Reasons listed as obstacles to eradication.

<p><i>P</i> = 0.22 comparing the distribution of responses between the five neglected tropical diseases.</p

Timeline for elimination and eradication for five neglected tropical diseases.

<p>Beliefs regarding the earliest time at which (A) local elimination and (B) global eradication could be achieved in a district if repeated mass drug administrations began in 2011. LF = lymphatic filariasis, Oncho = onchocerciasis, Trach = trachoma, Schisto = schistosomiasis, STHs = soil-transmitted helminths.</p

Elimination and Eradication of Neglected Tropical Diseases with Mass Drug Administrations: A Survey of Experts

<div><p>Background</p><p>Lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, and trachoma are the five most prevalent neglected tropical diseases in the world, and each is frequently treated with mass drug administrations. We performed a survey of neglected tropical diseases experts to elicit their opinions on the role of mass drug administrations for the elimination of these infections.</p><p>Methodology/Principal Findings</p><p>We sent an online survey to corresponding authors who had published an article about a neglected tropical disease from 2007 to 2011. Of 825 unique authors who were invited to complete the survey, 365 (44.2%) responded, including 234 (28.4%) who answered questions regarding one of the five most prevalent neglected tropical diseases. Respondents had varying opinions about the goals of programmatic activities for their chosen neglected tropical disease, with elimination or eradication identified as the most important goal by 87% of lymphatic filariasis respondents, 66% of onchocerciasis respondents, 55% of trachoma respondents, 24% of schistosomiasis respondents, and 21% of soil-transmitted helminth respondents. Mass drug administrations, other non-medication health measures, and education were generally thought to be more important for elimination than vector control, development of a new tool, or the presence of a secular trend. Drug resistance was thought to be a major limitation of mass drug administrations for all five neglected tropical diseases. Over half of respondents for lymphatic filariasis and trachoma thought that repeated mass drug administrations could eliminate infection within ten years of the initiation of mass treatments.</p><p>Conclusions/Significance</p><p>Respondents for lymphatic filariasis, onchocerciasis, and trachoma were more enthusiastic about the prospects of elimination and eradication than were respondents for schistosomiasis or soil-transmitted helminths. Mass drug administrations were generally believed to be among the most important factors for the success of elimination efforts for each of the five neglected tropical diseases, highlighting the opportunity for integrating drug distributions.</p></div

Opinions about the goal of treatment programs for five neglected tropical diseases.

<p>Eradication was defined as the permanent reduction of infection to zero worldwide, not requiring any further intervention. Elimination was defined as reduction of infection to zero in a defined geographical area, requiring continued measures to prevent re-establishment of transmission. Control was defined as reduction of infection to an acceptable level, which requires continued intervention. LF = lymphatic filariasis, Oncho = onchocerciasis, Trach = trachoma, Schisto = schistosomiasis, STHs = soil-transmitted helminths.</p

Responses to questions about drug resistance.

*<p>Chi square test.</p

Responses to questions of target population for mass drug administrations (MDAs).

*<p>Respondents were allowed to provide more than 1 response; therefore, percentages within an NTD do not sum to 100%.</p><p>†Chi square test.</p

Circumstances under which local elimination of infection could occur for each of five neglected tropical diseases.

<p>Respondents were asked under what conditions elimination could occur: mass drug administrations (MDAs) using currently available drugs, MDAs plus other health measures, other health measures alone, or only if a new diagnostic test or interventional tool were developed. Alternatively, respondents could answer that elimination was not possible under any circumstances. LF = lymphatic filariasis, Oncho = onchocerciasis, Trach = trachoma, Schisto = schistosomiasis, STHs = soil-transmitted helminths.</p

‘If an Eye Is Washed Properly, It Means It Would See Clearly’: A Mixed Methods Study of Face Washing Knowledge, Attitudes, and Behaviors in Rural Ethiopia

<div><p>Background</p><p>Face cleanliness is a core component of the SAFE (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements) strategy for trachoma control. Understanding knowledge, attitudes, and behaviors related to face washing may be helpful for designing effective interventions for improving facial cleanliness.</p><p>Methods</p><p>In April 2014, a mixed methods study including focus groups and a quantitative cross-sectional study was conducted in the East Gojjam zone of the Amhara region of Ethiopia. Participants were asked about face washing practices, motivations for face washing, use of soap (which may reduce bacterial load), and fly control strategies.</p><p>Results</p><p>Overall, both knowledge and reported practice of face washing was high. Participants reported they knew that washing their own face and their children’s faces daily was important for hygiene and infection control. Although participants reported high knowledge of the importance of soap for face washing, quantitative data revealed strong variations by community in the use of soap for face washing, ranging from 4.4% to 82.2% of households reporting using soap for face washing. Cost and forgetfulness were cited as barriers to the use of soap for face washing. Keeping flies from landing on children was a commonly cited motivator for regular face washing, as was trachoma prevention.</p><p>Conclusions</p><p>Interventions aiming to improve facial cleanliness for trachoma prevention should focus on habit formation (to address forgetfulness) and address barriers to the use of soap, such as reducing cost. Interventions that focus solely on improving knowledge may not be effective for changing face-washing behaviors.</p></div

Focus group participant characteristics, stratified by community.

<p>Focus group participant characteristics, stratified by community.</p

Self-reported household face washing behaviors, stratified by community.

<p>Self-reported household face washing behaviors, stratified by community.</p