. 2018 Jun 1;66(Suppl 4):S253–S259. doi: 10.1093/cid/ciy002

Table 1.

Summary of Success or Failure to Meet World Health Organization Morbidity Goal of <1% Prevalence of Moderate- to Heavy-Intensity Infections in School-Aged Children

Current Guidelines	Recommended Updates
There is a high likelihood of failing to achieve the WHO morbidity goals as the baseline prevalence increases. Options where the treatment frequency is reduced at midline are unlikely to reach the morbidity goals. In general, if prevalence of infection remains high (≥20%) at the midline evaluation, models predict that MDA will fail to achieve the morbidity goal. Prevalence of infection <20% at midline indicates achievement of the goal in some circumstances.	We recommend providing 75% community-wide coverage while removing the option to reduce the treatment frequency. In areas where Trichuris is dominant, coadministration of albendazole and ivermectin would also be beneficial.

Current Guidelines

Recommended Updates

There is a high likelihood of failing to achieve the WHO morbidity goals as the baseline prevalence increases. Options where the treatment frequency is reduced at midline are unlikely to reach the morbidity goals. In general, if prevalence of infection remains high (≥20%) at the midline evaluation, models predict that MDA will fail to achieve the morbidity goal. Prevalence of infection <20% at midline indicates achievement of the goal in some circumstances.

We recommend providing 75% community-wide coverage while removing the option to reduce the treatment frequency. In areas where Trichuris is dominant, coadministration of albendazole and ivermectin would also be beneficial.

Prevalence of infection refers to measurements in school-aged children. Recommended updates are as follows: 75% community-wide treatment and no reduction in treatment frequency (unless prevalence falls below 1%, treatment may be stopped; follow-up assessments recommended). See also Figure 1 for prevalence-based treatment decisions.

Abbreviations: MDA, drug administration; WHO, World Health Organization.