Table 2.

Summary of Recommendations From Modeling for 5 Neglected Tropical Diseases Controlled Primarily by Mass Drug Administration

Disease	Current strategy	Key elimination strategies	Programmatic considerations
Soil-transmitted helminthiasis [40]	MDA to school-aged children and high-risk subgroups	• Community-wide MDA in all but low-prevalence settings • No reduction in treatment frequency at the midline evaluation point due to the risk of recrudescence and failure to meet morbidity goal	• Cost of expanding the treated population • Restriction of drug donations to SAC • Unknown risk of drug resistance
Schistosomiasis [41]	MDA to school-aged children and high-risk subgroups.	• Increasing treatment coverage in school-aged children and expanding treatment coverage to include adults • Or increasing treatment frequency in moderate- to high-prevalence regions.	• Cost of expanding the treated population • Restriction of drug donations to use in school- aged children and availability of praziquantel • Difficulties assessing adherence to treatment • Defining the optimal strategy for tailoring the intervention to infection prevalence
Lymphatic filariasis [43]	MDA of all eligible persons	• Increasing coverage and reducing systematic nonadherence• Using the triple-drug to accelerate declines in appropriate areas	• Addressing systematic nonadherence• Availability of drug donations for triple-drug
Onchocerciasis [44]	Annual MDA with ivermectin of population aged 5 years	• Alternative MDA strategies (enhanced coverage, increased frequency), with or without complementary vector control, depending on history of MDA and local transmission conditions (or baseline endemicity)	• Vector control is laborious but could have benefits • Need for in-depth knowledge of vector breeding site ecology and hydrological conditions in rivers to be treated with larvicides for vector control • Cost and appropriate and timely implementation of higher frequency MDA programs in low-resources settings
Trachoma [45]	Annual MDA of all individuals	• In areas that have not reached control goals after a decade of treatment, intensive targeting of residual core group • Investigating coverage	• Identification of areas where current strategy is not working • Efficient assessment and treatment of residual core group

Abbreviations: MDA, mass drug administration; SAC, school-aged children.