scholarly journals Cutaneous leishmaniasis control in Alta Verapaz (northern Guatemala): evaluating current efforts through stakeholders’ experiences

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Renata Mendizábal-Cabrera ◽  
Isabel Pérez ◽  
Víctor Becerril Montekio ◽  
Freddy Pérez ◽  
Erick Durán ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Health Workers ◽  
Resource Scarcity ◽  
Economic Resources ◽  
Poor People ◽  
Local Health ◽  
Preventive Action ◽  
Endemic Region ◽  
Key Stakeholders ◽  
Alta Verapaz

Abstract Background Cutaneous leishmaniasis (CL), endemic in Guatemala, mostly affects poor people living in the northern region. A national control program that includes surveillance, diagnose, and treatment offered free of cost by the Ministry of Health (MoH) has been in place since 2003. However, the incidence is increasing and treatment rates are not optimal, suggesting that current efforts are not being effective. This study aimed to understand barriers and facilitators of CL control in Guatemala as experienced and perceived by key stakeholders in order to comprehend what works well and does not and suggest evidence-informed interventions. Methods The study was conducted in the Cobán municipality, the most endemic of Guatemala, situated in the Department of Alta Verapaz. Data were collected during May and June 2019 via focus groups and semi-structured interviews with key stakeholders, including local and national health personnel and residents of four communities of the endemic region. Thematic and content analysis of the collected data was conducted using NVIVO. Results Three overarching issues hamper the effectiveness of current CL efforts: resource scarcity, treatment challenges, and knowledge-action gaps. Scarce economic resources from the MoH and community residents negatively impact incidence, detection of cases and treatment rates in that preventive action is insufficient and healthcare access is low. In addition, local health workers often lack specialized CL training and access to the national CL control guidelines. With regards to the population living in the study area, misunderstanding of disease causation, shame associated with CL lesions, treatment pain fear, and long (often uncertain) waiting times for diagnose and treatment negatively affect people’s willingness to seek help, treatment adherence, and their trust on the healthcare provided. Conclusions Culturally sensitive CL preventive action must be developed. Given the scarce economic resources available for CL control in the country, the involvement of trained community health workers and the inclusion of thermotherapy as a treatment option is also advised. Other cost-effective actions include: ensuring all health workers receive CL training and have access to national CL control guidelines, improving national procurement system to avoid treatment shortages, and provision of motorized vehicles to increase active surveillance and treatment rates. Graphical abstract

scholarly journals Clinical Manifestations and Distribution of Cutaneous Leishmaniasis in Pakistan

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Abaseen Khan Afghan ◽  
Masoom Kassi ◽  
Pashtoon Murtaza Kasi ◽  
Adil Ayub ◽  
Niamatullah Kakar ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cutaneous Leishmaniasis ◽  
Primary Care Physicians ◽  
Health Workers ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Skin Lesions ◽  
Major Public Health Problem ◽  
Local Health

Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL.

scholarly journals Prevalence of Schistosoma Haematobium Measured by a Mobile Health System in an Unexplored Endemic Region in the Subprefecture of Torrock, Chad (Preprint)

2019 ◽  
Author(s):  
Didier Lalaye ◽  
Mirjam E de Bruijn ◽  
Tom PVM de Jong
Keyword(s):  
Mobile Health ◽  
Distribution System ◽  
Schistosoma Haematobium ◽  
Health Workers ◽  
Age Groups ◽  
Total Sample ◽  
Medical Doctor ◽  
Digenetic Trematode ◽  
Local Health ◽  
Endemic Region

BACKGROUND Schistosoma haematobium is a parasitic digenetic trematode responsible for schistosomiasis (also known as bilharzia). The disease is caused by penetration of the skin by the parasite, spread by intermediate host molluscs in stagnant waters, and can be treated by administration of praziquantel. Schistosomiasis is considered to be an important but neglected tropical disease. OBJECTIVE The aim of this pilot study was to investigate the prevalence of schistosomiasis in the subprefecture of Torrock, an endemic area in Chad where no earlier investigation had been conducted and no distribution system for pharmacotherapy has ever existed. METHODS This study examined 1875 children aged 1 to 14 years over a period of 1 year. After centrifugation, urine examination was performed by a direct microscopic investigation for eggs. The investigation was conducted with a mobile health (mHealth) approach, using short message service (SMS) for communication among parents, local health workers, a pharmacist, and a medical doctor. An initial awareness campaign requested parents to have their children examined for schistosomiasis. Urine was then collected at home by the parents following the SMS request. Urine results that proved positive were sent to a medical doctor by SMS, who in turn ordered a pharmacist by SMS to distribute praziquantel to the infected children. RESULTS Direct microscopic examination of urine found 467 positive cases (24.9% of the total sample). Of all male and female samples, 341 (34%) and 127 (14.4%) samples were positive, respectively. The infection rate was equally distributed over age groups. The newly developed mHealth system had a limited level of participation (8%) from an estimated total of 25,000 children in the target group. CONCLUSIONS The prevalence of schistosomiasis in children in the subprefecture of Torrock is moderately high. Efforts will be required to enhance the awareness of parents and to reach a larger percentage of the population. Systematic governmental measures should be put in place as soon as possible to increase awareness in the area and to diagnose and treat cases of schistosomiasis.

