Community awareness and participation in mass screening is critical for schistosomiasis control. This study assessed the impact of sharing anonymized image-based positive test results on the uptake of screening during community mobilization outreach. We conducted an observational study to compare the population response to standard and image-based strategies in 14 communities in Abuja, Nigeria. Six hundred and ninety-one (341 females, 350 males) individuals participated in this study. We analyzed the response ratio, relative increase, and sample collection time. The potential treatment uptake and change in social behavior were determined based on a semi-structured questionnaire. The mean response ratio of the image-based strategy was 89.7% representing a significantly higher ratio than the 27.8%, which was observed under the standard mobilization approach (p ≤ 0.001). The image-based method was associated with 100% of the participants agreeing to provide urine samples, 94% willing to be treated, 89% claiming to have been invited to participate in the study by a friend, and 91% desiring to change a predisposing behavioral habit. These findings indicate that image-based community awareness campaigns may increase the population’s perception about schistosomiasis transmission and treatment. This raises new possibilities for local resource mobilization to expand services in reaching the last mile in schistosomiasis control.

Background: Schistosomiasis (SCH) and soil transmitted helminthiasis (STH) have been targeted for elimination as a public health problem (EPHP) within the World Health Organization (WHO)’s Roadmap for Neglected Tropical Diseases (NTDs) 2021–2030. One of the global strategies for the control and elimination of these diseases is the mass administration of praziquantel and albendazole/mebendazole without prior individual diagnosis. To measure the progress towards the 2030 target, we conducted an assessment to determine the impact of the 3–5 rounds of annual mass drug administration among school age children in Ekiti State. Such scientific insights into the impact of these treatments will facilitate improved planning and targeting of resources towards reaching the last mile. Methodology: This assessment was conducted in 16 local government areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in 166 primary and junior secondary schools across 166 wards of the State. Urine and stool samples were collected from 7670 pupils of ages 5 to 14 years, following standard laboratory procedures. Urine membrane filtration techniques were used for urine preparation while the Kato–Katz technique was used for stool preparation. A novel AiDx digital microscope was used to examine the presence of any ova in the prepared specimen. Parasite ova in urine were reported as the number of ova/10 mL of urine, and were categorized as light infection (˂50 ova/10 mL of urine) or heavy infection (>50 ova/10 mL of urine) while ova of parasites in stool samples were reported as eggs per gram of stool (EPG) and categorized into light, moderate and heavy infection. Results: Overall, 0.76% (0.56–0.95) at 95% CI of the 7670 respondents were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in the study. Similarly, 3.9% (3.43–4.29) at 95% CI were infected with STHs. The overall prevalence of schistosomiasis had significantly reduced from 8.2% in 2008 to 0.8%, while the overall prevalence of STHs significantly reduced from 30.9% to 3.9% with Ascaris lumbricoides being the dominant species of STH. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked second and third with a prevalence of 3.48% and 2.40% respectively, while all other LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45% while Emure and Ikole Local Governments had the lowest prevalence of 0.31% and 0.38%, respectively. There was no significant difference in the prevalence of schistosomiasis between male (0.76%) and female (0.75%) as p ≥ 0.05. Similarly, the difference in prevalence for STH among males (3.95%) was not significantly different from their female counterparts (3.77%), p ≥ 0.05. Conclusions: Based on the WHO guidelines, this study demonstrated that only three LGAs require continued MDA every 2/3 years, seven require only surveillance while six are now non-endemic for schistosomiasis. Similarly, two of the LGAs require one round of MDA yearly, eight LGAs need one round of MDA every two to three years and six LGAs are now below the treatment threshold and no longer require treatment for STH.

