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Koricha ZB, Abraha YG, Ababulgu SA, Abraham G, Morankar S. Community engagement in research addressing infectious diseases of poverty in sub-Saharan Africa: A qualitative systematic review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003167. [PMID: 39008476 PMCID: PMC11249264 DOI: 10.1371/journal.pgph.0003167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/05/2024] [Indexed: 07/17/2024]
Abstract
Though engaging communities in research processes has several advantages and implications, research efforts are poorly embedded in and linked with communities, especially in low- and middle-income countries (LMICs). There is also a need for more empirical evidence on effectively engaging communities in research in LMICs, specifically in Sub-Saharan Africa (SSA). Thus, there is an urgent need to synthesize existing evidence on community engagement experiences in research in SSA. Therefore, this review aimed to synthesize the existing community engagement experiences and related barriers to engaging communities in health research focusing on infectious diseases of poverty in SSA. The systematic review was conducted following the JBI methodology for qualitative systematic reviews. The review included both published and unpublished studies. A thematic analysis approach was used for data synthesis. A total of 40 studies were included in the review. Community engagement in the conceptualization of the research project, analysis, dissemination, and interpretation of the result was rare. On top of this, almost all the research projects engaged the community at a lower level of engagement (i.e., informing or consulting the community at some point in the research process), suggesting the importance of integrating communities in the entire research cycle. The lack of shared control over the research by the community was one of the significant challenges mentioned. This review uncovered that community engagement in the research process is minimal. Nevertheless, the review generated valuable evidence that can inform researchers and research stakeholders to promote effective community engagement in the research process addressing infectious diseases of poverty. Despite these, it requires rigorous primary studies to examine the applicability and usefulness of community engagement, including developing valid metrics of engagement, standardizations of reporting community engagements, and views and understandings of communities and stakeholders on the values, expectations, and concepts of community engagement in research.
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Affiliation(s)
- Zewdie Birhanu Koricha
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence-Based Healthcare and Development Centre: a JBI Centre of Excellence, Jimma University, Jimma, Ethiopia
| | - Yosef Gebreyohannes Abraha
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Public Health Institute, Knowledge Translation Directorate, Addis Ababa, Ethiopia
- The Ethiopian Public Health Institute, Ethiopian Knowledge Translation Group for Health: a JBI Affiliated Group, Addis Ababa, Ethiopia
| | - Sabit Ababor Ababulgu
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Public Health Institute, Knowledge Translation Directorate, Addis Ababa, Ethiopia
- The Ethiopian Public Health Institute, Ethiopian Knowledge Translation Group for Health: a JBI Affiliated Group, Addis Ababa, Ethiopia
| | - Gelila Abraham
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence-Based Healthcare and Development Centre: a JBI Centre of Excellence, Jimma University, Jimma, Ethiopia
- Health Policy & Management Department, Jimma Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sudhakar Morankar
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence-Based Healthcare and Development Centre: a JBI Centre of Excellence, Jimma University, Jimma, Ethiopia
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Hoefle-Bénard J, Salloch S. Mass drug administration for neglected tropical disease control and elimination: a systematic review of ethical reasons. BMJ Glob Health 2024; 9:e013439. [PMID: 38485140 PMCID: PMC10941120 DOI: 10.1136/bmjgh-2023-013439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/25/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a diverse group of debilitating diseases and conditions afflicting more than one billion people in impoverished communities. Control of these diseases is crucial to achieve Sustainable Development Goal 3 and the pledge to 'leave no one behind'. Relying on large-scale delivery of wide-spectrum drugs to individuals in at-risk communities irrespective of their health status, mass drug administration is a core strategy for tackling half of the NTDs targeted by the latest WHO roadmap (2021-2030). However, ethical challenges surround its implementation and long-term impact. This systematic review aims to give a comprehensive picture of the variety of ethical reasons for and against mass drug administration for NTD control and elimination, facilitating further debate in ethics and policy. METHODS PubMed and Web of Science Core Collection were searched for all relevant publications. Of the 486 retrieved records, 60 met the inclusion criteria for qualitative analysis. Ethical reasons discussing the topic at hand were extracted from full texts and synthesised through the Kuckartz method of qualitative content analysis. RESULTS Data extraction revealed 61 ethical reasons, of which 20 (32.7%) had positive, 13 (21.3%) had ambivalent and 28 (45.9%) had negative implications regarding mass drug administration for NTDs. The health benefits and cost-effectiveness of the measure were extensively highlighted. However, equity, autonomy and sustainability emerged as the domains with the most pressing ethical concerns. Many issues related to implementation are yet to be adequately addressed in policy documents. CONCLUSIONS This is the first systematic review of ethical reasons pertaining to mass drug administration for NTD control and elimination. Due to the diversity of included studies, no general recommendations can be made. Instead, context-specific strategies seem necessary. Alternative approaches tackling socioecological determinants of ill health are needed for long-term sustainability. Future research could benefit from contributions of non-Western philosophies and perspectives by local researchers.
