scholarly journals Mass drug administration with azithromycin for trachoma elimination and the population structure of Streptococcus pneumoniae in the nasopharynx

2020 ◽  
Author(s):  
Rebecca A. Gladstone ◽  
Ebrima Bojang ◽  
John Hart ◽  
Emma M Harding-Esch ◽  
David Mabey ◽  
...  
Keyword(s):  
Population Structure ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Resistance ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Macrolide Resistance ◽  
P Value ◽  
Cross Sectional ◽  
The Third ◽  
Before And After

ABSTRACTBackgroundMass drug administration (MDA) with azithromycin for trachoma elimination reduces nasopharyngeal carriage of Streptococcus pneumoniae in the short term. We evaluated S. pneumoniae carried in the nasopharynx before and after a round of azithromycin MDA to determine whether MDA was associated with changes in pneumococcal population structure.MethodsWe analysed 514 pneumococcal isolates cultured from nasopharyngeal samples collected in Gambian villages that received MDA for trachoma elimination. The samples were collected during three cross-sectional surveys conducted before the third round of MDA (CSS-1) and at one (CSS-2) and six (CSS-3) months after MDA. Whole genome sequencing was conducted on randomly selected isolates. Bayesian Analysis of Population Structure (BAPS) was used to cluster related isolates by capturing variation in the core genome. Serotype and multi-locus sequence type were inferred from the genotype. The Antimicrobial Resistance Identification by Assembly (ARIBA) tool was used to identify macrolide resistance genes.ResultsTwenty-seven BAPS clusters were assigned. These consisted of 81 sequence types (STs), 15 of which were novel additions to pubMLST. Two BAPS clusters, BAPS20 (p-value<=0.016) and BAPS22 (p-value<=0.032) showed an increase in frequency at CSS-3 not associated with antimicrobial resistance. Macrolide resistance within BASP17 increased after treatment (p<0.05) and was carried on a mobile transposable element that also conferred resistance to tetracycline.ConclusionsLimited changes in pneumococcal population structure were observed after the third round of MDA suggesting treatment had little effect on the circulating lineages. An increase in macrolide resistance within one BAPS highlights the need for antimicrobial resistance surveillance in treated villages.

scholarly journals Low Knowledge and Lack of Awareness Regarding the Mass Drug Administration Health Promotion as the Determinant Factors in Non-Compliance to the Mass Drug Administration Health Program

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nissa Noor Annashr ◽  
Icca Stella Amalia ◽  
Hoa Thi Phuong Dinh
Keyword(s):  
Health Promotion ◽  
Family Support ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
P Value ◽  
Fisher Exact Test ◽  
Cross Sectional ◽  
Determinant Factors

From the total population of the community in Kuningan District, 78.61% were taking filariasis drugs in the Mass Drug Administration (MDA) program in 2017. Cilimus Subdistrict became a filariasis-endemic area in Kuningan with 72.39% of the MDA program coverage in 2017 (government target >86%). The purpose of this study was to analyze the determinant factors of compliance with the MDA program. The study was an analytical study with a cross-sectional design and conducted from May to June 2018. The sample of 106 people was taken from the population living in Cilimus Subdistrict, Kuningan District, using a simple random sampling technique. Independent variables were collected by a constructed questionnaire included age, education level, knowledge, attitude, health promotion, and family support. A questionnaire also measured compliance with MDA as a dependent variable. Data analysis consisted of univariate, bivariate (chi-square and Fisher exact test), and multivariate analyses (multiple logistic regression). The results showed that the variables of knowledge, attitude, MDA health promotion, and family support influence compliance with the MDA (p-value < 0.05). Low knowledge and unawareness of the MDA health promotion proved to be the dominant factors in non-compliance with the MDA program.

scholarly journals Mass Drug Administration Interruption by COVID-19 reportedly increases lymphatic filarial attacks, pains, and perceived increased lymphatic filarial infection transmission in rural Ghana

2021 ◽  
Author(s):  
Alexander Kwarteng ◽  
Yarhands Dissou Arthur ◽  
Samuel Opoku Asiedu ◽  
John Kanyiri Yamba ◽  
Emmanuel Kobla Amewu ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Statistical Tool ◽  
Cross Sectional ◽  
Rural Ghana ◽  
The Impact

