Expanding Access to Preventive Chemotherapy Among Mobile and Migrant Populations

Summary

Neglected Tropical Diseases (NTDs) are among the most common groups of diseases affecting over one billion people globally and are disproportionately concentrated in remote, underserved, and marginalized communities. Efforts toward NTD elimination have largely relied on preventive chemotherapy (PC), large-scale distribution of free, safe, and effective medicines to at-risk populations. One major challenge threatening elimination efforts is the poor participation of mobile and migrant populations (MMPs) in treatment programs. Despite this gap, few studies have explored strategies to improve access among these underserved populations. This study aims to determine the burden of NTDs among MMPs and explore strategies for expanding access to preventive chemotherapy through social and occupational networks using community mapping and participatory action research approaches in Nigeria. This project is a multi-site implementation research study involving 15 communities across three Nigerian states-Taraba, Akwa Ibom, and Ondo-representing pastoralist, fishing, and agrarian settings, respectively. The study comprises four phases. The first two formative phases will assess the baseline burden of NTDs and coverage of preventive chemotherapy interventions using community surveys, parasitological and serological assessments, mapping, and participatory workshops to identify migration patterns, anchor points, and social and occupational networks that could support expansion of PC. The third phase will use participatory approaches to co-construct context-specific strategies for expanding access to preventive chemotherapy among MMPs. In the fourth phase, the co-developed strategies will be implemented and evaluated for impact using established implementation research frameworks and mixed methods approaches. Through this project, investigators will develop and evaluate a novel strategy for expanding access to PC among MMPs. The study will generate evidence on the feasibility, acceptability, reach, and sustainability of the proposed approach and is expected to inform adaptable implementation models for inclusive NTD programming in Nigeria and similar endemic settings.

Timeline

Start

2026-07-01

Primary completion

2027-07-30

Completion

2027-11-30

Publications

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• Background Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7.
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• Background Sangare M, Coulibaly YI, Ravichandran P, Diabate AF, Duguay C, Vlassoff C, Kulkarni MA, Krentel A. Exploring the impact of mobile and migrant populations on mass drug administration coverage and effectiveness in Africa: A scoping review protocol. PLoS One. 2025 May 29;20(5):e0324949. doi: 10.1371/journal.pone.0324949. eCollection 2025.
• Background Sangare M, Diabate AF, Coulibaly YI, Tanapo D, Thera SO, Dolo H, Dicko I, Coulibaly O, Sall B, Traore F, Doumbia S, Kulkarni MA, Nutman TB, Krentel A. Understanding the barriers and facilitators related to never treatment during mass drug administration among mobile and migrant populations in Mali: a qualitative exploratory study. BMJ Glob Health. 2024 Oct 9;9(10):e015671. doi: 10.1136/bmjgh-2024-015671.
• Background 25. UN Migration. Climate change, disasters, insecurity, and displacement: The impact of flooding on youth marginalization and human mobility in Nigeria. Available at https://environmentalmigration.iom.int/blogs/climate-change-disasters-insecurity-and-displacement-impact-flooding-youth-marginalization-and-human-mobility-nigeria
• Background Mogaji HO, Olamiju FO, Oyinlola F, Achu I, Adekunle ON, Udofia LE, Edelduok EG, Yaro CA, Oladipupo OO, Kehinde AY, Oyediran F, Aderogba M, Makau-Barasa LK, Ekpo UF. Prevalence, intensity and risk factors of soil-transmitted helminthiasis after five effective rounds of preventive chemotherapy across three implementation units in Ondo State, Nigeria. PLoS Negl Trop Dis. 2025 Jan 6;19(1):e0012533. doi: 10.1371/journal.pntd.0012533. eCollection 2025 Jan.
• Background Ekpo UF, Olamiju FO, Mogaji HO, Ovia SN, Oladipupo OO, Kehinde AY, Oyediran FO, Aderogba M, Makau-Barasa LK. Sensitivity of Three Impact Assessment Methodologies in Adjusting Preventive Chemotherapy Treatment Decisions for Schistosomiasis Elimination in Ondo State, Nigeria. Am J Trop Med Hyg. 2025 Feb 18;112(5):987-999. doi: 10.4269/ajtmh.24-0352. Print 2025 May 7.
• Background Mogaji HO, Okoh HI, Lawal AM, Ojo KH, Marcus AJ, Aaron NO, Adeleye DR, Olamiju FO, Ekpo UF. A Post-Lockdown Assessment of Albendazole Treatment Coverage in Mass Drug Administration Campaigns Implemented Before and During COVID-19 Pandemic in Ekiti, Southwest Nigeria. Int J Public Health. 2023 Feb 9;68:1605510. doi: 10.3389/ijph.2023.1605510. eCollection 2023.
• Background 3. World Health Organization. Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030. Geneva. World Health Organization;2020
• Background Hotez PJ, Asojo OA, Adesina AM. Nigeria: "Ground Zero" for the high prevalence neglected tropical diseases. PLoS Negl Trop Dis. 2012;6(7):e1600. doi: 10.1371/journal.pntd.0001600. Epub 2012 Jul 31. No abstract available.

Drugs

Indications