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Affiliation(s)
- Juliette Hoefle-Bénard
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
| | - Sabine Salloch
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
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Saxena M, Roll A, Walson JL, Pearman E, Legge H, Nindi P, Chirambo CM, Titus A, Johnson J, Bélou EA, Togbevi CI, Chabi F, Avokpaho E, Kalua K, Ajjampur SSR, Ibikounlé M, Aruldas K, Means AR. "Our desire is to make this village intestinal worm free": Identifying determinants of high coverage of community-wide mass drug administration for soil transmitted helminths in Benin, India, and Malawi. PLoS Negl Trop Dis 2024; 18:e0011819. [PMID: 38319937 PMCID: PMC10846705 DOI: 10.1371/journal.pntd.0011819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/25/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Soil-transmitted helminth infections (STH) are associated with substantial morbidity in low-and-middle-income countries, accounting for 2.7 million disability-adjusted life years annually. Current World Health Organization guidelines recommend controlling STH-associated morbidity through periodic deworming of at-risk populations, including children and women of reproductive age (15-49 years). However, there is increasing interest in community-wide mass drug administration (cMDA) which includes deworming adults who serve as infection reservoirs as a method to improve coverage and possibly to interrupt STH transmission. We investigated determinants of cMDA coverage by comparing high-coverage clusters (HCCs) and low-coverage clusters (LCCs) receiving STH cMDA in three countries. METHODS A convergent mixed-methods design was used to analyze data from HCCs and LCCs in DeWorm3 trial sites in Benin, India, and Malawi following three rounds of cMDA. Qualitative data were collected via 48 community-level focus group discussions. Quantitative data were collected via routine activities nested within the DeWorm3 trial, including annual censuses and coverage surveys. The Consolidated Framework for Implementation Research (CFIR) guided coding, theme development and a rating process to determine the influence of each CFIR construct on cMDA coverage. RESULTS Of 23 CFIR constructs evaluated, we identified 11 constructs that differentiated between HCCs and LCCs, indicating they are potential drivers of coverage. Determinants differentiating HCC and LCC include participant experiences with previous community-wide programs, communities' perceptions of directly observed therapy (DOT), perceptions about the treatment uptake behaviors of neighbors, and women's agency to make household-level treatment decisions. CONCLUSION The convergent mixed-methods study identified barriers and facilitators that may be useful to NTD programs to improve cMDA implementation for STH, increase treatment coverage, and contribute to the successful control or elimination of STH. TRIAL REGISTRATION The parent trial was registered at clinicaltrials.gov (NCT03014167).
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Affiliation(s)
- Malvika Saxena
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Amy Roll
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Judd L. Walson
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, Medicine, Pediatrics and Epidemiology, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, Seattle, Washington, United States of America
| | - Emily Pearman
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, Seattle, Washington, United States of America
| | - Hugo Legge
- The DeWorm3 Project, Seattle, Washington, United States of America
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Providence Nindi
- Blantyre Institute for Community Outreach (BICO), Lions Sight First Eye Hospital, Blantyre, Malawi
| | | | - Angelin Titus
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jabaselvi Johnson
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | - Félicien Chabi
- Institut de Recherche Clinique du Benin, Abomey-Calavi, Benin
| | | | - Khumbo Kalua
- Blantyre Institute for Community Outreach (BICO), Lions Sight First Eye Hospital, Blantyre, Malawi
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Sitara Swarna Rao Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Benin, Abomey-Calavi, Benin
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT/TIDRC), Université d’Abomey-Calavi, Abomey-Calavi, Benin
| | - Kumudha Aruldas
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Arianna Rubin Means
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, Seattle, Washington, United States of America
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Shirley H, Orriols A, Hogan D, Chimfwembe K, Balya A, Sibbuku K, Lardizabal J, Tillotson S, Coombs PE, Wamai R. Lymphatic filariasis in Zambia: A scoping review protocol. PLoS One 2023; 18:e0292237. [PMID: 37792737 PMCID: PMC10550120 DOI: 10.1371/journal.pone.0292237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Zambia is among the countries making major progress in limiting cases of the neglected tropical disease lymphatic filariasis on the path to reaching global elimination targets. For this trend to continue, it is essential for strategies and policies targeting the disease in Zambia to be based on the most recent and relevant literature. The scope of research on lymphatic filariasis in the Zambian context is currently poorly understood. Therefore, this study describes a scoping review protocol which will be used to analyze the body of literature on lymphatic filariasis in Zambia. METHODS The scoping review protocol was developed following the PRISMA reporting guidelines for Scoping Reviews (PRISMA-ScR) and the JBI Scoping Review Methodology Group's guidance on conducting scoping reviews. In consultation with a research librarian, these guidelines will be applied to a literature search of articles from peer-reviewed journals, or government and international regulatory bodies using PubMed, Embase, Web of Science, Cochrane CENTRAL, WHO ICTRP, Pan African Clinical Trials Registry, and ClinicalTrials.gov. Each record will be screened at the abstract and full-text level by two independent reviewers, and results reported via summary statistics. DISCUSSION Understanding the current state of research on lymphatic filariasis in Zambia will identify major knowledge and intervention gaps in this context, and serve as a source of information for surrounding countries in the region. As the disease prevalence drops, efforts for elimination will require carefully targeted strategies which can be informed from the literature identified in this protocol.