scholarly journals Examining local perspectives on the influence of climate change on the health of Hamer pastoralists and their livestock in Ethiopia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Samuel Lumborg ◽  
Samuel Tefera ◽  
Barry Munslow ◽  
Siobhan M. Mor
Keyword(s):  
Climate Change ◽  
Water Scarcity ◽  
Health Workers ◽  
Animal Health ◽  
Disease Outbreaks ◽  
Vulnerable Groups ◽  
Local Health ◽  
Framework Analysis ◽  
Healthcare Facilities ◽  
Grazing Lands

AbstractThis study explores the perceived influence of climate change on the health of Hamer pastoralists and their livestock in south-western Ethiopia. A combination of focus group discussions and key informant interviews were conducted with Hamer communities as well as local health workers, animal health workers and non-governmental organisation (NGO) staff. Thematic framework analysis was used to analyse the data. Reductions in rangeland, erratic rainfall, recurrent droughts and loss of seasonality were perceived to be the biggest climate challenges influencing the health and livelihoods of the Hamer. Communities were travelling greater distances to access sufficient grazing lands, and this was leading to livestock deaths and increases in ethnic violence. Reductions in suitable rangeland were also precipitating disease outbreaks in animals due to increased mixing of different herds. Negative health impacts in the community stemmed indirectly from decreases in livestock production, uncertain crop harvests and increased water scarcity. The remoteness of grazing lands has resulted in decreased availability of animal milk, contributing to malnutrition in vulnerable groups, including children. Water scarcity in the region has led to utilisation of unsafe water sources resulting in diarrhoeal illnesses. Further, seasonal shifts in climate-sensitive diseases such as malaria were also acknowledged. Poorly resourced healthcare facilities with limited accessibility combined with an absence of health education has amplified the community’s vulnerability to health challenges. The resilience and ambition for livelihood diversification amongst the Hamer was evident. The introduction of camels, increase in permanent settlements and new commercial ideas were transforming their livelihood strategies. However, the Hamer lack a voice to express their perspectives, challenges and ambitions. There needs to be collaborative dynamic dialogue between pastoral communities and the policy-makers to drive sustainable development in the area without compromising the values, traditions and knowledge of the pastoralists.

scholarly journals Knowledge, Attitudes, Practices and its associated risk factors related to Cutaneous Leishmaniasis in Ilam province of Iran

2022 ◽  
Vol 3 (1) ◽  
pp. 01-14
Author(s):  
Fatima Ibrahim ABDULSALAM ◽  
◽  
Tabarak Malik ◽  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Intervention Program ◽  
Control Measures ◽  
Endemic Region ◽  
Attitudes And Practices ◽  
Disease Occurrence ◽  
Kap Survey ◽  
Border Town ◽  
Associated Risk Factors ◽  
And Control

Knowledge, Attitudes and Practices (KAP) surveys precede an awareness or intervention program, it addresses a felt need in a population in which that need exists. In an endemic region of cutaneous leishmaniasis disease occurrence, public enlightenment on its preventive and control measures is highly important. Ilam province of Iran is a provincial border town transited annually by pilgrims was reported to have the most cases of cutaneous leishmaniasis ranking highest since 2010 yet no report on KAP survey has been previously conducted.

scholarly journals Policy Model of Community Adaptation using AHP in the Malaria Endemic Region of Lahat Regency - Indonesia

2020 ◽  
Vol 4 (9) ◽  
pp. 44-48
Keyword(s):  
Local Governments ◽  
Health Workers ◽  
Group Discussion ◽  
Community Empowerment ◽  
Endemic Region ◽  
Policy Model ◽  
Policy Adaptation ◽  
Malaria Endemic Region ◽  
Wide Range ◽  
Control Centre

