scholarly journals Factors influencing mass drug administration adherence and community drug distributor opportunity costs in Liberia: a mixed-methods approach

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Efundem Agboraw ◽  
Fred Sosu ◽  
Laura Dean ◽  
Alice Siakeh ◽  
Rachael Thomson ◽  
...  
Keyword(s):  
Health System ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Opportunity Cost ◽  
Health Workers ◽  
Neglected Tropical Diseases ◽  
Opportunity Costs ◽  
Supply Side ◽  
Preventive Chemotherapy ◽  
The Mean

Abstract Background Preventive chemotherapy delivered via mass drug administration (MDA) is essential for the control of neglected tropical diseases (NTDs), including lymphatic filariasis (LF), schistosomiasis and onchocerciasis. Successful MDA relies heavily on community drug distributor (CDD) volunteers as the interface between households and the health system. This study sought to document and analyse demand-side (households) and supply-side (health system) factors that affect MDA delivery in Liberia. Methods Working in two purposively selected counties, we conducted a household MDA access and adherence survey; a CDD survey to obtain information on direct and opportunity costs associated with MDA work; an observational survey of CDDs; and key informant surveys (KIS) with community-level health workers. Data from the CDD survey and Liberian minimum wage rates were used to calculate the opportunity cost of CDD participation per MDA round. The observational data were used to calculate the time spent on individual household-level tasks and CDD time costs per house visited. KIS data on the organisation and management of the MDA in the communities, and researcher reflections of open-ended survey responses were thematically analysed to identify key demand- and supply-side challenges. Results More respondents were aware of MDA than NTD in both counties. In Bong, 39% (103/261) of respondents reported taking the MDA tablet in the last round, with “not being informed” as the most important reason for non-adherence. In Maryland, 56% (147/263) reported taking MDA with “being absent” at the time of distribution being important for non-adherence. The mean cost per CDD of participating in the MDA round was −$11.90 (median $5.04, range −$169.62 to $30.00), and the mean time per household visited was 17.14 min which equates to a mean opportunity cost of $0.03 to $0.05 per household visited. Thematic analysis identified challenges, including shortages of and delays in medicine availability; CDD frustration over costs; reporting challenges; and household concerns about drug side effects. Conclusions Improved adherence to MDA and subsequent elimination of NTDs in Liberia would be supported by an improved medicine supply chain, financial compensation for CDDs, improved training, healthcare workforce strengthening, greater community involvement, capacity building, and community awareness. Graphical Abstract

scholarly journals The contribution of mass drug administration to global health: past, present and future

2014 ◽  
Vol 369 (1645) ◽  
pp. 20130434 ◽  
Author(s):  
Joanne P. Webster ◽  
David H. Molyneux ◽  
Peter J. Hotez ◽  
Alan Fenwick
Keyword(s):  
Global Health ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
World Health Organisation ◽  
Essential Medicines ◽  
World Health ◽  
Diagnostic Tools ◽  
Preventive Chemotherapy ◽  
High Coverage

Mass drug administration (MDA) is a means of delivering safe and inexpensive essential medicines based on the principles of preventive chemotherapy, where populations or sub-populations are offered treatment without individual diagnosis. High-coverage MDA in endemic areas aims to prevent and alleviate symptoms and morbidity on the one hand and can reduce transmission on the other, together improving global health. MDA is the recommended strategy of the World Health Organisation to control or eliminate several neglected tropical diseases (NTDs). More than 700 million people now receive these essential NTD medicines annually. The combined cost of integrated NTD MDA has been calculated to be in the order of $0.50 per person per year. Activities have recently been expanded due, in part, to the proposed attempt to eliminate certain NTDs in the coming two decades. More than 1.9 billion people need to receive MDA annually across several years if these targets are to be met. Such extensive coverage will require additional avenues of financial support, expanded monitoring and evaluation focusing on impact and drug efficacy, as well as new diagnostic tools and social science strategies to encourage adherence. MDA is a means to help reduce the burden of disease, and hence poverty, among the poorest sector of populations. It has already made significant improvements to global health and productivity and has the potential for further successes, particularly where incorporated into sanitation and education programmes. However logistical, financial and biological challenges remain.