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Affiliation(s)
- Hugh Shirley
- Harvard Medical School, Boston, MA, United States of America
- African Center for Community Investment in Health, Nginyang, Baringo County, Kenya
- Climate, Obstetrics, Anesthesia, and Surgery Team (COAST), Program for Global Surgery and Social Change (PGSSC), Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Adrienne Orriols
- African Center for Community Investment in Health, Nginyang, Baringo County, Kenya
- University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Dylan Hogan
- College of Science, Northeastern University, Boston, MA, United States of America
| | | | | | | | - Janelle Lardizabal
- Department of Behavioral Neuroscience, College of Science, Northeastern University, Boston, MA, United States of America
| | - Sophie Tillotson
- University of Florida College of Medicine, Gainesville, FL, United States of America
| | - Philip Espinola Coombs
- Department of Research & Instruction, Northeastern University Library, Northeastern University, Boston, MA, United States of America
| | - Richard Wamai
- African Center for Community Investment in Health, Nginyang, Baringo County, Kenya
- Department of Cultures, Societies and Global Studies, College of Social Sciences and Humanities, Integrated Initiative for Global Health, Northeastern University, Boston, MA, United States of America
- Department of Global and Public Health, University of Nairobi, Nairobi, Kenya
- Nigerian Institute of Medical Research, Federal Ministry of Health, Lagos, Nigeria
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Maritim P, Chewe M, Munakaampe MN, Silumbwe A, Sichone G, Zulu JM. Applying community health systems lenses to identify determinants of access to surgery among mobile & migrant populations with hydrocele in Zambia: A mixed methods assessment. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002145. [PMID: 37463160 DOI: 10.1371/journal.pgph.0002145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/15/2023] [Indexed: 07/20/2023]
Abstract
Hydrocele which is caused by long term lymphatic filariasis infection can be treated through the provision of surgery. Access to surgeries remains low particularly for hard to reach populations. This study applied community health system lenses to identify determinants to the adoption, implementation and integration of hydrocele surgeries among migrants &mobile populations in Luangwa District, Zambia. A concurrent mixed methods design consisting of cross-sectional survey with hydrocele patients (n = 438) and in-depth interviews with different community actors (n = 38) was conducted in October 2021. Data analysis was based on the relational and programmatic lenses of Community Health Systems. Under the Programmatic lens, insufficient resources resulted in most health facilities being incapable of providing the minimum package of care for lymphatic filariasis. The absence of cross border collaborative structures limits the continuity of care for patients moving across the three countries. Other programmatic barriers include language barriers, inappropriate appointment systems, direct and indirect costs. In the relational lens, despite the key role that community leaders play their engagement in service delivery was low. Community actors including patients were rarely included in planning, implementation or evaluation of hydrocele services. Some patients utilized their power within to act as champions for the surgery but local groups such as fishing associations remained underutilized. Community health systems provide a potential avenue through which access amongst mobile and migrant populations can be enhanced through strategies such engagement of patient groups, knowledge sharing across borders and use of community monitoring initiatives.
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Affiliation(s)
- Patricia Maritim
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Mwimba Chewe
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Margarate Nzala Munakaampe
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Adam Silumbwe
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
| | - George Sichone
- Participatory Research and Innovations Management, Lusaka, Zambia
| | - Joseph Mumba Zulu
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
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Shaw C, McLure A, Graves PM, Lau CL, Glass K. Lymphatic filariasis endgame strategies: Using GEOFIL to model mass drug administration and targeted surveillance and treatment strategies in American Samoa. PLoS Negl Trop Dis 2023; 17:e0011347. [PMID: 37200375 DOI: 10.1371/journal.pntd.0011347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 05/31/2023] [Accepted: 04/29/2023] [Indexed: 05/20/2023] Open
Abstract
American Samoa underwent seven rounds of mass drug administration (MDA) for lymphatic filariasis (LF) from 2000-2006, but subsequent surveys found evidence of ongoing transmission. American Samoa has since undergone further rounds of MDA in 2018, 2019, and 2021; however, recent surveys indicate that transmission is still ongoing. GEOFIL, a spatially-explicit agent-based LF model, was used to compare the effectiveness of territory-wide triple-drug MDA (3D-MDA) with targeted surveillance and treatment strategies. Both approaches relied on treatment with ivermectin, diethylcarbamazine, and albendazole. We simulated three levels of whole population coverage for 3D-MDA: 65%, 73%, and 85%, while the targeted strategies relied on surveillance in schools, workplaces, and households, followed by targeted treatment. In the household-based strategies, we simulated 1-5 teams travelling village-to-village and offering antigen (Ag) testing to randomly selected households in each village. If an Ag-positive person was identified, treatment was offered to members of all households within 100m-1km of the positive case. All simulated interventions were finished by 2027 and their effectiveness was judged by their 'control probability'-the proportion of simulations in which microfilariae prevalence decreased between 2030 and 2035. Without future intervention, we predict Ag prevalence will rebound. With 3D-MDA, a 90% control probability required an estimated ≥ 4 further rounds with 65% coverage, ≥ 3 rounds with 73% coverage, or ≥ 2 rounds with 85% coverage. While household-based strategies were substantially more testing-intensive than 3D-MDA, they could offer comparable control probabilities with substantially fewer treatments; e.g. three teams aiming to test 50% of households and offering treatment to a 500m radius had approximately the same control probability as three rounds of 73% 3D-MDA, but used < 40% the number of treatments. School- and workplace-based interventions proved ineffective. Regardless of strategy, reducing Ag prevalence below the 1% target threshold recommended by the World Health Organization was a poor indicator of the interruption of LF transmission, highlighting the need to review blanket elimination targets.
