scholarly journals Implementation challenges and opportunities for improved mass treatment uptake for lymphatic filariasis elimination: Perceptions and experiences of community drug distributors of coastal Kenya

2020 ◽  
Vol 14 (12) ◽  
pp. e0009012
Author(s):  
Doris W. Njomo ◽  
Bridget W. Kimani ◽  
Lydiah W. Kibe ◽  
Collins Okoyo ◽  
Wyckliff P. Omondi ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Selection Criteria ◽  
Health Workers ◽  
Drug Distribution ◽  
Record Keeping ◽  
Implementation Challenges ◽  
Challenges And Opportunities ◽  
Quasi Experimental ◽  
Community Drug Distributors

Community drug distributors (CDDs) who are volunteers have the responsibility of awareness creation, household census, drug distribution and record-keeping and are thus key stakeholders in the campaign for Lymphatic Filariasis (LF) elimination. Taking into account their experiences and perceptions is important for a successful elimination campaign. We conducted a qualitative study in 2018 to identify implementation challenges and opportunities for improved mass drug administration (MDA) uptake based on the CDDs perceptions and experiences. Within a larger study that used mixed methods quasi-experimental design, we collected qualitative data from two wards in Kaloleni Sub-County of Kilifi County which was purposively selected owing to its low, 56% and 50.5% treatment coverage in 2015 and 2016 respectively. Focus group discussions (FGDs) (n = 8) and in-depth interviews (IDIs) (n = 8) with CDDs, IDIs (n = 22) with opinion leaders and IDIs (n = 8) with health workers were conducted and the data analyzed by QSR NVIVO version 10 according to thematic areas. The results showed that based on the perceptions and experiences of the CDDs, several challenges: communities’ refusal to take the drugs; absenteeism during MDA; non-adherence to CDDs selection criteria; inadequacy in number of CDDs engaged during the campaign and training provided; insufficiency of drugs issued to CDDs; lack of CDDs supervision and low motivation negatively impact on MDA uptake. Opportunities to address the challenges included: awareness creation on MDA, health education on LF and observation of hygiene during drug administration, increased duration of awareness creation and drug administration, adherence to CDDs selection criteria and putting into consideration the vastness of an area and population density while deploying CDDs. Other opportunities include: improved CDDs training and scheduling; issuing of enough drugs to CDDs to meet the communities’ demand and improved supervision and motivation of CDDs. Addressing the challenges highlighted is an important step of maximizing MDA uptake. The opportunities presented need to be considered by the NTD program personnel, the county health personnel and the community while planning the implementation of MDA campaigns.

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 Coverage and compliance of mass drug administration against lymphatic filariasis in Kalaburgi district

2017 ◽  
Vol 4 (7) ◽  
pp. 2502
Author(s):  
Mallikarjun K. Biradar ◽  
Sharankumar Holyachi
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Public Health Problem ◽  
Side Reaction ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Male Subjects ◽  
Evaluation Survey

Background: Lymphatic filariasis (LF) is endemic in 83 countries and territories, with more than a billion people at risk of infection. Filariasis has been a major public health problem in India next only to malaria. Study was done to assess coverage and compliance of mass drug administration (MDA) against lymphatic filariasis in Kalaburgi districts.Methods: This cross-sectional coverage evaluation survey was done in one urban and three rural clusters in district.The data was compiled, tabulated and analyzed using proportions.Results: A total of 791 subjects were interviewed, male subjects constituted about 47.7%. Majority of the subjects were in the age group of 16-60 years (69.9%), while only 3.2% were in <2years. 82.9% persons have received the drugs.  Out of the 530 persons who have received the drugs, 86.9% persons have consumed the drugs. Only 59.9% of study subjects consumed tablets in front of health workers. A total of 69 subjects have not consumed tablets, 20.3% said told fear of side reaction, and 20.3% subjects said they don’t have faith in tablet. Only 11 persons suffered from vomiting and nausea.Conclusions: There is an urgent need for more effective drug delivery strategies and also proper IEC should be done to educate and to improve the coverage and compliance in the districts. 

