Background Current programs to control schistosomiasis mainly target school-aged children and rely on mass drug administration centered on primary schools. Alternative drug distribution platforms need to be identified to ensure equitable access to the potential new treatment option for pre-school aged children, once registered.

Methods The Paediatric Praziquantel Consortium has developed an operational research program with the aim to identify and describe robust yet flexible drug distribution platforms and delivery modalities that can easily be adapted to different settings. Called ADOPT program, the approach includes a rigorous acceptability and perception assessment as basis for small-scale pilot studies to evaluate and compare potential delivery platforms and access strategies in terms of feasibility, costs and coverage. Insights and lessons learnt from this phase will inform and guide the roll-out of the most promising approaches.

Results Working with partners in three countries, social science studies were already conducted to establish a baseline of acceptability and perception of paediatric schistosomiasis and its potential new treatment, and to inform the social mobilization strategy. Following the systematic assessment of a range of potential distribution platforms, a restricted number per country has been prioritized. Standard protocols for the pilot studies are currently under development and will be submitted to ethics review committees to start the pilots soon after obtaining a positive opinion from regulatory authorities. Practical aspects including the determination of the correct drug dose in settings without access to scales, drug administration to small children, and training needs are also explored.

Conclusion High geographic and population coverage will only be achieved if the social mobilization is effective, the drug distribution platform has universal reach, and staff are adequately trained. A toolbox with a selection of tested protocols and guidance documents for their adaptation will facilitate rapid expansion both inside study countries and by other interested partners.