The impact of neglected tropical diseases on the socioeconomic and social wellbeing of individuals in low-income and middle-income countries is enormous. These neglected tropical diseases account for around 14·5 million disability-adjusted life years, with substantial variation among tropical and non-tropical countries and high-resource and low-resource regions.1WHOGlobal health estimates: leading causes of death.https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-deathDate accessed: April 24, 2023Google Scholar Working in a resource-poor setting and managing these disorders is a challenge for practitioners. Outpatient units are flooded with patients with scabies, helminthiasis, and other neglected tropical diseases. Despite the availability of effective treatment, these diseases continue to occur in large numbers.2Narain JP Dash AP Parnell B et al.Elimination of neglected tropical diseases in the South-East Asia Region of the World Health Organization.Bull World Health Organ. 2010; 88: 206-210Crossref PubMed Scopus (42) Google Scholar In this context, mass drug administration (MDA) is an effective method to manage many helminthic infestations.3WHOPrevention and control of intestinal parasitic infections: WHO Technical Report Series N°749.https://www.who.int/publications/i/item/WHO-TRS-749Date: May 8, 1987Date accessed: April 24, 2023Google Scholar In various eradication programmes, MDA has a pivotal role in the reduction of infection.4Lake SJ Kaldor JM Hardy M Engelman D Steer AC Romani L Mass drug administration for the control of scabies: a systematic review and meta-analysis.Clin Infect Dis. 2022; 75: 959-967Crossref PubMed Scopus (3) Google Scholar MDA requires the coordinated work of health-care administrators, professionals, and field workers. Successful implementation of these programmes results in a reduction in hospital admissions and secondary infections. But the role of other factors, such as sanitation, water supply, and hygiene cannot be forgotten.5Medley GF Hollingsworth DT MDA helminth control: more questions than answers.Lancet Glob Health. 2015; 10: e583-e584Summary Full Text Full Text PDF Scopus (4) Google Scholar In a well-designed and executed study in The Lancet Global Health,6Le B Monteiro MAA Amaral S et al.The impact of ivermectin, diethylcarbamazine citrate, and albendazole mass drug administration on the prevalence of scabies and soil-transmitted helminths in school-aged children in three municipalities in Timor-Leste: a before–after assessment.Lancet Glob Health. 2023; 11: e924-e932Summary Full Text Full Text PDF Google Scholar Brandon Le and colleagues report the results of a pragmatic school-based study on the effect of MDA in multiple neglected tropical diseases in Timor-Leste. For this study, the authors examined the effect of an MDA that combined ivermectin, albendazole, and diethylcarbamazine citrate. This combination addresses the most common diseases in school children in the tropics, such as scabies,7Romani L Marks M Sokana O et al.Efficacy of mass drug administration with ivermectin for control of scabies and impetigo, with coadministration of azithromycin: a single-arm community intervention trial.Lancet Infect Dis. 2019; 19: 510-518Summary Full Text Full Text PDF PubMed Google Scholar pediculosis, helminthiasis, and filariasis. Treatment of scabies also reduces the incidence of bacterial infection.7Romani L Marks M Sokana O et al.Efficacy of mass drug administration with ivermectin for control of scabies and impetigo, with coadministration of azithromycin: a single-arm community intervention trial.Lancet Infect Dis. 2019; 19: 510-518Summary Full Text Full Text PDF PubMed Google Scholar The authors examined the effect of MDA on children attending six schools and laboratory tests, such as stool examination, were used to establish the presence of infection, which is to be commended. MDA was associated with reductions in the prevalence of impetigo, Trichuris trichiura, and scabies in the schools studied. Scabies is highly contagious and reinfection is common after treatment from an individual's contacts. A high prevalence of scabies is seen in children in Latin America and the Pacific region compared with elsewhere in the world.8Karimkhani C Colombara DV Drucker AM et al.The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015.Lancet Infect Dis. 2017; 17: 1247-1254Summary Full Text Full Text PDF PubMed Scopus (134) Google Scholar Hence, treatment members of the household as well as infected individuals is important. Relapse rates of scabies could have been reduced by treating the contacts of patients with scabies in addition to MDA. The combination of ivermectin with albendazole showed high therapeutic efficacy in the reduction of strongyloidosis. WHO recommends that lymphatic filariasis can be eliminated by stopping the spread of infection through preventive chemotherapy with safe medicine combinations repeated annually. Hence diethylcarbamazine citrate is a useful addition to mass prophylaxis for eradication of filariasis. It should also be remembered that the role of MDA, other than eradication, is in reducing the burden of the disease and morbidity. In Le and colleagues’ study, the authors discussed important confounding factors, such as hygiene practices and environmental factors which possibly prevent successful eradication. This study was possible because of funding from the local government, which is unavailable in many countries. Community control will be a central component of any elimination strategy, alongside several interrelated issues, such as engagement with key stakeholders at national, regional, and global levels to develop a coordinated mechanism for integrating existing neglected tropical disease programmes. Furthermore, cost-effectiveness, provision of guidelines for monitoring and evaluation of control programmes, ensuring drug supply at a large scale, identifying funding partners, and promoting implementation and operational research with overall improvement of the public health parameters will ensure we meet the WHO goal of ending the epidemic of neglected tropical diseases by 2030. I declare no competing interests. The impact of ivermectin, diethylcarbamazine citrate, and albendazole mass drug administration on the prevalence of scabies and soil-transmitted helminths in school-aged children in three municipalities in Timor-Leste: a before–after assessmentIvermectin, diethylcarbamazine citrate, and albendazole MDA was associated with substantial reductions in prevalence of scabies, impetigo, and T trichiura, and of moderate-to-heavy intensity A lumbricoides infections. Combination MDA could be used to support integrated control programmes to target multiple NTDs. 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