Knopp S, et al. - Via a 5-year repeated cross-sectional cluster-randomized trial of 90 shehias in Zanzibar eligible owing to accessible natural open freshwater bodies and public primary schools, the researchers intended to evaluate biannual mass drug administration (MDA) applied alone or with complementary snail control or behavior change interventions for the reduction of Schistosoma haematobium prevalence and infection severity and to contrast the impact within the clusters. Out of 8,278 individuals who were included, 2,899 were randomly allotted to arm 1, 2,741 to arm 2, and 2,638 to arm 3. One hundred and twenty of 2,853, 209 of 2,688 and 167 of 2, 613 in arm 1, arm 2, and arm 3, respectively, had S haematobium infections at baseline. Out of 8,073 children at baseline, 126 were detected with heavy infections. S haematobium infections were discovered in 46 of 3,184 in arm 1, 56 of 3,217 in arm 2, and 58 of 3,080 in arm 3 at the 5-year end-line survey. Out of 9, 462 children, heavy infections were identified in 33. Hence, biannual MDA substantially decreased the S haematobium prevalence and infection severity, however, it was inadequate to prevent transmission. Although snail control or behavior change activities did not markedly raise the impact of MDA, improvement in the interruption of transmission when tailored to focal endemicity and utilized for a more prolonged period may be seen. Moreover, it was now essential to concentrate on decreasing prevalence in remaining hotspot areas and to add new methods of surveillance and public health response to sustain and improve the important gains.