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.

scholarly journals Evaluation of mass drug administration programme for elimination of lymphatic filariasis in Bidar district, Karnataka

2018 ◽  
Vol 5 (3) ◽  
pp. 1020 ◽  
Author(s):  
Mahesh S. Hoolageri ◽  
Ramachandra Kamath ◽  
K. Ravikumar ◽  
Jagadish G. ◽  
Surekha Kamath
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Male Subjects ◽  
Evaluation Survey ◽  
Mass Drug Administration Programme

Background: Lymphatic filariasis (LF) is endemic in 83 countries and territories, with more than a billion people at risk of infection. Filariasis has been a major public health problem in India next only to malaria. Study was done to assess coverage and compliance of mass drug administration (MDA) against lymphatic filariasis in Bidar district.Methods: This cross-sectional coverage evaluation survey was done in one urban and three rural clusters in district. The data was compiled, tabulated and analyzed using proportions.Results: A total of 739 subjects were interviewed, male subjects constituted about 57.5%. 96.58% persons have received the drugs. Out of the 678 persons who have received the drugs, 85.4% persons have consumed the drugs. Only 31.95% of study subjects consumed tablets in front of health workers. A total of 99 subjects not consumed tablets, 22.22% told drug distributor did not visit, 21.21% were out of station and 14.14% subjects were not aware. 24 persons suffered from nausea and vomiting.Conclusions: There is an urgent need for more effective drug delivery strategies and also proper IEC should be done to educate and to improve the coverage and compliance in the districts.

scholarly journals Evaluating context-specific evidence-based quality improvement intervention on lymphatic filariasis mass drug administration in Northern Ghana using the RE-AIM framework

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Alfred Kwesi Manyeh ◽  
Tobias Chirwa ◽  
Rohit Ramaswamy ◽  
Frank Baiden ◽  
Latifat Ibisomi
Keyword(s):  
Quality Improvement ◽  
Needs Assessment ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Northern Ghana ◽  
Quality Improvement Intervention ◽  
Evidence Based ◽  
Context Specific ◽  
Improvement Intervention

Abstract Background Over a decade of implementing a global strategy to eliminate lymphatic filariasis in Ghana through mass drug administration, the disease is still being transmitted in 11 districts out of an initial 98 endemic districts identified in 2000. A context-specific evidence-based quality improvement intervention was implemented in the Bole District of Northern Ghana after an initial needs assessment to improve the lymphatic filariasis mass drug administration towards eliminating the disease. Therefore, this study aimed to evaluate the process and impact of the lymphatic filariasis context-specific evidence-based quality improvement intervention in the Bole District of Northern Ghana. Method A cross-sectional mixed methods study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the context-specific evidence-based quality improvement intervention was employed. Quantitative secondary data was extracted from the neglected tropical diseases database. A community survey was conducted with 446 randomly selected participants. Qualitative data were collected from 42 purposively selected health workers, chiefs/opinion leaders and community drug distributors in the study area. Results The evaluation findings showed an improvement in social mobilisation and sensitisation, knowledge about lymphatic filariasis and mass drug administration process, willingness to ingest the medication and adherence to the direct observation treatment strategy. We observed an increase in coverage ranging from 0.1 to 12.3% after implementing the intervention at the sub-district level and reducing self-reported adverse drug reaction. The level of reach, effectiveness and adoption at the district, sub-district and individual participants’ level suggest that the context-specific evidence-based quality improvement intervention is feasible to implement in lymphatic filariasis hotspot districts based on initial context-specific needs assessment. Conclusion The study provided the groundwork for future application of the RE-AIM framework to evaluate the implementation of context-specific evidence-based quality improvement intervention to improve lymphatic filariasis mass drug administration towards eliminating the disease as a public health problem.

scholarly journals Lymphatic filariasis, infection status in Culex quinquefasciatus and Anopheles species after six rounds of mass drug administration in Masasi District, Tanzania

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Eliza Lupenza ◽  
Dinah B. Gasarasi ◽  
Omary M. Minzi
Keyword(s):  
Vector Control ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Wuchereria Bancrofti ◽  
Elimination Phase ◽  
Anopheles Species ◽  
The Status ◽  
Household Environment ◽  
Indoor And Outdoor