Community mobilisation is a vital process for raising awareness and increasing participation in healthcare interventions, research, and programmes that require human sample collection and mass management. In this report, we present the community mobilisation approach undertaken for the implementation of the operational mapping and assessment of granular schistosomiasis and soil-transmitted helminths in Ekiti State, Nigeria. The mobilisation was conducted in 177 communities/wards of the 16 local government areas. A total of 15,340 urine and stool samples were collected in 34 days. The efficacy and success of the strategy were evaluated through the following three performance metrics: community compliance rate, the participant response rate at the community level, and the overall compliance response rate of the four most sensitive LGAs. Community compliance was 93.7% as sample collection was denied in nine communities and two other communities demanded the return of the collected samples despite our mobilisation effort because of cultural bias and myths that connect the collection of stool and urine samples to ritual activities in the local context. The participant response rate at the community level was 86.7%. Three of the four sensitive LGAs (based on previous assessment programmes) demonstrated satisfactory compliance rates of 100%, while a response rate of 64.0% was computed for one of the LGAs. We believe our approach contributed to effective community mobilisation and awareness and that the developed model has the potential to improve participation rates in large healthcare assessments and intervention programmes.

Background: Granular assessment of Schistosomiasis (SCH) and soil-transmitted helminthiasis (STHs) in a population with instituted treatment programs is a critical step in understanding the progress of control programs towards the 2030 elimination targets. Such scientific insight into the impact of recurrent rounds of mass treatment with Praziquantel and Albendazole/Mebendazole should facilitate improved planning and targeting of resources. Methodology: This schistosomiasis and STHs granular assessment was conducted in 16 Local Government Areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in166 primary and junior secondary schools across 166 wards/communities. Urine and stool samples were collected from 7670 pupils between 5 and 14 years, comprising 3823 (49.8%) males and 3847 (50.1%) females. When aggregated at individual LGA, the highest number of participants (658 children) was recorded in Ado Ekiti LGA. Emure recorded the lowest number of participants with 320 children across 9 out of 10 wards in the LGA. The result of this granular assessment was compared to the 2008 and 2015 baseline prevalence of each LGA to assess the level of reduction in both prevalence and intensity. Results: Overall, 58 (0.76%) out of 7670 pupils were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in any of the 7670 analyzed samples. Two hundred and ninety-six (3.86%) of the examined samples were infected with STHs. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked 2nd and 3rd with a prevalence of 3.48% & 2.40% respectively. There were no reported infection of S. haematobium in Efon, Ekiti-East, Ekiti South-west, Ido/Osi & Moba, LGAs while a further 7 LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45%. Gbonyin & Ise/Orun had the prevalence of 9.62% & 8.9% respectively, making them 2nd and 3rd in ranking accordingly. Emure, Ikole and Irepodun Local Governments had the lowest prevalence of 0.31%, 0.38% & 1.01% respectively. Conclusion: There was a sharp decline in the prevalence of S. haematobium & STHs in the State across the 16 LGAs as compared to the baseline prevalence obtained from the Federal Ministry of Health NTD program. Our assessment demonstrates that only 3 LGAs require continued MDA every 2/3 years based on the WHO guidelines, while 6 are now non-endemic and 7 require only surveillance. The prevalence of STHs has significantly reduced across the 16 LGAs. Comparative analysis of the computed and baseline prevalence shows that 6 LGAs are not endemic according to WHO guidelines. Two of the assessed LGAs require one round of MDA yearly and 8 LGAs need one round of MDA every two to three years.

Community mobilisation is a vital process for raising awareness and increasing participation in healthcare interventions, research and programs that require human sample collection and mass management. In this report, we present the community mobilisation approach undertaken for the implementation of granular schistosomiasis and soil-transmitted helminths operational mapping and assessment in Ekiti State Nigeria. The mobilisation was conducted in 177 communities/wards of the 16 Local Government Areas. A total of 15,340 urine and stool samples were collected in 34 days. The efficacy and success of the strategy was evaluated through three performance metrics: Community compliance rate, the participant response rate at community level and overall compliance response rate of the 4 most sensitive LGAs. Community compliance was 93.7% as sample collection was denied in 9 communities. Two other communities demanded return of collected samples. Participant response rate at the community level was 86.7%. Three of the 4 sensitive LGAs (based on previous assessment programs) demonstrated satisfactory compliance rates of 100%, while a response rate of 64.0% was computed for one of the LGAs. We believe our approach contributed to effective community mobilisation & awareness and the developed model has potential for improving participation rates in large healthcare assessments and intervention programs.