The Schistosomiasis Consortium for Operational Research and Evaluation Rapid Answers Project: Systematic Reviews and Meta-Analysis to Provide Policy Recommendations Based on Available Evidence.

Charles H King,Gisele N Andrade,Daniel G Colley,David Bertsch,Amara E Ezeamama,Michael Burnim,Sue Binder

doi:10.4269/ajtmh.19-0806

Abstract

.The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in late 2008 to conduct operational research to inform global health practices related to the control and elimination of schistosomiasis. The greatest part of the SCORE investment has been in multiyear, long-term efforts, including cluster-randomized trials of gaining and sustaining control of schistosomiasis, trials on elimination of schistosomiasis, and diagnostic test development and evaluation. In the course of planning and conducting SCORE studies, critical questions were raised that could be answered relatively quickly by collecting, collating, and synthesizing existing data. Through its Rapid Answers Project (RAP), the SCORE conducted seven systematic reviews, including four associated meta-analyses, on issues related to screening for schistosomiasis, enhancing mass drug administration, treatment impacts, and the efficacy of snail control for prevention of human schistosomiasis. This article summarizes the findings of the seven RAP reports and provides links to the studies and their supporting information.

Highlights

The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was funded by the Bill & Melinda Gates Foundation in 2008 to conduct research that would inform programmatic decision-making for schistosomiasis control.[1]
During an early planning meeting to design the studies of gaining and sustaining control of schistosomiasis,[2] the question was raised whether a program could reliably use urine dipsticks to assess local prevalence of Schistosoma haematobium, especially at the time of intake eligibility screening, for determining whether a potential study community met a prevalence cutoff criterion for participation in SCORE randomized trials
Our model suggests that double dosing is cost-effective in controlling infection-associated morbidity. Results of this Rapid Answers Project (RAP) were later influential in the design of the SCORE study on interruption of seasonal transmission of S. haematobium in northern Cote d’Ivoire.[21,22]

Summary

INTRODUCTION

The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was funded by the Bill & Melinda Gates Foundation in 2008 to conduct research that would inform programmatic decision-making for schistosomiasis control.[1]. RAP 5: As the SCORE’s large intervention studies were implemented, concerns were raised about treatment coverage[12] and how to reach children who were not in school This resulted in a systematic review published as RAP 5.7. The field of systematic review and meta-analysis of data across similar studies is a discipline that emerged just before the beginning of the SCORE project.[13,14] We quickly realized that this approach had the potential to provide answers within a reasonable period of time to inform policy-related questions that had been previously studied in more than one location but without any global synthesis to provide generalizable recommendations. Onset in preschool years, the chronicity of infection, and the cumulative impact of multiple waves of worm infection can be tested for association with these “non-classic” forms of schistosomiasis-related morbidity

METHODS

Findings

SUMMARY