Lahat Regency is a malaria-endemic region, so the research aims to develop a model of policy adaptation of society in the malaria-endemic region to Lahat Regency. This research is a qualitative study by collecting data through interviews and Focus Group Discussion (FGD), which is then processed using Expert Choice that is analyzed by the Analytical Hierarchy Process (AHP) technique. The results showed that there were 3 criteria in determining the priorities of the adaptation policy, i.e the hosts/society, agent/cause of the disease, and vector/environment. The policy Model was compiled using 3 criteria that resulted in successive policy priorities as follows: strengthening of preventive and curative malaria program of local-based (39.8%), strengthening malaria information system through community empowerment (17.4%), strengthening the commitment of central and local governments in sustainability fulfilment of program needs and coordination among related agencies (14.7%), projection of malaria transmission in space and time scale periodically and sustainably based on environmental factors (9%), malaria centre or malaria control centre (6.2%), the program of Chemoppropilaxis as an action against Plasmodium (5.8%), strengthening the capacity of health workers and laboratory personnel (4.2%), and development of the cross-sectoral intervention model (3%). 3 priorities became the main program conducted through a wide range of strategies.

scholarly journals Control of Aedes aegypti in a remote Guatemalan community vulnerable to dengue, chikungunya and Zika virus: Prospective evaluation of an integrated intervention of web-based health worker training in vector control, low-cost ecological ovillantas, and community engagement

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 598
Author(s):  
Gerard Ulibarri ◽  
Angel Betanzos ◽  
Mireya Betanzos ◽  
Juan Jacobo Rojas
Keyword(s):  
Community Engagement ◽  
Vector Control ◽  
Zika Virus ◽  
Health Personnel ◽  
Mosquito Control ◽  
Health Workers ◽  
Low Cost ◽  
Local Health ◽  
Worker Training ◽  
Integrated Intervention

Objective: To study the effectiveness of an integrated intervention of health worker training, a low-cost ecological mosquito ovitrap, and community engagement on Aedes spp. mosquito control over 10 months in 2015 in an urban remote community in Guatemala at risk of dengue, chikungunya and Zika virus transmission. Methods: We implemented a three-component integrated intervention consisting of: web-based training of local health personnel in vector control, cluster-randomized assignment of ecological ovillantas or standard ovitraps to capture Aedes aegypti mosquito eggs, and community engagement to promote participation of community members and health personnel in the understanding and maintenance of ovitraps for mosquito control. The intervention was implemented in local collaboration with the Ministry of Health’s Vector Control Programme, and in international collaboration with the National Institute of Public Health in Mexico. Findings: Eighty percent of the 25 local health personnel enrolled in the training programme received accreditation of their improved knowledge of vector control. Significantly more eggs were trapped by  ecological ovillantas than standard ovitraps over the 10 month (42 week) study period (t=5.2577; p<0.05). Among both community members and health workers, the levels of knowledge, interest, and participation in community mosquito control and trapping increased. Recommendations for enhancing and sustaining community mosquito control were identified. Conclusion: Our three-component integrated intervention proved beneficial to this remote community at risk of mosquito-borne diseases such as dengue, chikungunya, and Zika. The combination of training of health workers, low-cost ecological ovillanta to destroy the second generation of mosquitoes, and community engagement ensured the project met local needs and fostered collaboration and participation of the community, which can help improve sustainability. The ovillanta intervention and methodology may be modified to target other species such as Culex, should it be established that such mosquitoes carry Zika virus in addition to Aedes.

scholarly journals The Macro Economic Management Challenges of Foreign Aid in Developing Countries

1970 ◽  
Vol 3 (3) ◽  
pp. 161-170
Author(s):  
U Arabi ◽  
Nagendra
Keyword(s):  
Foreign Aid ◽  
International Organizations ◽  
Low Income ◽  
Developed Countries ◽  
Primary Objective ◽  
Economic Resources ◽  
Poor People ◽  
Global Integration ◽  
Economic Management ◽  
International Consensus

Foreign aid is one of the most powerful weapons in the war against poverty.  Many people equate aid with charity as one way act of generosity directed from high income countries to their low income counterparts. Foreign aid is indispensable for the development of less developed countries. It flows in the form of loans, assistance outright grants from various governmental and international organizations. It spreads the benefits of global integration and shared prosperity by enabling poor people and countries to overcome the health, education and economic resources barriers that keep them in poverty. There is an international consensus that human development should be the primary objective. Hence aid budgets are raising despite the several fiscal and public debt problems facing some of the donor countries.