scholarly journals Towards elimination of Lymphatic Filariasis in Kenya: Improving advocacy, communication and social mobilization activities for mass drug administration

2021 ◽  
Author(s):  
Lydiah W. Kibe ◽  
Bridget W. Kimani ◽  
Collins Okoyo ◽  
Wyckliff P. Omondi ◽  
Hadley M Sultani ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Neglected Tropical Diseases ◽  
Social Mobilization ◽  
Sub Saharan Africa ◽  
Successful Implementation ◽  
Health Extension Workers ◽  
Transmission Strategy

Abstract Introduction Understanding challenges affecting the implementation process of Mass Drug Administration for Lymphatic Filariasis (MDA for LF) elimination programmes is critical for successful implementation of similar interventions. The sub-Saharan Africa (SSA) region records the second highest prevalence of the disease and subsequently several countries have initiated and implemented MDA for LF. A major pillar in the Kenya Neglected Tropical Diseases (NTD) breaking transmission strategy of 2019 -2023 is that of intensifying advocacy, coordination and partnerships in NTD control and elimination. The purpose of this study was therefore to explore views and experiences of stakeholders and health workers on ways of improving Advocacy, Communication and Social Mobilization (ACSM) activities of MDA for LF programmes through participatory approaches in Kilifi County, Kenya. Methods Two wards were purposely selected in 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 (IDI) 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 better understanding their perceptions of the NTD program about ACSM, challenges to ACSM strategies, and ways to improve the strategies for ACSM in MDA for LF. Data was organized and classified into codes and themes using QSR NVIVO version 12.Results The study observed a low participation of stakeholders in ACSM activities of MDA for LF and identified potential areas for stakeholders’ involvement to strengthen the activities. Challenges hindering effective implementation of ACSM activities included late delivery of Information Educational and Communication (IEC) and few IEC materials, insufficient funding, inadequate time allocated to reach to the assigned households with messages, messaging and packaging of information for dissemination and vastness of the area. Also, highlighted were challenges with morbidity management and disability prevention services. 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 effectiveness of MDA in accordance to 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.

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.

scholarly journals Costs of Integrated Mass Drug Administration for Neglected Tropical Diseases in Haiti

2011 ◽  
Vol 85 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Ann S. Goldman ◽  
Molly A. Brady ◽  
Luccene Desir ◽  
Abdel Direny ◽  
Roland Oscard ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases

scholarly journals Eliminating Neglected Tropical Diseases in Urban Areas: A Review of Challenges, Strategies and Research Directions for Successful Mass Drug Administration

2018 ◽  
Vol 3 (4) ◽  
pp. 122 ◽  
Author(s):  
Alayne Adams ◽  
Myriam Vuckovic ◽  
Eleanor Birch ◽  
Tara Brant ◽  
Stephanie Bialek ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Rural Areas ◽  
Urban Areas ◽  
Neglected Tropical Diseases ◽  
Monitoring And Evaluation ◽  
Population Heterogeneity ◽  
Tropical Diseases ◽  
Urban Settings ◽  
Context Specific

Since 1950, the global urban population grew from 746 million to almost 4 billion and is expected to reach 6.4 billion by mid-century. Almost 90% of this increase will take place in Asia and Africa and disproportionately in urban slums. In this context, concerns about the amplification of several neglected tropical diseases (NTDs) are warranted and efforts towards achieving effective mass drug administration (MDA) coverage become even more important. This narrative review considers the published literature on MDA implementation for specific NTDs and in-country experiences under the ENVISION and END in Africa projects to surface features of urban settings that challenge delivery strategies known to work in rural areas. Discussed under the thematics of governance, population heterogeneity, mobility and community trust in MDA, these features include weak public health infrastructure and programs, challenges related to engaging diverse and dynamic populations and the limited accessibility of certain urban settings such as slums. Although the core components of MDA programs for NTDs in urban settings are similar to those in rural areas, their delivery may need adjustment. Effective coverage of MDA in diverse urban populations can be supported by tailored approaches informed by mapping studies, research that identifies context-specific methods to increase MDA coverage and rigorous monitoring and evaluation.

