Insights gained from conductinga randomised controlled trial onIvermectin-albendazole against Trichuris trichiura in Côte d'Ivoire, Lao PDR and Pemba Island

There is only limited scientific literature on trial methodology, trial procedures and mit-igation strategies to overcome challenges faced during clinical research taking place inresource constrained healthcare environments. Organisational, cultural, infrastructuraland ethical challenges may vary between settings although conduct of clinical trialsfor the same disease (in our case soil-transmitted helminth (STH) infections) share similarrisks for implementation. We use the example of a phase III randomised controlled trial,conducted between 2018 and 2020 in C^ote d'Ivoire, Lao PDR and Pemba Island(Tanzania), to share challenges faced and mitigation strategies to guide future planningof studies in similar settings. We describe the planning, screening, enrolment and imple-mentation phases in each of the three settings. Our findings indicate that involvementof local staff and close collaboration are essential factors for successful trial preparationand implementation. A strategic plan adapted to each setting with a distinct focus oncommunity engagement and workforce is crucial to proceed efficiently. Mutual trustbetween the trial population and the trial team is of utmost importance and allowsfor early reaction and adaption to emerging issues.