scholarly journals Mass administration of medicines in changing contexts: Acceptability, adaptability and community directed approaches in Kaduna and Ogun States, Nigeria

2020 ◽  
Vol 14 (11) ◽  
pp. e0008857
Author(s):  
Oluwatosin Adekeye ◽  
Kim Ozano ◽  
Ruth Dixon ◽  
Elisabeth Osim Elhassan ◽  
Luret Lar ◽  
...  
Keyword(s):  
Neglected Tropical Diseases ◽  
Sub Saharan Africa ◽  
Health Governance ◽  
Preventive Chemotherapy ◽  
Ogun State ◽  
Equity In Access ◽  
New Challenges ◽  
Sub Saharan ◽  
Different Levels ◽  
Programme Delivery

Nigeria has the highest burden of NTDs in sub-Saharan Africa. Commitments to reach the control and elimination of many Neglected Tropical Diseases (NTDs), particularly those amenable to preventive chemotherapy (onchocerciasis, schistosomiasis, soil transmitted helminths, lymphatic filariasis and trachoma) by 2020 are detailed in the London declaration. Strategies to reach targets build on existing approaches, one of which is the use of community directed intervention (CDI) methods to deliver the mass administration of medicines (MAM). However, treatment using this approach has been inconsistent and there are questions about the acceptability and adaptability of these interventions during periods of programmatic, social, and political change. This paper explores the current strengths and weaknesses of CDI approaches in MAM delivery. We consider the acceptability and adaptability of existing MAM approaches to ensure equity in access to essential treatments. Using qualitative methods, we explore implementer perspectives of MAM delivery. We purposively selected programme implementers to ensure good programmatic knowledge and representation from the different levels of health governance in Nigeria. Data collection took place across two States (Kaduna and Ogun). Our results indicate that CDI approaches have underpinned many historic successes in NTD programme acceptance in Nigeria, specifically in Kaduna and Ogun State. However, our results also show that in some contexts, factors that underpin the success of CDI have become disrupted presenting new challenges for programme implementers. Capturing the tacit knowledge of health implementers at varying levels of the health system, we present the current and changing context of MAM delivery in Kaduna and Ogun States and consolidate a platform of evidence to guide future programme delivery and research studies. We situate our findings within the broader NTD literature, specifically, in identifying how our findings align to existing reviews focused on factors that shape individual acceptance of MAM.

scholarly journals The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002–2008

Parasitology ◽  
2009 ◽  
Vol 136 (13) ◽  
pp. 1719-1730 ◽  
Author(s):  
A. FENWICK ◽  
J. P. WEBSTER ◽  
E. BOSQUE-OLIVA ◽  
L. BLAIR ◽  
F. M. FLEMING ◽  
...  
Keyword(s):  
Neglected Tropical Diseases ◽  
Integrated Control ◽  
Monitoring And Evaluation ◽  
Sub Saharan Africa ◽  
Preventive Chemotherapy ◽  
Schistosomiasis Control ◽  
Control Programmes ◽  
Sub Saharan ◽  
Management Approaches ◽  
Control Initiative

SUMMARYSchistosomiasis remains one of the most prevalent parasitic diseases in developing countries. After malaria, schistosomiasis is the most important tropical disease in terms of human morbidity with significant economic and public health consequences. Although schistosomiasis has recently attracted increased focus and funding for control, it has been estimated that less than 20% of the funding needed to control the disease in Africa is currently available. In this article the following issues are discussed: the rationale, development and objectives of the Schistosomiasis Control Initiative (SCI)-supported programmes; the management approaches followed to achieve implementation by each country; mapping, monitoring and evaluation activities with quantifiable impact of control programmes; monitoring for any potential drug resistance; and finally exit strategies within each country. The results have demonstrated that morbidity due to schistosomiasis has been reduced by the control programmes. While challenges remain, the case for the control of schistosomiasis has been strengthened by research by SCI teams and the principle that a national programme using ‘preventive chemotherapy’ can be successfully implemented in sub-Saharan Africa, whenever the resources are available. SCI and partners are now actively striving to raise further funds to expand the coverage of integrated control of neglected tropical diseases (NTDs) in sub-Saharan Africa.

scholarly journals Health governance in Sub-Saharan Africa

2015 ◽  
Vol 15 (3) ◽  
pp. 345-348 ◽  
Author(s):  
Keneilwe Sadie Mooketsane ◽  
Molefe B Phirinyane
Keyword(s):  
Sub Saharan Africa ◽  
Health Governance ◽  
Sub Saharan

scholarly journals Evaluating survey designs for targeting preventive chemotherapy against Schistosoma haematobium and Schistosoma mansoni across Sub-Saharan Africa: a geostatistical analysis and modelling study

2020 ◽  
Author(s):  
Kimberly Fornace ◽  
Claudio Fronterrè ◽  
Fiona M Fleming ◽  
Hope Simpson ◽  
Honorat Zoure ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Schistosoma Haematobium ◽  
Sampling Strategy ◽  
Sub Saharan Africa ◽  
Spatial Distributions ◽  
Preventive Chemotherapy ◽  
School Based ◽  
Control Programmes ◽  
Sub Saharan ◽  
Survey Designs

