{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T23:06:49Z","timestamp":1781996809385,"version":"3.54.5"},"reference-count":49,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3_Suppl","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>In Nigeria, mass drug administration (MDA) for schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) has often been coordinated with other programs that receive greater external funding. As these programs reach stop MDA milestones, SCH and STH programs will likely need to transition implementation, or \u201cmainstream,\u201d to domestic support. A mixed-methods study was conducted in four districts before (2021) and after (2022) mainstreaming to evaluate its impact on MDA coverage. Household surveys were done in 30 villages per district pre- and post-mainstreaming. All selected communities were eligible for STH treatment; around a third were eligible for SCH treatment. Mass drug administration was primarily conducted in schools. A total of 5,441 school-aged children were included in pre-mainstreaming and 5,789 were included in post-mainstreaming. Mass drug administration coverage was heterogeneous, but overall, mebendazole coverage declined nonsignificantly from 81% pre-mainstreaming to 76% post-mainstreaming (<jats:italic>P =<\/jats:italic> 0.09); praziquantel coverage declined significantly from 73% to 55% (<jats:italic>P =<\/jats:italic> 0.008). Coverage was significantly lower among unenrolled children or those reporting poor school attendance in nearly every survey. For the qualitative component, 173 interviews and 74 focus groups were conducted with diverse stakeholders. Respondents were deeply pessimistic about the future of MDA after mainstreaming and strongly supported a gradual transition to full government ownership. Participants formulated recommendations for effective mainstreaming: clear budget\u00a0allocation by governments, robust and targeted training, trust building, and comprehensive advocacy. Although participants lacked confidence that SCH and STH programs could be sustained after reductions in external support, initial results indicate that MDA coverage can remain high 1\u2009year into mainstreaming.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0600","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T17:47:59Z","timestamp":1712684879000},"page":"69-80","source":"Crossref","is-referenced-by-count":3,"title":["A Mixed-Methods Evaluation of Mainstreaming Mass Drug Administration for Schistosomiasis and Soil-Transmitted Helminthiasis in Four Districts of Nigeria"],"prefix":"10.4269","volume":"111","author":[{"given":"Emily","family":"Griswold","sequence":"first","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abel","family":"Eigege","sequence":"additional","affiliation":[{"name":"The Carter Center, Jos, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel C.","family":"Emukah","sequence":"additional","affiliation":[{"name":"The Carter Center, Benin City, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayden Pace","family":"Gallagher","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Coalson","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Rakers","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bulus","family":"Mancha","sequence":"additional","affiliation":[{"name":"The Carter Center, Jos, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okocha","family":"Ndudi","sequence":"additional","affiliation":[{"name":"The Carter Center, Benin City, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ugbadamu","sequence":"additional","affiliation":[{"name":"The Carter Center, Benin City, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philomena","family":"Dikedi","sequence":"additional","affiliation":[{"name":"The Carter Center, Benin City, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Happiness","family":"Poko","sequence":"additional","affiliation":[{"name":"Edo State Primary Health Care Development Agency, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Danboyi","sequence":"additional","affiliation":[{"name":"Nasarawa State Ministry of Health, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philemon","family":"Dagwa","sequence":"additional","affiliation":[{"name":"Plateau State Ministry of Health, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Anighoro","sequence":"additional","affiliation":[{"name":"Delta State Primary Health Care Development Agency, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana Davou","family":"Gwong","sequence":"additional","affiliation":[{"name":"NTD Unit, Bassa LGA, Plateau State, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Otabor","sequence":"additional","affiliation":[{"name":"NTD