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In Guinea, N'Zérékoré region has historically been endemic for both Schistosoma mansoni and S. haematobium. Following eight years of mass treatment with praziquantel to treat schistosomiasis, as part of a multi-country project, the country was selected to pilot the Schistosomiasis Practical and Precision Assessment (SPPA) approach. The SPPA pilot was conducted in five health districts in the forest region. The main objectives were to determine the current infection status and treatment strategy for each health sub-district and to evaluate the feasibility of the SPPA approach. A cross-sectional study among children aged 10-14 years of age was conducted. In each health district, a systematic sample of 15 schools were selected with 32 school children selected randomly from each. Stool and urine samples were collected from each child. Two Kato-Katz slides were examined for S. mansoni and soil transmitted helminthiasis (STH) and one urine filtration slide and one hemastix for S. haematobium infections and microhaematuria, respectively. Of the 2400 children targeted for inclusion, 2325 provided samples (96.9%). The combined prevalence of Schistosoma species across the five health districts was 66.4%. S. mansoni had a high prevalence of 66.1% with four health districts above 50%. S. haematobium had a low prevalence of 4.3%. The overall prevalence of any combined STH (Ascaris lumbricoides, Trichuris trichiura or hookworm) was 11.7%. Sex, age and contact with a freshwater body during the last week before the survey, were not statistically significant in their association with schistosomiasis. The results of the SPPA indicate that schistosomiasis remains homogeneously high across all five health districts. Consequently, it is recommended to maintain annual treatment in each sub-health district, and to extend treatment to whole communities aged two years of age and over, while strengthening critical cross-sectoral interventions such as behaviour change and environmental management.

This study documents the experiences of health system personnel in the implementation of mass distribution campaigns for the control of lymphatic filariasis in rural Guinea. This was an exploratory qualitative study using data collected from implementing actors of mass distribution campaigns in the Boke health district. The results showed four main facilitators of mass distribution campaign rollout in the Boke health district: (i) support to the district teams in the organization of the campaigns; (ii) involvement of community-based associations in social mobilization; (iii) strong adherence of the communities to the different mass distribution campaigns, facilitated through the involvement of community relays, who are members of these communities, in the distribution of drugs; and (iv) transparency in the allocation of incentives to drug dispensers and supervisors. However, the frequent shortages of medicines, the difficulty of access to rural areas, and the lack of logistical means for the supervision of activities were the main obstacles to the success of the various mass distribution campaigns in Boke. The provision of buffer stocks for special areas such as Boke by national programme actors and partners, joint planning of campaign activities with local managers of health systems and services, and improvement of existing mechanisms for motivating health workers, including community health workers, during future campaigns should help to achieve national objectives in the fight against NTDs in Guinea.

This study aimed to describe the experiences of healthcare personnel and patients in the organization of free surgical campaigns and care for trachomatous trichiasis in the health district of Siguiri in Guinea, including challenges experienced in providing surgical care. This was an explana- tory qualitative study conducted in 2022 in the health district of Siguiri. A total of 20 participants were interviewed including patients (n equivalent 7; 35%), community health workers (n equivalent 4; 20%), health services managers, and healthcare providers (n equivalent 8; 40%). Two main data collection technics were used: documentary review and in-depth individual interviews. All interviews were transcribed and manually coded using an Excel extraction spreadsheet. Data were analysed using inductive and deductive approaches. The results showed several organizational, structural, and community challenges that underlined the low surgical coverage of trachomatous trichiasis in the health district of Siguiri. Organizational challenges included the low involvement of local actors in planning activities, the limited timeframe of the campaigns, and the lack of logistics for activities supervision and patients' transportation to surgery sites. Structural challenges included the inadequacy of health centres to provide surgical services, poor health infrastructures, and sanitation conditions in some areas. Indi- vidual challenges included remoteness of surgical sites and costs associated with services provision including medicines. Community challenges included fear of surgery and the coincidence of the cam- paigns with agricultural and mining activities. The results of the study call on the national neglected tropical disease program and its partners to adopt and promote micro-planning of trachomatous trichiasis surgical activities, with the effective participation of local stakeholders in endemic health districts. They should also envision integrating the management of surgical treatment including costs associated with care (transportation, food, rehabilitation support for patients who have undergone surgery) and complications of surgical procedures for an expansion of the trachomatous trichiasis free surgical care coverage in endemic health districts in Guinea.