Abstract BackgroundLike all other diseases, the advent of the COVID-19 pandemic has been implicated to impact the elimination schedule and control of neglected tropical diseases such as human lymphatic filarial (LF) infections in endemic countries. However, it is unclear the extent to which delays in mass drug administration has affected people living with chronic lymphatic filarial pathology in rural Ghana as a result of the COVID-19 pandemic, and thus remain to be investigated. MethodTo address this, a cross-sectional study where 133 LF participants from 8 LF-endemic communities in the Ahanta West District of Ghana were recruited to assess the impact of MDA interruptions as a result of COVID-19 among individuals presenting with the filarial pathology. Here, the chi-square test of independence was used as a statistical tool to assess the dependency: 1) between MDA interruption and filarial attacks 2) between MDA interruption and filarial-related pains 3) between MDA interruption and a perceived increase in LF transmission.ResultsStudy participants were asked whether the MDA interruption has affected them in any way. Here, 81% of the patients indicated yes, it had. In addition, we sought to investigate whether MDA interruption has resulted in increased filarial attacks and pains. At this, 68% of the study respondents reported an increase in filarial attacks. Similarly, 65% reported an increase in filarial-related pains. The study further reported that filarial attacks (B=14.997, df=1, p-value <0.001) and pains (a=11.773, df=1, p-value <0.001) are dependent on MDA interruption. Next, we further report that the perceived increase in LF transmission is dependent on MDA interruption (c=9.415, df=1, p-value=0.002). ConclusionIn this study, MDA interruption is reported to increase filarial attacks, filarial-related pains, and a perceived LF transmission increase in the study communities. This study's findings are important and urgent, suggesting that sustained MDA interruption in LF-endemic communities could further worsen LF patients' plight as filarial attacks, pains, and transmission could increase. Therefore, the need to immediately identify alternative modes of MDA distribution in LF-endemic areas where mass treatment has been halted in the wake of COVID-19 to prevent an unwarranted surge in LF attacks, pains, and transmission.

Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

2020 ◽  
Vol 20 (2) ◽  
pp. 167-174
Author(s):  
Ilo Dicko ◽  
Yaya Ibrahim Coulibaly ◽  
Modibo Sangaré ◽  
Bismark Sarfo ◽  
Priscillia Awo Nortey
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Compliance Rate ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Improve Compliance ◽  
Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

2021 ◽  
Vol 11 (1) ◽  
pp. 4-8
Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Cross Sectional ◽  
Unconjugated Hyperbilirubinemia ◽  
Before And After

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

scholarly journals PENGARUH PENDEKATAN MELALUI KONSELING INTERPERSONAL TERHADAP RESPON SOSIAL, EMOSIONAL DAN SPIRITUAL PADA PASIEN HIV/AIDS

2020 ◽  
Vol 8 (1) ◽  
pp. 62
Author(s):  
Indah Jayani ◽  
Fatma Sayekti Ruffaida
Keyword(s):  
Opportunistic Infections ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
P Value ◽  
Social Emotional ◽  
Aids Patients ◽  
Cross Sectional ◽  
Before And After ◽  
The Right ◽  
Hiv Aids

Approach to PLWHA by providing interpersonal counseling is the right thing to do to overcome psychological problems including social, emotional and spiritual aspects of PLWHA. This study aims to look at the effect of interpersonal counseling on social, emotional and spiritual responses in HIV/ AIDS patients. This research is a type of non-experimental research with a cross-sectional approach. The sample is post-test people and tested positive for HIV in the Kediri region, which is 32 with purpossive sampling technique. Data on social, emotional and spiritual responses were obtained based on the results of data recapitulation from the instrument in the form of a questionnaire. The results of the study with the non-parametric Wilcoxon test showed there were differences between social responses of HIV/AIDS patients before and after given interpersonal counseling with p value = 0,000, there were differences between the emotional responses of HIV/AIDS patients before being given interpersonal counseling and after being given counseling with p value = 0,000, and there is a difference between spiritual responses in HIV/AIDS patients before being given interpersonal counseling and after being given interpersonal counseling with p value = 0,000. It can be concluded that interpersonal counseling influences social, emotional and spiritual responses of HIV/AIDS patients. It is recommended that the mentoring of HIV/AIDS patients through interpersonal counseling can continue so as to enhance physiological responses that will have an impact on disease prognosis, prevention of opportunistic infections and reduce mortality rates for HIV patients/ AIDS.

scholarly journals Impact of seven years of mass drug administration and recrudescence of Schistosoma haematobium infections after one year of treatment gap in Zanzibar: Repeated cross-sectional studies

2021 ◽  
Vol 15 (2) ◽  
pp. e0009127
Author(s):  
Lydia Trippler ◽  
Shaali Makame Ame ◽  
Jan Hattendorf ◽  
Saleh Juma ◽  
Salum Abubakar ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Odds Ratio ◽  
Schistosoma Haematobium ◽  
Treatment Gap ◽  
Urogenital Schistosomiasis ◽  
Cross Sectional ◽  
Reagent Strips ◽  
One Year ◽  
Low Prevalence

