About

deworm3-malawi-LMS-full-width

DeWorm3 travels house-to-house to ensure the trial reaches every person in every cluster

The World Health Organization (WHO) estimates more than 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. That is: 

24percentpopulation

The DeWorm3 approach

DeWorm3 is testing the feasibility of interrupting the transmission of STH infections and to develop feasible, effective strategies for scaling-up transmission interruption programs.

One approach to interrupting the STH transmission cycle and prevent ongoing transmission to children is to broadly administer the deworming drug albendazole to people of all age groups in these areas (community-wide deworming) compared to the current regime of only deworming children (school-based deworming). 

New modelling of STH transmission dynamics suggests that it may be possible to interrupt the transmission of STH using preventative chemotherapy (PC) alone – with an “intensified” community-wide MDA strategy.

We will test the principal hypothesis:

  • Three years of community-wide treatment with albendazole will be sufficient to interrupt transmission of each individual species in the same areas, whereas programmes targeted at pre-school and school-age children will not achieve such interruption. 
DeWorm3 Endpoint Scenarios.© Arianna Means, DeWorm3

DeWorm3 Endpoint Scenarios.© Arianna Means, DeWorm3

Current WHO guidelines

Current WHO STH guidelines recommend delivering preventative chemotherapy -  albendazole or mebendazole - via

  • mass drug administration (MDA) campaigns
  • targeting pre-school and school-age children
  • living in areas where the baseline prevalence of any STHs infection is 20% or higher among children.

The purpose of this strategy is to reduce STH-associated morbidity by reducing STH worm burdens in children.

However, the targeted approach is unlikely to break transmissions of STHs in the community because adults and other untreated community members may act as reservoirs for STHs infections, contributing to ongoing reinfection of treated children.

Project summary

  • Focus: To test the feasibility of interrupting the transmission of STH infections and to develop feasible, effective strategies for scaling-up transmission interruption programs.
  • Funding: Bill and Melinda Gates Foundation
  • Start date: 2015
  • End date: 2020

References

 Anderson R, Truscott J, Hollingsworth TD (2014) The coverage and frequency of mass drug administration required to eliminate persistent transmission of soil-transmitted helminths  Philos Trans R Soc Lond B Bio Sci 369: 20130435.

Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups World Health Organisation, September 17 2017.

Neglected Tropical Diseases

DeWorm3 research focusses on roundworm, whipworm and hookworm. Find out more here.