A multi-state evaluation of health system opportunities and challenges facing community-wide mass drug administration for the elimination of parasitic worms in India

Abstract

An estimated 1.45 billion people are infected with Soil Transmitted Helminths (STH) globally, with a large proportion of the burden in India. At moderate to high infection intensity, STH is associated with a number of morbidities that disproportionately affect children, including, malnutrition, impaired cognitive development and anemia. The World Health Organization Neglected Tropical Disease (NTD) guidelines recommends controlling STH-associated morbidity via mass drug administration (MDA) to treat school-aged children. Recent evidence suggests however, that it may be possible to interrupt STH transmission, therefore preventing infection, by expanding MDA to a community-wide program. Similar NTDs, such as Lymphatic Filariasis (LF) already operate on a community-wide scale. This research assesses government stakeholder readiness for transitioning from school-based to community-wide MDA for STH, as well as identifies strategic opportunities to leverage existing LF infrastructure. Findings from this study are intended to proactively support government decision making, prioritization, and program planning across heterogenous implementation contexts in India in order to speed the translation of research findings into practice.