scholarly journals Peran Tenaga Pelaksana Eliminasi dalam Pelaksanaan Program Pemberian Obat Secara Massal (POPM) Filariasis di Kota Pekalongan

2020 ◽  
Vol 19 (1) ◽  
pp. 14-18
Author(s):  
Herlysse Jorghi Jorghi ◽  
Praba Ginandjar ◽  
Nissa Kusariana ◽  
Lintang Dian Saraswati
Keyword(s):  
Family Member ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Research Method ◽  
Health Workers ◽  
Family Members ◽  
Cross Sectional ◽  
Target Family ◽  
The Given

Latar belakang: Penyakit Filariasis merupakan penyakit yang disebabkan oleh cacing filaria. Kota Pekalonganmerupakan kota dengan endemis filariasis dan telah dilakukan Program Pemberian Obat secara Massal (POPM) sejak tahun 2011 hingga 2015, Namun, hasil Survei Darah Jari (SDJ) menunjukkan nilai Mikrofilaria Rate di Kota  Pekalongan  masih  >  1%.  Penelitian  ini  bertujuan  untuk  menggambarkan  peran  Tenaga  Pelaksana Eliminasi (TPE) filariasis dan hambatan yang ditemui pada pelaksanaan POPM di Kota Pekalongan.Metode: Penelitian ini merupakan penelitian cross sectiona. Jumlah sampel 95 orang petugas TPE dengan menggunakan simple ramdom sampling. Pengumpulan data dengan wawancara menggunakan kuesioner.  Hasil: Hasil penelitian menunjukkan bahwa EP dalam memilih anggota keluarga target yang akan dirawat adalah optimal (63,2%). EP dalam membantu puskesmas menentukan dosis dan pemberian obat-obatan untuk masing-masing keluarga yang dibantu (52,6%). EP dalam merekam keluarga yang dibantu yang minum obat pada kartu sudah optimal (55,8%). EP dalam memantau dan mencatat reaksi perawatan yang mungkin timbul dan melaporkan kepada petugas kesehatan adalah optimal (61,1%).Simpulan: Peran tenaga pelaksana eliminasi TPE di Kota Pekalongan dalam menyeleksi anggota keluarga binaan yang akan diobati, dalam membantu puskesmas menentukan dosis dan pemberian obat pada setiap keluarga binaan, dalam pencatatan keluarga binaan yang meminum obat pada kartu, dan dalam pengawasan dan pencatatan reaksi pengobatan yang mungkin timbul serta pelaporan kepada petugas kesehatan sudah optimalKata kunci: Filariasis, Tenaga Pelaksana EliminasiABSTRACT Title: The role of Elimination Personnel (EP) implementing filariasis MDA in Pekalongan City Background: Filariasis is a disease caused by filarial worms, Pekalongan City has carried out filariasis MDA (Mass Drug Administration) since 2011-2015. However, the results of the Finger Blood Survey (SDJ) showed that the microfilaria rate was > 1%. This study aims to describe the role of Elimination Personnel (EP) and the obstacles faced in implementing filariasis MDA in Pekalongan City.Method: This study used a cross sectional research method. Sampling in this study used simple random side, total 95 respondents. Data obtained by structure interviews using questionnaires.Result: The results showed that EP in selecting the target family members to be treated is optimal (63.2%). EP in helping puskesmas determine the dosage and administration of medicines for each of the assisted families (52.6%). EP in recording the assisted families who drank the medicine on the card was optimal (55.8%). EP in monitoring and recording treatment reactions that may arise and reporting to health workers was optimal (61.1%).Conclusion: The roles of TPE elimination workers of Pekalongan City were optimum, such as selecting family member who will be treated, helping Puskesmas in deciding the dosage and giving the medicine to every treated family, record of treated family who take the medicine in the given card, and in the supervision and record of medical reaction that might happen and reporting it to health workers.Keywords: Filariasis, Elimination Personnel  

scholarly journals Human population movement can impede the elimination of soil-transmitted helminth transmission in regions with heterogeneity in mass drug administration coverage and transmission potential between villages: a metapopulation analysis