Unit, Egor LGA, Edo State, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goodluck James","family":"Amayat","sequence":"additional","affiliation":[{"name":"NTD Unit, Wamba LGA, Nasarawa State, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina Ese","family":"Unukopia","sequence":"additional","affiliation":[{"name":"NTD Unit, Ughelli South LGA, Delta State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel S.","family":"Miri","sequence":"additional","affiliation":[{"name":"The Carter Center, Jos, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Noland","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","year":"2018"},{"key":"b2","series-title":"Parasit Vectors","first-page":"37","article-title":"Global numbers of infection and disease burden of soil transmitted helminth infections in 2010","volume":"7","author":"Pullan","year":"2014"},{"key":"b3","series-title":"Nat Rev Microbiol","first-page":"12","article-title":"Schistosomiasis","volume":"2","author":"Chitsulo","year":"2004"},{"key":"b4","series-title":"Lancet","first-page":"2163","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990\u20132010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Vos","year":"2012"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e1600","article-title":"Nigeria: \u201cGround Zero\u201d for the high prevalence neglected tropical diseases","volume":"6","author":"Hotez","year":"2012"},{"key":"b6","series-title":"World Health Organ Tech Rep Ser","first-page":"i","article-title":"Prevention and control of schistosomiasis and soil-transmitted helminthiasis","volume":"912","year":"2002"},{"key":"b7"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"266","article-title":"Lymphatic filariasis elimination and schistosomiasis control in combination with onchocerciasis control in Nigeria","volume":"67","author":"Hopkins","year":"2002"},{"key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e0005202","article-title":"The impact of lymphatic filariasis mass drug administration scaling down on soil-transmitted helminth control in school-age children: present situation and expected impact from 2016 to 2020","volume":"10","author":"Mupfasoni","year":"2016"},{"key":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e0006929","article-title":"Organization of oversight for integrated control of neglected tropical diseases within Ministries of Health","volume":"12","author":"Standley","year":"2018"},{"key":"b11","series-title":"WHO Guideline on Control and Elimination of Human Schistosomiasis","year":"2022"},{"key":"b12","series-title":"Gates Open Res","first-page":"1632","article-title":"Insights from quantitative analysis and mathematical modelling on the proposed WHO 2030 goals for soil-transmitted helminths","volume":"3","year":"2019"},{"key":"b13","series-title":"One Health","first-page":"100183","article-title":"Schistosomiasis in Nigeria: gleaning from the past to improve current efforts towards control","volume":"11","author":"Oyeyemi","year":"2020"},{"key":"b14","series-title":"Ending the Neglect to Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030","year":"2021"},{"key":"b15","series-title":"Trop Med Infect Dis","first-page":"112","article-title":"Helminthiasis among school-age children and hygiene conditions of selected schools in Lafia, Nasarawa State, Nigeria","volume":"4","author":"Abe","year":"2019"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"132","article-title":"Impact of three to five rounds of mass drug administration on schistosomiasis and soil-transmitted helminths in school-aged children in North-Central Nigeria","volume":"107","author":"Griswold","year":"2022"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"441","article-title":"Assessing the WHO 50% prevalence threshold in school-aged children as indication for treatment of urogenital schistosomiasis in adults in central Nigeria","volume":"88","author":"Evans","year":"2013"},{"key":"b18","series-title":"Ann Trop Med Parasitol","first-page":"335","article-title":"Missed treatment opportunities for Schistosomiasis mansoni, in an active programme for the treatment of urinary schistosomiasis in Plateau and Nasarawa states, Nigeria","volume":"102","author":"Gutman","year":"2008"},{"key":"b19","series-title":"Parasite Epidemiol Control","first-page":"e00255","article-title":"Prevalence and risk factors associated with urogenital schistosomiasis among primary school pupils in Nigeria","volume":"18","author":"Onyekwere","year":"2022"},{"key":"b20","series-title":"Helminth Control in School-Age Children: A Guide for Managers of Control Programmes","year":"2011"},{"key":"b21"},{"key":"b22","series-title":"Nigeria 