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Affiliation(s)
- Callum Shaw
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Angus McLure
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
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Kibe LW, Kimani BW, Okoyo C, Omondi WP, Sultani HM, Njomo DW. Towards elimination of Lymphatic Filariasis in Kenya: improving advocacy, communication and social mobilization activities for mass drug administration, a qualitative study. Trop Dis Travel Med Vaccines 2022; 8:16. [PMID: 35668465 PMCID: PMC9167906 DOI: 10.1186/s40794-022-00172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/16/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction The Kenya Breaking Transmission Strategy for Neglected Tropical Diseases (NTD) from 2019 to 2023 intensifies advocacy, coordination, and partnerships. The purpose of this study was to explore views and experiences of stakeholders and health workers on ways of improving the Advocacy, Communication and Social Mobilization (ACSM) activities of Mass Drug Administration (MDA) for Lymphatic Filariasis (LF) programs through participatory approaches in Kilifi County, Kenya. Methods Two wards were purposely selected in the Kaloleni sub-county, Kilifi County, where there was an average treatment coverage of 56% in 2015, 50.5% in 2016. Qualitative data collection methods were employed, which included participatory meetings with county stakeholders to understand their views, experiences, and suggestions on how ACSM strategies can be improved in MDA for LF. Twelve In-Depth Interviews (IDIs) were conducted (six with opinion leaders and six with Community Health Extension Workers (CHEWs) and two semi-structured interviews (SSIs) were held with county and sub-county coordinators involved in MDA administration. The aim was to better to understand their perceptions of the NTD program about ACSM, challenges to ACSM strategies, and ways to improve the strategies for ACSM in MDA for LF. The Data was organized and classified into codes and themes using QSR NVIVO version 12. Results The study observed the low participation of stakeholders in the ACSM activities of MDA for LF and identified potential areas for stakeholders’ involvement to strengthen the activities. Challenges hindering effective implementation of ACSM activities include late delivery of Information, Educational and Communication (IEC) and few IEC materials, insufficient funding, inadequate time allocated to reach the assigned households with messages, messaging, and packaging of information for dissemination due to the vastness of the area. The stakeholders recommended innovative strategies and techniques to improve ACSM activities. Discussion and conclusion The results of this study show key challenges to ACSM implementation of MDA for LF. Implementers need to pay attention to these challenges to enhance the effectiveness of MDA per the Kenya NTD Breaking Transmission Strategy. ACSM efforts in MDA for LF control and elimination should be linked with overarching efforts to mainstream partnerships and coordination in control and elimination. Supplementary Information The online version contains supplementary material available at 10.1186/s40794-022-00172-8.
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Nieto-Sanchez C, Hatley DM, Grijalva MJ, Peeters Grietens K, Bates BR. Communication in Neglected Tropical Diseases' elimination: A scoping review and call for action. PLoS Negl Trop Dis 2022; 16:e0009774. [PMID: 36228006 PMCID: PMC9595560 DOI: 10.1371/journal.pntd.0009774] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/25/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Although the practice of communication is often called upon when intervening and involving communities affected by NTDs, the disciplinary framework of health communication research has been largely absent from NTD strategies. To illustrate how practices conceptualized and developed within the communication field have been applied in the context of NTD elimination, we conducted a scoping review focusing on two diseases currently targeted for elimination by the WHO: lymphatic filariasis and Chagas disease. METHODS We examined studies published between 2012 and 2020 in five electronic databases. Selected articles were required to (i) have explicit references to communication in either the abstract, title, or key words; (ii) further elaborate on the search terms (communication, message, media, participation and health education) in the body of the article; and (iii) sufficiently describe communication actions associated to those terms. Using the C-Change Socio-Ecological Model for Social and Behavior Change Communication as a reference, the articles were analysed to identify communication activities, theoretical frameworks, and/or rationales involved in their design, as well as their intended level of influence (individual, interpersonal, community, or enabling environment). RESULTS AND IMPLICATIONS A total of 43 articles were analysed. Most interventions conceptualized communication as a set of support tools or supplemental activities delivering information and amplifying pre-defined messages aimed at increasing knowledge, encouraging community involvement, promoting individual behavior change, or securing some degree of acceptability of proposed strategies. Although important attempts at further exploring communication capabilities were identified, particularly in participation-based strategies, for most studies, communication consisted of an underdeveloped and under-theorized approach. We contend that a more complex understanding of the capacities offered by the health communication field could help attain the biomedical and social justice goals proposed in NTD elimination strategies. Three ways in which the field of health communication could further enhance NTD efforts are presented: informing interventions with theory-based frameworks, exploring the political complexity of community participation in specific contexts, and identifying conceptualizations of culture implied in interventions' design. CONCLUSION This article is a call to action to consider the resources offered by the health communication field when researching, designing, or implementing NTD interventions.