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Carolin Vegvari ◽  
James E. Truscott ◽  
Klodeta Kura ◽  
Roy M. Anderson
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Human Population ◽  
Sub Saharan Africa ◽  
Population Movement ◽  
Mobility Patterns ◽  
Preventive Chemotherapy ◽  
Cross Sectional ◽  
The Impact ◽  
Human Population Movement

Abstract Background Soil-transmitted helminth (STH) infections affect predominantly socio-economically disadvantaged populations in sub-Saharan Africa, East Asia and the Americas. Previous mathematical modelling studies have evaluated optimal intervention strategies to break STH transmission in clusters of villages. These studies assumed that villages are closed independent units with no movement of people in or out of communities. Here we examine how human population movement, for example, of seasonal migrant labourers, affect the outcome of mass drug administration (MDA) programmes. Results We used a stochastic individual-based metapopulation model to analyse the impact of human population movement at varying rates on STH elimination efforts. Specifically, we looked at seasonal clumped movement events of infected individuals into a village. We showed that even if on average 75% of the entire resident population within a village are treated, an annual rate of 2–3% of the population arriving from an untreated source village can reduce the probability of STH elimination to less than 50% in high-prevalence settings. If a village is infection-free, an annual movement rate of 2–3% from an infected source village imposes a risk of re-introduction of STH of 75% or higher, unless the prevalence in the source village is less than 20%. Even a single arrival of 2–3% of the population can impose a risk of re-introducing STH of 50% or greater depending on the prevalence in the source village. The risk of re-introduction also depends on both the age group of moving individuals and STH species, since the pattern of cross-sectional age-prevalence and age-intensity profiles of infection in the human host are species-specific. Conclusions Planning for STH elimination programmes should account for human mobility patterns in defined regions. We recommend that individuals arriving from areas with ongoing STH transmission should receive preventive chemotherapy for STHs. This can most easily be implemented if migration is seasonal and overlaps with treatment rounds, e.g. seasonal migrant labour. Moreover, transmission hotspots in or near treatment clusters should be eliminated, for example, by implementing appropriate water, sanitation and hygiene (WASH) measures and targeting treatment to individuals living in hotspots.

scholarly journals Can we eradicate trachoma? A survey of stakeholders

2020 ◽  
pp. bjophthalmol-2020-315815
Author(s):  
Catherine E Oldenburg ◽  
Solomon Aragie ◽  
Abdou Amza ◽  
Anthony W Solomon ◽  
Jessica Brogdon ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Operational Research ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
Tropical Diseases ◽  
Important Goal ◽  
Tremendous Progress ◽  
Global Eradication

Background/AimsAlthough tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.MethodsWe conducted a survey at the beginning of a trachoma eradication session at the 2019 Coalition for Operational Research on Neglected Tropical Diseases meeting in National Harbor, Maryland, USA. We asked respondents what the most important goal of azithromycin mass drug administration was for trachoma (control, elimination of infection or eradication) and if and when they believed trachoma eradication would occur. We then asked what the biggest obstacles were to global eradication.ResultsFifty-six surveys were returned (95%). Most (91%) participants reported that the most important goal of azithromycin mass drug administration was control or elimination of infection, and 24% of participants reported that global eradication was not possible. Of the 76% who reported a year by which they believed trachoma could be eradicated, most fell between 2040 and 2050. Commonly cited barriers to global eradication included lack of surveillance tools to confirm eradication or monitor for infection recrudescence (32%) and lack of resources (23%).ConclusionsDevelopment of alternative indicators for trachoma surveillance and continued investment in trachoma programmes, particularly focused support in the most heavily affected populations, might increase enthusiasm for the feasibility of eradication.

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