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.

Conditions

• Onchocerciasis (River Blindness)
• Schistosomiasis
• Soil Transmitted Helminth (STH) Infections
• Lymphatic Filariasis

Interventions

OTHER

Modified Mass Administration of Medicines Strategy

Unlike routine MAM, which primarily relies on fixed household-based distribution strategies, the modified MAM will be developed through community-based participatory research (CBPR) with MMPs and other stakeholders to better accommodate their mobility patterns and livelihood activities. The intervention will include: (i) selection of convenient and accessible community anchor sites for medicine distribution; (ii) flexible timing of medicine distribution to coincide with periods when MMPs are available; (iii) integration of community-prioritized livelihood additionalities to enhance participation, engagement, and demand for treatment; and (iv) implementation of an electronic system for the collection, documentation, and transmission. The medicines administered, dosage schedules, and eligibility criteria will remain consistent with World Health Organization (WHO) recommendations.

DRUG

Albendazole 400 mg

Medicines administered to prevent and treat soil-transmitted helminthiasis

DRUG

Praziquantel 40 mg/kg

Medicines administered to prevent and treat schistosomiasis

DRUG

Ivermectin

Medicines administered to prevent and treat onchocerciasis

DRUG

Ivermectin + albendazole

Medicines administered to prevent and treat lymphatic filariasis

Sponsors & Collaborators

• Mission To Save The Helpless

  collaborator UNKNOWN

• Marian University

  collaborator OTHER

• Hellen Keller International

  collaborator UNKNOWN

• Nigerian Federal Ministry of Health

  collaborator UNKNOWN

• Uwemedimo Friday Ekpo

  lead OTHER

Principal Investigators

• Uwem Ekpo, PhD · Akwa Ibom State University

• Hammed Mogaji, PhD · Marian University

Study Design

Allocation

NA

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

5 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-07-01

Primary Completion

2027-07-30

Completion

2027-11-30

Countries

• Nigeria

Study Locations