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Affiliation(s)
- Claudia Nieto-Sanchez
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - David M. Hatley
- Department of Epidemiology, University of London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mario J. Grijalva
- Infectious and Tropical Disease Institute (ITDI), Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
- Center for Research in Health in Latin America (CISeAL), Facultad de Ciencias Exactas y Naturales, Pontifical Catholic University of Ecuador, Quito, Ecuador
| | - Koen Peeters Grietens
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Nagasaki, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Benjamin R. Bates
- Infectious and Tropical Disease Institute (ITDI), Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
- Center for Research in Health in Latin America (CISeAL), Facultad de Ciencias Exactas y Naturales, Pontifical Catholic University of Ecuador, Quito, Ecuador
- School of Communication Studies, Ohio University, Athens, Ohio, United States of America
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Olsen SH, Roh EJ, Syakayuwa T, Chola M, Agbakwuru C, Stafford KA, Stoebenau K, Dzekedzeke K, Charurat M. Confluence of crises: COVID-19, "gassings", blood draws and the continued importance of community engagement in Zambia. Health Promot Perspect 2022; 12:67-76. [PMID: 35854852 PMCID: PMC9277288 DOI: 10.34172/hpp.2022.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/24/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Nationally representative, household-based, health-related surveys are an invaluable source of health information, but face implementation challenges. In sub-Saharan Africa, these challenges are exacerbated when surveys include the collection of biological specimens. In this study, we describe the potential implementation challenges identified during field practice leading up to the 2020 Zambia Population-based HIV Impact Assessment (ZAMPHIA) survey, and explore the role of two crises on community mistrust of, and apprehension to, participate in the survey. Methods: Using focus group methodology to better understand the influence of crises on ZAMPHIA participation, we conducted 12 focus group discussions (FGDs) in five districts across two provinces. FGDs were conducted with three purposively sampled study groups: recognized household heads, community leaders, and young adults aged 18-24 years. We used reflexive thematic analysis to develop themes from across the FGDs. Results: We identified two key themes: the ever-present threat a stranger posed to the community is enhanced by crises, and endorsement of community awareness through sensitization can mitigate outsider challenges in medical research. Conclusion: We argue that these crises emphasized underlying mistrust that can only be addressed with substantial investment in community engagement efforts to build trust and partnership in medical research endeavors. Our findings underline the importance of prioritizing community engagement through substantial investment in varied and extensive approaches to sensitization to facilitate community engagement toward community acceptance of ZAMPHIA and similar studies.
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Affiliation(s)
- Sara H Olsen
- Department of Behavioral and Community Health, University of Maryland School of Public Health, Maryland, USA
| | - Esther J Roh
- Department of Behavioral and Community Health, University of Maryland School of Public Health, Maryland, USA
| | - Tandwa Syakayuwa
- Center for International Health, Education, and Biosecurity, Zambia
| | - Mumbi Chola
- Center for International Health, Education, and Biosecurity, Zambia
| | - Chinedu Agbakwuru
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Maryland, USA
| | - Kristen A Stafford
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Maryland, USA.,Institute of Human Virology, University of Maryland School of Medicine, Maryland, USA
| | - Kirsten Stoebenau
- Department of Behavioral and Community Health, University of Maryland School of Public Health, Maryland, USA
| | | | - Manhattan Charurat
- Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Maryland, USA.,Institute of Human Virology, University of Maryland School of Medicine, Maryland, USA
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Avokpaho E, Lawrence S, Roll A, Titus A, Jacob Y, Puthupalayam Kaliappan S, Gwayi-Chore MC, Chabi F, Togbevi CI, Elijan AB, Nindi P, Walson JL, Ajjampur SSR, Ibikounle M, Kalua K, Aruldas K, Means AR. It depends on how you tell: a qualitative diagnostic analysis of the implementation climate for community-wide mass drug administration for soil-transmitted helminth. BMJ Open 2022; 12:e061682. [PMID: 35701056 PMCID: PMC9198697 DOI: 10.1136/bmjopen-2022-061682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Current soil-transmitted helminth (STH) morbidity control guidelines primarily target deworming of preschool and school-age children. Emerging evidence suggests that community-wide mass drug administration (cMDA) may interrupt STH transmission. However, the success of such programmes depends on achieving high treatment coverage and uptake. This formative analysis was conducted to evaluate the implementation climate for cMDA and to determine barriers and facilitators to launch. SETTINGS Prior to the launch of a cMDA trial in Benin, India and Malawi. PARTICIPANTS Community members (adult women and men, children, and local leaders), community drug distributors (CDDs) and health facility workers. DESIGN We conducted 48 focus group discussions (FGDs) with community members, 13 FGDs with CDDs and 5 FGDs with health facility workers in twelve randomly selected clusters across the three study countries. We used the Consolidated Framework for Implementation Research to guide the design of the interview guide and thematic analysis. RESULTS Across all three sites, aspects of the implementation climate that were facilitators to cMDA launch included: high community member demand for cMDA, integration of cMDA into existing vaccination campaigns and/or health services, and engagement with familiar health workers. Barriers to launching cMDA included mistrust towards medical interventions, fear of side effects and limited perceived need for interrupting STH transmission. We include specific recommendations from community members regarding cMDA distribution sites, personnel requirements, delivery timing and incentives, leaders to engage and methods for mobilising participants. CONCLUSIONS Prior to launching the cMDA programme as an alternative to school-based MDA, cMDA was found to be generally acceptable across diverse geographical and demographic settings. Community members, CDDs and health workers felt that engaging communities and tailoring programmes to the local context are critical for success. Potential barriers may be mitigated by identifying local concerns and addressing them via targeted community sensitisation prior to implementation. TRIAL REGISTRATION NUMBER NCT03014167; Pre-results.