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programmes","volume":"374","author":"Rakers","year":"2009"},{"key":"b28","series-title":"J Pharm Policy Pract","first-page":"21","article-title":"Country ownership and sustainability of Nigeria\u2019s HIV\/AIDS supply chain system: qualitative perceptions of progress, challenges and prospects","volume":"11","author":"Itiola","year":"2018"},{"key":"b29","series-title":"PLoS One","first-page":"e0221809","article-title":"Effect of PEPFAR funding policy change on HIV service delivery in a large HIV care and treatment network in Nigeria","volume":"14","author":"Banigbe","year":"2019"},{"key":"b30","series-title":"Health Policy Plan","first-page":"1326","article-title":"Sparking, supporting and steering change: grounding an accountability framework with viewpoints from Nigerian routine immunization and primary health care government officials","volume":"31","author":"George","year":"2016"},{"key":"b31","series-title":"Infect Drug Resist","first-page":"2453","article-title":"The impact of targeted treatment and mass drug administration delivery strategies on the prevalence and intensity of schistosomiasis in school aged children in Africa: a systematic review","volume":"16","author":"Chanhanga","year":"2023"},{"key":"b32","series-title":"PLoS Negl Trop Dis","first-page":"e0006211","article-title":"Strategies to improve treatment coverage in community-based public health programs: a systematic review of the literature","volume":"12","author":"Deardorff","year":"2018"},{"key":"b33","series-title":"Trop Med Int Health","first-page":"887","article-title":"Additional health and development activities for community-directed distributors of ivermectin: threat or opportunity for onchocerciasis control?","volume":"9","author":"Okeibunor","year":"2004"},{"key":"b34","series-title":"BMJ Glob Health","first-page":"e008162","article-title":"Multilevel determinants of community health workers for an effective maternal and child health programme in sub-Saharan Africa: a systematic 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J","first-page":"201","article-title":"Urinary schistosomiasis in school children of a southern Nigerian community 8 years after the provision of potable water","volume":"24","author":"Ekanem","year":"2017"},{"key":"b43","series-title":"Am J Trop Med Hyg","first-page":"407","article-title":"The effects of integration on financing and coverage of neglected tropical disease programs","volume":"89","author":"Hooper","year":"2013"},{"key":"b44","series-title":"Int J Equity Health","first-page":"160","article-title":"Financing care for severe stigmatizing skin diseases (SSSDs) in Liberia: challenges and opportunities","volume":"21","author":"Smith","year":"2022"},{"key":"b45","series-title":"Int Health","first-page":"376","article-title":"Donor reliance and the impact on neglected tropical disease programme delivery: reflections and solutions for change from programme management perspectives","volume":"13","author":"Kollie","year":"2021"},{"key":"b46","series-title":"BMJ Glob Health","first-page":"e006968","article-title":"How can we better integrate the prevention, treatment, control and elimination of neglected tropical diseases with other health interventions? A systematic review","volume":"6","author":"Banda","year":"2021"},{"key":"b47","series-title":"PLoS Negl Trop Dis","first-page":"e0008565","article-title":"Building country capacity to sustain NTD programs and progress: a call to action","volume":"14","author":"Sodahlon","year":"2020"},{"key":"b48","series-title":"Soc Sci Med","first-page":"51","article-title":"\u201cFor how long are we going to take the tablets?\u201d Kenyan stakeholders\u2019 views on priority investments to sustainably tackle soil-transmitted helminths","volume":"228","author":"Khan","year":"2019"},{"key":"b49","series-title":"Health Policy Plan","first-page":"1045","article-title":"Progress in the face of cuts: a qualitative Nigerian case study of maintaining progress towards universal health coverage after losing donor assistance","volume":"36","author":"Obi","year":"2021"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/3_Suppl\/article-p69.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/3_Suppl\/article-p69.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/3_Suppl\/article-p69.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T19:54:51Z","timestamp":1725479691000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/3_Suppl\/article-p69.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,3]]},"references-count":49,"journal-issue":{"issue":"3_Suppl"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0600","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,3]]}}}