Evaluating a multi-component drug and school and community based health and sanitation interventions for elimination of Schistosoma mekongi in endemic communities in Cambodia and Lao PDR

Baseline pre intervention followed by a 12 month follow-up to assess impact of the intervention. Mass drug administration (MDA) All consented individuals will be treated with a single dose of praziquantel (PZQ) (40 mg/kg) orally via tablet. Tablets will be administered individually by local health staff. Staff will observe participants taking the drug. This treatment is in line with the national control programs of both Cambodia and Lao PDR. School based health education A health education package 'The Magic Glasses' is being developed for schistosomiasis mekongi, based on previous iterations developed for soil-transmitted helminths. The Magic Glasses education intervention will be performed in schools linked to study villages. This will be delivered in two phases: initially after the baseline survey and subsequently 6-8 weeks following the initial delivery. At both phases the same health education package will be delivered. 'The Magic Glasses' consists of a short cartoon (10 to 12 minutes in duration) which educates about Schistosoma mekongi, its health impacts, ways to prevent infection/re-infection, and importance of treatment. There will also be drawing and essay competitions which will be given in a form of school assignments after the video showing as reinforcement activity to further enforce messaging, and pamphlets, developed at the same time as the Magic Glasses by the infectious diseases and public health teams from Australia, Lao PDR, Cambodia and Japan, with key messages will be distributed following the initial video showing. 'The Magic Glasses' video and pamphlets are being developed specially for this project but will be made freely available post study. Community health education Community wide information, education and communication (IEC) materials will be developed and used across all participating communities. These materials will include information billboards (featuring key messages on S. mekongi prevention) in each village and educational brochures distributed during the community lectures. All the IEC materials will be initially developed in English and subsequently translated to the local language of each country to be distributed by local health care workers. IEC materials will be provided and available at the village health centers for the duration of the entire study in intervention villages and at the end of the study in control villages. Resources will be made freely available at conclusion to the study. Latrine coverage (Cambodia) We aim to increase latrine coverage in all villages to above 90%. Households in all study villages (control and intervention) will be revisited by local health officers, Rural development department and CNM staff, to confirm latrine status and encourage having a latrine. Households lacking a latrine who want to build a latrine will be provided with the building materials and relevant guidance on how to build the latrine. Three 1 hour community lectures will be conducted in the first month of the trial to promote S. mekongi awareness and improve practices. Each session will cover key topics including S. mekongi (its transmission, signs and symptoms and preventive measures), as well the importance of latrine, how to build latrine and its maintenance. To reinforce the information shared during the lecture, brochures on S. mekongi and latrine construction and maintenance will be developed and distributed for participants to take home. Those who attend the latrine information sessions and wish to build one will be given a ticket for materials. Those who take a ticket will be followed up later to check if construction occurred. Study duration The study will take place over an estimated 15 months which will include recruitment and implementation of interventions as well as the 12 month period to follow up. Actual study time may vary depending on external factors such as weather.