Abstract Background: Schistosomiasis control programmes primarily use school-based surveys to identify areas for mass drug administration of preventive chemotherapy. However, as the spatial distribution of schistosomiasis can be highly focal, transmission may not be detected by surveys implemented at districts or larger spatial units. Improved mapping strategies are required to accurately and cost-effectively target preventive chemotherapy to remaining foci across all possible spatial distributions of schistosomiasis. Methods: Here, we use geostatistical models to quantify the spatial heterogeneity of Schistosoma haematobium and S. mansoni across sub-Saharan Africa using the most comprehensive dataset available on school-based surveys. Applying this information to parameterise simulations, we assess the accuracy and cost of targeting alternative implementation unit sizes across the range of plausible schistosomiasis distributions. We evaluate the consequences of decisions based on survey designs implemented at district and subdistrict levels sampling different numbers of schools. Cost data were obtained from field surveys conducted across multiple countries and years, with cost effectiveness evaluated as the cost per correctly identified school. Results: Models identified marked differences in prevalence and spatial distributions between countries and species; however, results suggest implementing surveys at subdistrict level increase the accuracy of treatment classifications across most scenarios. While sampling intensively at the subdistrict level resulted in the highest classification accuracy, this sampling strategy resulted in the highest costs. Alternatively, sampling the same numbers of schools currently recommended at the district level but stratifying by subdistrict increased cost effectiveness.Conclusions: This study provides a new tool to evaluate schistosomiasis survey designs across a range of transmission settings. Results highlight the importance of considering spatial structure when designing sampling strategies, illustrating that a substantial proportion of children may be undertreated even when an implementation unit is correctly classified. Control programmes need to weigh the increased accuracy of more detailed mapping strategies against the survey costs and treatment priorities.

A Critical Evaluation of New Challenges Pertaining to the Activities of Translation and Interpretation in Sub-Saharan Africa

2021 ◽  
pp. 25-38
Author(s):  
Milburga ATCERO
Keyword(s):  
Critical Evaluation ◽  
Sub Saharan Africa ◽  
Afrique Subsaharienne ◽  
New Challenges ◽  
Sub Saharan

Cette contribution vise à évaluer de façon critique les nouveaux défis liés à la traduction et à l’interprétation (TI) dans une Afrique subsaharienne caractérisée par sa grande diversité linguistique. L’auteur espère identifier et suggérer des méthodologies pouvant être appliquées pour rapprocher cette région du reste du monde. Il identifie, en outre, la nécessité pour l’Afrique subsaharienne de mettre en œuvre des politiques et pratiques qui favorisent le multilinguisme. Elles sont principalement basées sur la pluralité des langues, avec un espace adéquat pour les langues internationales, étant donnée le rôle crucial des parcours scolaires sur ce continent. Dans l’environnement de travail dynamique d’aujourd’hui, différentes institutions reconnaissent le rôle important joué par la TI dans la recherche et le renforcement de l’efficacité des individus comme des organisations. L’auteur s’appuie sur un cadre logique illustrant l’importance de la traduction dans les sphères socioculturelles et linguistiques, pour la production de connaissances sur l’Afrique. Il soutient que la traduction devrait être considérée comme une occasion d’explorer la diversité des possibles dans la littérature africaine. Il conclut en décrivant les méthodes envisageables et les nouvelles orientations.

scholarly journals Arthritogenic Alphaviruses: A Worldwide Emerging Threat?

2019 ◽  
Vol 7 (5) ◽  
pp. 133 ◽  
Author(s):  
Laura I. Levi ◽  
Marco Vignuzzi
Keyword(s):  
Chikungunya Virus ◽  
Neglected Tropical Diseases ◽  
Current Knowledge ◽  
Life Quality ◽  
Sub Saharan Africa ◽  
Ross River Virus ◽  
Pacific Island ◽  
The Pacific ◽  
Sub Saharan ◽  
Mayaro Virus

Arthritogenic alphaviruses are responsible for a dengue-like syndrome associated with severe debilitating polyarthralgia that can persist for months or years and impact life quality. Chikungunya virus is the most well-known member of this family since it was responsible for two worldwide epidemics with millions of cases in the last 15 years. However, other arthritogenic alphaviruses that are as of yet restrained to specific territories are the cause of neglected tropical diseases: O’nyong’nyong virus in Sub-Saharan Africa, Mayaro virus in Latin America, and Ross River virus in Australia and the Pacific island countries and territories. This review evaluates their emerging potential in light of the current knowledge for each of them and in comparison to chikungunya virus.

scholarly journals Genetic dissection of drug resistance in trypanosomes

Parasitology ◽  
2013 ◽  
Vol 140 (12) ◽  
pp. 1478-1491 ◽  
Author(s):  
SAM ALSFORD ◽  
JOHN M. KELLY ◽  
NICOLA BAKER ◽  
DAVID HORN
Keyword(s):  
Neglected Tropical Diseases ◽  
Sub Saharan Africa ◽  
Genetic Dissection ◽  
Molecular Tools ◽  
Sequencing Technology ◽  
Exponential Increase ◽  
Technological Developments ◽  
Sub Saharan ◽  
Identification And Characterization

SUMMARYThe trypanosomes cause two neglected tropical diseases, Chagas disease in the Americas and African trypanosomiasis in sub-Saharan Africa. Over recent years a raft of molecular tools have been developed enabling the genetic dissection of many aspects of trypanosome biology, including the mechanisms underlying resistance to some of the current clinical and veterinary drugs. This has led to the identification and characterization of key resistance determinants, including transporters for the anti-Trypanosoma bruceidrugs, melarsoprol, pentamidine and eflornithine, and the activator of nifurtimox-benznidazole, the anti-Trypanosoma cruzidrugs. More recently, advances in sequencing technology, combined with the development of RNA interference libraries in the clinically relevant bloodstream form ofT. bruceihave led to an exponential increase in the number of proteins known to interact either directly or indirectly with the anti-trypanosomal drugs. In this review, we discuss these findings and the technological developments that are set to further revolutionise our understanding of drug-trypanosome interactions. The new knowledge gained should inform the development of novel interventions against the devastating diseases caused by these parasites.

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