The DeWorm3 Project is a collection of BMGF funded grants with interconnected objectives. Aligned to distinct study phases, the overarching goal is to determine the feasibility of STH transmission. The first phase, ‘The Intervention’ led by the Natural History Museum (2015-2021) sought to identify effective drug-delivery strategies to interrupt STH transmission by undertaking three years of twice-annual community-wide mass drug administration (MDA) with albendazole as compared to the standard national STH control strategy in each trial country (Fig. 1).
Fig. 1: The DeWorm3 Intervention Timeline.
Study areas with target populations between 80,000 and 110,000 were selected in each site. Following complete enumeration of the population of each study site, clusters were demarcated within the study area (Fig. 2). Following cluster demarcation, stool samples were collected from a random subset of individuals for baseline STH prevalence assessment and randomization of the clusters. Following randomization, clusters received either twice-annual community-wide MDA or standard-of-care school-age-targeted deworming (per national guidelines in each country) for three years.
Fig. 2: Study clusters and households enumerated in India, Malawi and Benin.
As of December 2020, all Intervention Phase activities have been completed, with annual censuses (Fig. 3) enumerating approximately 260,000 households and 1,065,000 individuals across three sites over three years.
Annual longitudinal monitoring (LMC) and a baseline Cross-Sectional Survey (CSS) resulted in approximately 93,000 stool samples being collected and stored for future analysis in the next phases of the project.
Similarly, all six rounds of planned MDA and subsequent coverages surveys have been delivered in India, Malawi and Benin with 890,134 albendazole doses being distributed to eligible participants.
With consistently high coverage and a stalwart reputation amongst local communities, the DeWorm3 project is significantly contributing towards the global targets of eliminating STH as a public health problem. Through DeWorm3, the Natural History Museum has championed collaboration, capacity-building and exceptional research governance, and is proud of its legacy as leader upon the successful completion of Phase 1 of DeWorm3.
Click here for the next phase of DeWorm3.
Fig. 3: Demographics of the trial Censuses.
DeWorm3 has fostered a positive relationship with the local communities.
School children being treated with albendazole in Malawi.