"name":"Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan P.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juerg","family":"Utzinger","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute, Basel, Switzerland;"},{"name":"University of Basel, Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health, University of Georgia, Athens, Georgia;"},{"name":"Odum School of Ecology, University of Georgia, Athens, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Binder","sequence":"additional","affiliation":[{"name":"Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Colley","sequence":"additional","affiliation":[{"name":"Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia;"},{"name":"Department of Microbiology, University of Georgia, Athens, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Fifty-Fourth World Health Assembly Resolution WHA54.19 Schistosomiasis and Soil-Transmitted Helminth Infections","author":"World Health 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