Academic Journal
Optimising cluster survey design for planning schistosomiasis preventive chemotherapy
| Title: | Optimising cluster survey design for planning schistosomiasis preventive chemotherapy |
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| Authors: | Knowles, SCL, Sturrock, HJW, Turner, H, Whitton, JM, Gower, CM, Jemu, S, Phillips, AE, Meite, A, Thomas, B, Kollie, K, Thomas, C, Rebollo, MP, Styles, B, Clements, M, Fenwick, A, Harrison, WE, Fleming, FM |
| Contributors: | Department for International Development (UK) (DFID) |
| Publisher Information: | Public Library of Science |
| Publication Year: | 2017 |
| Collection: | Imperial College London: Spiral |
| Subject Terms: | Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, Parasitology, Tropical Medicine, NEGLECTED TROPICAL DISEASES, COST-EFFECTIVENESS, URINARY SCHISTOSOMIASIS, INTEGRATED CONTROL, CONTROL PROGRAM, MANSONI, AFRICA, THRESHOLD, INFECTION, TRACHOMA, Adolescent, Chemoprevention, Child, Preschool, Cote d'Ivoire, Female, Health Care Costs, Humans, Liberia, Logistic Models, Malawi, Male, Practice Guidelines as Topic, Praziquantel, Schistosomiasis |
| Description: | Background The cornerstone of current schistosomiasis control programmes is delivery of praziquantel to at-risk populations. Such preventive chemotherapy requires accurate information on the geographic distribution of infection, yet the performance of alternative survey designs for estimating prevalence and converting this into treatment decisions has not been thoroughly evaluated. Methodology/Principal findings We used baseline schistosomiasis mapping surveys from three countries (Malawi, Côte d’Ivoire and Liberia) to generate spatially realistic gold standard datasets, against which we tested alternative two-stage cluster survey designs. We assessed how sampling different numbers of schools per district (2–20) and children per school (10–50) influences the accuracy of prevalence estimates and treatment class assignment, and we compared survey cost-efficiency using data from Malawi. Due to the focal nature of schistosomiasis, up to 53% simulated surveys involving 2–5 schools per district failed to detect schistosomiasis in low endemicity areas (1–10% prevalence). Increasing the number of schools surveyed per district improved treatment class assignment far more than increasing the number of children sampled per school. For Malawi, surveys of 15 schools per district and 20–30 children per school reliably detected endemic schistosomiasis and maximised cost-efficiency. In sensitivity analyses where treatment costs and the country considered were varied, optimal survey size was remarkably consistent, with cost-efficiency maximised at 15–20 schools per district. Conclusions/Significance Among two-stage cluster surveys for schistosomiasis, our simulations indicated that surveying 15–20 schools per district and 20–30 children per school optimised cost-efficiency and minimised the risk of under-treatment, with surveys involving more schools of greater cost-efficiency as treatment costs rose. |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | PLOS Neglected Tropical Diseases; http://hdl.handle.net/10044/1/48852; https://dx.doi.org/10.1371/journal.pntd.0005599; PO 5471 |
| DOI: | 10.1371/journal.pntd.0005599 |
| Availability: | http://hdl.handle.net/10044/1/48852 https://doi.org/10.1371/journal.pntd.0005599 |
| Rights: | © 2017 Knowles et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited (https://creativecommons.org/licenses/by/4.0/) |
| Accession Number: | edsbas.B4CE0C88 |
| Database: | BASE |
| DOI: | 10.1371/journal.pntd.0005599 |
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