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Affiliation(s)
| | - Sarah Lawrence
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Amy Roll
- Department of Global Health, University of Washington, Seattle, Washington, USA
- The DeWorm3 Project, Seattle, Washington, USA
| | - Angelin Titus
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Vellore, India
| | - Yesudoss Jacob
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Vellore, India
| | | | - Marie Claire Gwayi-Chore
- Department of Global Health, University of Washington, Seattle, Washington, USA
- The DeWorm3 Project, Seattle, Washington, USA
| | - Félicien Chabi
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
| | | | | | | | - Judd L Walson
- Department of Global Health, University of Washington, Seattle, Washington, USA
- The DeWorm3 Project, Seattle, Washington, USA
| | - Sitara Swarna Rao Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Vellore, India
| | - Moudachirou Ibikounle
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT/TIDRC), Université d'Abomey-Calavi, Cotonou, Littoral, Benin
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | - Kumudha Aruldas
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Vellore, India
| | - Arianna Rubin Means
- Department of Global Health, University of Washington, Seattle, Washington, USA
- The DeWorm3 Project, Seattle, Washington, USA
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Taylor M, Thomas R, Oliver S, Garner P. Community views on mass drug administration for filariasis: a qualitative evidence synthesis. Cochrane Database Syst Rev 2022; 2:CD013638. [PMID: 35174482 PMCID: PMC8851040 DOI: 10.1002/14651858.cd013638.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends mass drug administration (MDA), giving a drug at regular intervals to a whole population, as part of the strategy for several disease control programmes in low- and middle-income countries. MDA is currently WHO policy for areas endemic with lymphatic filariasis, which is a parasitic disease that can result in swollen limbs and disability. The success depends on communities adhering to the drugs given, and this will be influenced by the perception of the drug, the programme, and those delivering it. OBJECTIVES: To synthesize qualitative research evidence about community experience with, and understanding and perception of, MDA programmes for lymphatic filariasis. To explore whether programme design and delivery influence the community experience identified in the analysis. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, and seven other databases up to 8 April 2021, together with reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA This review synthesized qualitative research and mixed-methods studies when it was possible to extract qualitative data. Eligible studies explored community experiences, perceptions, or attitudes towards MDA programmes for lymphatic filariasis in any country, conducted between 2000 and 2019. DATA COLLECTION AND ANALYSIS: We extracted data on study design including: authors, aims, participants, methods, and qualitative data collection methods. We also described programme delivery factors including: country, urban or rural setting, endemicity, drug regimen, rounds of MDA received at the time of the study, who delivered the drugs, how the drugs were delivered, use of health education, and sensitization and adherence monitoring. We conducted a thematic analysis and developed codes inductively using ATLAS.ti software. We examined codes for underlying ideas, connections, and interpretations and, from this, generated analytical themes. We assessed the confidence in the findings using the GRADE-CERQual approach, and produced a conceptual model to display our findings. MAIN RESULTS: From 902 results identified in the search, 29 studies met our inclusion criteria. The studies covered a broad range of countries in Africa, South-East Asia, and South America, and explored the views and experiences of community members and community drug distributors in low-income countries endemic for lymphatic filariasis. Four themes emerged. People weigh up benefits and harms before participating. People understand the potential benefits in terms of relief of suffering, stigma, and avoiding costs (high confidence); however, these theoretical benefits do not always mesh with their experiences (high confidence). In particular, adverse effects are frightening and unwelcome (high confidence); and these effects are amplified through rumour and social media (moderate confidence). Many people are suspicious of MDA programmes. When people lack a scientific explanation for the programme and their experiences of it, they often develop social explanations instead. These are largely shaped on the historical backdrop and level of trust people have in relevant authority figures (high confidence), although some have unwavering faith in their government and, by extension, the programme (moderate confidence). Programmes expect compliance, and this can become coercive and blaming. Health workers and community members stigmatize non-compliance, which can become coercive (moderate confidence), so communities may appear to comply publicly, but privately reject treatment (moderate confidence). Community distributors are often not respected or valued. They have little authority (moderate confidence), and the behaviour of some distributors damages the MDA programme's reputation (high confidence). Communities want information about programmes to help make decisions about participation, but drug distributors are not sufficiently informed, or skilled in this communication (high confidence). We intended to assess whether programme designs influenced communities' perceptions of the programme and decision to adhere but were unable to do so as few studies adequately reported the design and implementation of the local programme. We have moderate to high confidence in the evidence contributing to the review themes and subthemes. AUTHORS' CONCLUSIONS Adherence with MDA for filariasis is influenced by individual direct experience of benefit and harm; social influences in the community; political influences and their relationship to government; and historical influences. Fear of adverse effects was frequently described and this appears to be particularly important for communities. When views were negative, we were surprised by the strength of feeling expressed. Enthusiasm for these schemes as a strategy in global policy needs debate in the light of these findings.