Using Ethical Principles

2021 ◽  
pp. 213-221
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Health Planning ◽  
Local Health ◽  
Ethical Practice ◽  
National Guidelines ◽  
District Health ◽  
Do No Harm ◽  
The Right ◽  
Local Research

Ethical practice is important for all health workers in public, non-government, and private health services that aim to strengthen primary health care. Four general principles are important: respect for the right of individuals to practice informed choices (autonomy), a fair distribution of benefits and risks (justice), benefits that should far outweigh risks (beneficence), and do no harm or injury (non-maleficence). Local health teams should use these principles together with national guidelines to organise a fair and just approach to district health planning, data collection, and local research studies.

scholarly journals Community Health Worker Training Curricula and Intervention Outcomes in African American and Latinx Communities: A Systematic Review

2020 ◽  
pp. 109019812095932
Author(s):  
Leslie B. Adams ◽  
Jennifer Richmond ◽  
Sable N. Watson ◽  
Crystal W. Cené ◽  
Rachel Urrutia ◽  
...  
Keyword(s):  
Public Health ◽  
African American ◽  
Community Health ◽  
Health Workers ◽  
Health Interventions ◽  
Intervention Effectiveness ◽  
Racially Diverse ◽  
Public Health Interventions ◽  
Worker Training ◽  
Key Stakeholders

In recent years, community health workers (CHWs) have emerged as key stakeholders in implementing community-based public health interventions in racially diverse contexts. Yet little is known about the extent to which CHW training curriculums influence intervention effectiveness in marginalized racial and ethnic minority communities. This review summarizes evidence on the relationship between CHW training curricula and intervention outcomes conducted among African American and Latinx populations. We conducted a literature search of intervention studies that focused on CHW public health interventions in African American and Latinx populations using PubMed, PsycINFO, ERIC, CINAHL, EMBASE, and Web of Science databases. Included studies were quantitative, qualitative, and mixed methods studies employed to conduct outcome (e.g., blood pressure and HbA1c) and process evaluations (e.g., knowledge and self-efficacy) of CHW-led interventions. Out of 3,295 articles from the database search, 36 articles met our inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary intervention health outcomes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that described training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training features. These findings suggest that CHW training may positively influence intervention effectiveness but additional research using more robust methodological approaches is needed to clarify these relationships.

scholarly journals DANGER! Crisis Health Workers at Risk

2020 ◽  
Vol 17 (15) ◽  
pp. 5270
Author(s):  
Mason Harrell ◽  
Saranya A. Selvaraj ◽  
Mia Edgar
Keyword(s):  
Protective Factors ◽  
Disease Transmission ◽  
Patient Population ◽  
Health Workers ◽  
Mental Fatigue ◽  
Local Health ◽  
Occupational Hazards ◽  
Medical Systems ◽  
Post Traumatic Stress ◽  
Healthcare Needs

The occupational hazards of health workers (HWs) in standard work environments have been well defined in both the developed and developing world during routine working conditions. Less defined are the hazards to HWs during pandemics, epidemics, natural disasters, wars, conflicts, and other crises. How do crises affect the infrastructure of medical systems? What are the distinct needs of the patient population during crises? What are the peculiarities of the Crisis Health Worker (CHW)? What are the known CHWs’ occupational risks? What are the protective factors? By means of a PubMed search, we synthesized the most relevant publications to try to answer these questions. Failures of healthcare infrastructure and institutions include CHW shortages, insufficient medical supplies, medications, transportation, poorly paid health workers, security concerns, and the absence of firm guidance in health policy. Healthcare needs affecting the patient population and CHWs include crisis-induced injury and illness, hazardous exposures, communicable diseases, mental healthcare, and continuity of care for pre-crisis medical conditions. CHWs’ occupational hazards include supply deficiencies, infectious disease transmission, long working hours, staff shortages, financial reimbursements, mental fatigue, physical exhaustion, and inconsistent access to clean water, electricity, and Internet. CHWs suffer from injuries and illnesses that range from immediate, debilitating injuries to chronic, unforeseen effects like mental fatigue, physical exhaustion, anxiety, burnout, and even post-traumatic stress syndrome (PTSD). Protective factors include personal traits such as adaptability and resilience as well as skills learned through structured education and training. Success will be achieved by constructively collaborating with local authorities, local health workers, national military, foreign military, and aid organizations.

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