Background Considerable progress towards the elimination of urogenital schistosomiasis was made by the Zanzibar Elimination of Schistosomiasis Transmission project from 2012 till 2016, when biannual praziquantel mass drug administration (MDA) alone or with additional snail control or behaviour change interventions were implemented. Annual MDA was continued in 2017 and 2018, but not in 2019, imposing a 16-month treatment gap. We monitored the Schistosoma haematobium prevalence from 2012 till 2020 and assessed recrudescence patterns with focus on 2020. Methodology Repeated cross-sectional surveys were conducted from 2011/12 till 2020 in 90 communities and 90 schools in Zanzibar. Annually, around 4,500 adults and up to 20,000 schoolchildren were surveyed. The S. haematobium prevalence was detected by urine filtration and reagent strips. In 2020, risk factors for infection were investigated using generalized estimated equation models. Principal findings In adults, the apparent S. haematobium prevalence was 3.9% in 2011 and 0.4% in 2020. In schoolchildren, the prevalence decreased from 6.6% in 2012 to 1.2% in 2019 with vicissitudes over the years. Prominent recrudescence of infection from 2.8% in 2019 to 9.1% (+225%) in 2020 was observed in 29 schools with historically moderate prevalences (≥10%). Compared with 2019, reinfection in 2020 was particularly striking in boys aged 9–16 years. Being male was a risk factor for infection in 2020 (adults: odds ratio (OR): 6.24, 95% confidence interval (95% CI): 1.96–19.60; schoolchildren: OR: 2.06, 95% CI: 1.52–2.78). Living near to a natural freshwater body significantly increased the odds of infection in adults (OR: 2.90, CI: 1.12–7.54). Conclusions/Significance After 11 rounds of MDA over 7 years and a 16-month treatment gap, the urogenital schistosomiasis prevalence considerably rebounded in hotspot areas. Future elimination efforts in Zanzibar should focus on re-intensifying MDA plus additional interventions in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted surveillance-response.

Assessment of Community Pharmacists Knowledge on dispensing of Antimicrobial drugs and Prevention of Antimicrobial Resistance in Community practice

2021 ◽  
Vol 11 (6) ◽  
pp. 14-20
Author(s):  
Nisar Ahmed ◽  
Mohanta GP ◽  
Bhagat MP
Keyword(s):  
Health Care ◽  
Antimicrobial Resistance ◽  
Health Care Cost ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Community Practice ◽  
Antimicrobial Drugs ◽  
Cross Sectional ◽  
Before And After ◽  
Prevention Programmes

The antimicrobial resistance has more impact on the health care division which would increase the mortality and hospital readmission duration. Our objective is to assess the community pharmacist’s knowledge on dispensing of antimicrobial drugs and prevention of antimicrobial resistance in community practice. A cross-sectional study was conducted for six months. A sample size of 150 registered community pharmacists participated in the study. We have used simple random techniques to select the community pharmacists. Questionnaire were distributed to the community pharmacists at pre and post visits and the response was analyzed. The collected data was analyzed using graph pad prism software. The mean and standard deviation was calculated and P<0.005 was considered to be statistically significant. For 25-30 years of age , community pharmacists were more 68 (45.33%) as compared to other ages. Pre visit before and after average mean antimicrobial resistance score was found to be 4.87. Proper implementation of antimicrobial resistance prevention programmes would drastically increases the rational use of antimicrobials could and minimizes the health care cost.

A cross-sectional research conducted in Malatya province, Turkey: Knowledge levels and awareness about rational antibiotic use and antimicrobial resistance before and after graduation

2019 ◽  
Author(s):  
ADEM KOSE
Keyword(s):  
Antimicrobial Resistance ◽  
Family Physicians ◽  
Antibiotic Use ◽  
Theoretical Knowledge ◽  
Cross Sectional ◽  
Before And After ◽  
Group 2 ◽  
Senior Students ◽  
Rational Antibiotic Use ◽  
Group 1

Abstract Background Irrational antibiotic use can adversely affect treatment outcomes or even lead to increased antimicrobial resistance. We aimed to determine antimicrobial prescribing habits and to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students of medical faculty and the family physicians in Malatya province in Turkey. Methods This study was cross-sectional research and was carried out between dates of 01 February-30 April 2019, in Malatya province. Power analysis was calculated as minimum 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A total 225 senior students in Inonu University Medical Faculty (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2) were included in to this study. A questionnaire form was prepared including seven sections and thirty questions. All of the participants were interviewed face to face. Before the questions, the purpose of the study and the contents of the questions were explained to participants. Qualitative data were analyzed by Pearson chi-square test. A p<0.05 value was considered to be statistically significant. Results The group 1 had a tendency to apply to specialist physician when starting to themselves antibiotic treatment, they were more cautious when making antibiotic decision, and their theoretical knowledge level was better. They argued that penal sanctions could be more effective by developing strict use policies to raise awareness of resistance to antibiotics. The group 2 had higher self-confidence and it was also concluded that forgot their theoretical antibiotic knowledge over time and could not follow the novel information because of the intensity of working life. Both groups stated that post-graduation trainings could be used effectively for reducing the antibiotic resistance. Conclusion This study highlighted the need for immediate action of training and corrective actions and might create awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation and to reduce higher use rates to lower levels. Key words: Antimicrobial resistance, antibiotic, awareness, rational use

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