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Affiliation(s)
- Melissa Taylor
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Rebecca Thomas
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sandy Oliver
- EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London, London, UK
- Africa Centre for Evidence, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Paul Garner
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Dilliott D, Addiss D, Thickstun C, Djima AM, Comoe E, Thompson L, Neema S, Amuyunzu-Nyamongo M, Wung-Buh A, McFarland D, Gyapong M, Krentel A. A mixed-methods exploration into the resilience of community drug distributors conducting mass drug administration for preventive chemotherapy of lymphatic filariasis and onchocerciasis in Côte d'Ivoire and Uganda. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000700. [PMID: 36962463 PMCID: PMC10022276 DOI: 10.1371/journal.pgph.0000700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022]
Abstract
Volunteer community drug distributors (CDDs) have been vital to progress made in the elimination of onchocerciasis and lymphatic filariasis; two neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). However, formative work in Côte d'Ivoire and Uganda revealed that CDDs can encounter considerable challenges during mass drug administration (MDA). CDDs must be resilient to overcome these challenges, yet little is known about their resilience. This mixed-methods study explored the resilience of CDDs in Côte d'Ivoire and Uganda. The characteristics and experiences of 248 CDDs involved in the 2018 MDAs in Côte d'Ivoire (N = 132) and Uganda (N = 116) were assessed using a micronarrative survey. Thematic analysis of CDDs' micronarratives was used to identify challenges they encountered during MDA. Resilience was assessed using the Connor-Davidson Resilience Scale 25 (CD-RISC-25). Variables from the micronarrative survey found to be individually associated with mean CD-RISC-25 score (P<0.05) through bivariate analyses were included in a multiple linear regression model. Post-hoc, country-specific analyses were then conducted. Thematic analysis showed that CDDs encountered a wide range of challenges during MDA. The aggregate model revealed that CDDs who had positive relationships or received support from their communities scored higher on the CD-RISC-25 on average (P<0.001 for both), indicating higher resilience. These trends were also observed in the country-specific analyses. Mean CD-RISC-25 scores were unaffected by variations in district, age, gender, and length of involvement with the NTD program. Community support during MDA and positive community-CDD relationships appear to be associated with CDDs' personal capacity to overcome adversity. Involving communities and community leadership in the selection and support of CDDs has the potential to benefit their well-being. This study establishes the CD-RISC-25 as a useful tool for assessing the resilience of CDDs. Further research is needed to understand, promote, and support the resilience of this valuable health workforce, upon which NTD programs depend.
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Affiliation(s)
| | - David Addiss
- NTD Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Charles Thickstun
- Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Adam Mama Djima
- Programme National de Lutte contre la Schistosomie, les Géo-Helminthiases et la Filariose Lymphatique, Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
| | - Esther Comoe
- Programme National de Lutte contre la Schistosomie, les Géo-Helminthiases et la Filariose Lymphatique, Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
| | - Lakwo Thompson
- Onchocerciasis Control Programme, Ministry of Health, Kampala, Uganda
| | | | | | | | - Deborah McFarland
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Margaret Gyapong
- Center for Health Policy and Implementation Research, Institute for Health Research, University for Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Alison Krentel
- Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Ackley C, Elsheikh M, Zaman S. Scoping review of Neglected Tropical Disease Interventions and Health Promotion: A framework for successful NTD interventions as evidenced by the literature. PLoS Negl Trop Dis 2021; 15:e0009278. [PMID: 34228729 PMCID: PMC8321407 DOI: 10.1371/journal.pntd.0009278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 07/29/2021] [Accepted: 02/26/2021] [Indexed: 11/19/2022] Open
Abstract
Background Neglected Tropical Diseases (NTDs) affect more than one billion people globally. A Public Library of Science (PLOS) journal dedicated to NTDs lists almost forty NTDs, while the WHO prioritises twenty NTDs. A person can be affected by more than one disease at the same time from a range of infectious and non-infectious agents. Many of these diseases are preventable, and could be eliminated with various public health, health promotion and medical interventions. This scoping review aims to determine the extent of the body of literature on NTD interventions and health promotion activities, and to provide an overview of their focus while providing recommendations for best practice going forward. This scoping review includes both the identification of relevant articles through the snowball method and an electronic database using key search terms. A two-phased screening process was used to assess the relevance of studies identified in the search–an initial screening review followed by data characterization using the Critical Appraisal Skills Program (CASP). Studies were eligible for inclusion if they broadly described the characteristics, methods, and approaches of (1) NTD interventions and/or (2) community health promotion. Principal findings 90 articles met the CASP criteria partially or fully and then underwent a qualitative synthesis to be included in the review. 75 articles specifically focus on NTD interventions and approaches to their control, treatment, and elimination, while 15 focus specifically on health promotion and provide a grounding in health promotion theories and perspectives. 29 of the articles provided a global perspective to control, treatment, or elimination of NTDs through policy briefs or literature reviews. 19 of the articles focused on providing strategies for NTDs more generally while 12 addressed multiple NTDs or their interaction with other infectious diseases. Of the 20 NTDs categorized by the WHO and the expanded NTD list identified by PLOS NTDs, several NTDs did not appear in the database search on NTD interventions and health promotion, including yaws, fascioliasis, and chromoblastomycosis. Conclusions Based on the literature we have identified the four core components of best practices including programmatic interventions, multi sectoral and multi-level interventions, adopting a social and ecological model and clearly defining ‘community.’ NTD interventions tend to centre on mass drug administration (MDA), particularly because NTDs were branded as such based on their being amenable to MDA. However, there remains a need for intervention approaches that also include multiple strategies that inform a larger multi-disease and multi-sectoral programme. Many NTD strategies include a focus on WASH and should also incorporate the social and ecological determinants of NTDs, suggesting a preventative and systems approach to health, not just a treatment-based approach. Developing strong communities and incorporating social rehabilitation at the sublocation level (e.g. hospital) could benefit several NTDs and infectious diseases through a multi-disease, multi-sectoral, and multi-lateral approach. Finally, it is important the ‘community’ is clearly defined in each intervention, and that community members are included in intervention activities and viewed as assets to interventions. Neglected Tropical Diseases (NTDs) affect more than one billion people globally. A person can be affected by more than one disease at the same time. Many of these diseases are preventable, and could be eliminated with various public health, health promotion and medical interventions. This scoping review aims to determine the extent of the body of literature on NTD interventions and health promotion activities, and to provide an overview of their focus while providing recommendations for best practice going forward. Through a database search and by identifying appropriate literature 75 articles were identified that specifically focus on NTD interventions and approaches to their control, treatment, and elimination, while 15 focus specifically on health promotion and provide a grounding in health promotion theories and perspectives. Based on the literature we have identified the four core components of best practices including programmatic interventions, multi sectoral and multi-level interventions, adopting a social and ecological model and clearly defining ‘community.’
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Affiliation(s)
- Caroline Ackley
- Global Health and Infection Department, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- * E-mail:
| | | | - Shahaduz Zaman
- Global Health and Infection Department, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
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Krentel A, Gyapong M, McFarland DA, Ogundahunsi O, Titaley CR, Addiss DG. Keeping communities at the centre of efforts to eliminate lymphatic filariasis: learning from the past to reach a future free of lymphatic filariasis. Int Health 2021; 13:S55-S59. [PMID: 33349882 PMCID: PMC7753171 DOI: 10.1093/inthealth/ihaa086] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/22/2020] [Accepted: 11/19/2020] [Indexed: 01/09/2023] Open
Abstract
Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestations of the disease. To achieve this, millions of community drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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Affiliation(s)
- Alison Krentel
- School of Epidemiology and Public Health, University of Ottawa, Canada K1G 5Z3.,Bruyère Research Institute, Ottawa K1R 6M1, Canada
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences Ho, Volta Region, Ghana
| | | | | | - Christiana R Titaley
- Faculty of Medicine, Pattimura University, Maluku Province, Ambon 97233 Indonesia
| | - David G Addiss
- Focus Area for Compassion and Ethics (FACE), The Task Force for Global Health, Atlanta 30030 USA
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Taylor M, Oliver S, Garner P. Mass drug administration for filariasis: community views and programme design influences - a qualitative evidence synthesis. Hippokratia 2020. [DOI: 10.1002/14651858.cd013638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Melissa Taylor
- Department of Clinical Sciences; Liverpool School of Tropical Medicine; Liverpool UK
| | - Sandy Oliver
- EPPI-Centre, Social Science Research Unit, UCL Institute of Education; University College London; London UK
| | - Paul Garner
- Department of Clinical Sciences; Liverpool School of Tropical Medicine; Liverpool UK
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