Abstract Background Lymphatic filariasis (LF) elimination program in Tanzania started in 2000 in response to the Global program for the elimination of LF by 2020. Evidence shows a persistent LF transmission despite more than a decade of mass drug administration (MDA). It is advocated that, regular monitoring should be conducted in endemic areas to evaluate the progress towards elimination and detect resurgence of the disease timely. This study was therefore designed to assess the status of Wuchereria bancrofti infection in Culex quinqefasciatus and Anopheles species after six rounds of MDA in Masasi District, South Eastern Tanzania. Methods Mosquitoes were collected between June and July 2019 using Center for Diseases Control (CDC) light traps and gravid traps for indoor and outdoor respectively. The collected mosquitoes were morphologically identified into respective species. Dissections and PCR were carried out to detect W. bancrofti infection. Questionnaire survey and checklist were used to assess vector control interventions and household environment respectively. A Poisson regression model was run to determine the effects of household environment on filarial vector density. Results Overall, 12 452 mosquitoes were collected of which 10 545 (84.7%) were filarial vectors. Of these, Anopheles gambiae complex, An. funestus group and Cx. quinquefasciatus accounted for 0.1%, 0.7% and 99.2% respectively. A total of 365 pools of Cx. quinquefasciatus (each with 20 mosquitoes) and 46 individual samples of Anopheles species were analyzed by PCR. For Cx. quinquefasciatus pools, 33 were positive for W. bancrofti, giving an infection rate of 0.5%, while the 46 samples of Anopheles species were all negative. All 1859 dissected mosquitoes analyzed by microscopy were also negative. Households with modern latrines had less mosquitoes than those with pit latrines [odds ratio (OR) = 0.407, P < 0.05]. Houses with unscreened windows had more mosquitoes as compared to those with screened windows (OR = 2.125, P < 0.05). More than 80% of the participants own bednets while 16.5% had no protection. Conclusions LF low transmission is still ongoing in Masasi District after six rounds of MDA and vector control interventions. The findings also suggest that molecular tools may be essential for xenomonitoring LF transmission during elimination phase.

The Effect of Breastfeeding Calendar Training on Knowledge and Attitudes of Mothers in Exclusive Breastfeeding

2021 ◽  
Vol 10 (1) ◽  
pp. 80-87
Author(s):  
Ari Indra Susanti ◽  
Aminarista Aminarista ◽  
Neneng Martini ◽  
Nur Rahmah ◽  
Sri Astuti
Keyword(s):  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
Test Design ◽  
Knowledge And Attitudes ◽  
Lactating Mothers ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental

Background: Lactating mothers were successful in giving exclusive breastfeeding as much as 42% based on SDKI (Survei Demografi Kesehatan Indonesia) in 2012. This is depend on the support of husbands and families as well as health workers. Thus, the husband or family should remind and motivate mothers as well as monitor the breastfeeding activity every day for 6 months using breastfeeding calendar.Objectives: This study aimed to determine the increase in knowledge and attitudes of mothers in providing exclusive breastfeeding after the exclusive breastfeeding calendar training.Materials and Methods: The research design used a quasi-experimental one group pre-test post-test design. This research was conducted on mothers who had babies (age 0-12 months) in Pasawahan Village and Pasawahan Kidul Village, Pasawahan District, Purwakarta Regency in April to November 2018, with 96 respondents. The sampling technique was conducted by purposive sampling. Data were collected by giving questionnaires to respondents, before and after the breastfeeding calendar training were given. The Wilcoxon test was used for the analysis of the data in this study.Results: The results showed that there were differences in the knowledge of mothers before and after training on breastfeeding calendar (p <0,000) and there were differences in the attitudes of mothers before and after the training on breastfeeding calendar (p <0,000).Conclusions: There was an increase in knowledge and changes in the attitude of mothers towards exclusive breastfeeding after being given the breastfeeding Calendar training. Therefore, suggestions for health workers, especially midwives and nutrition workers, can use the breastfeeding calendar as an educational medium to increase husband and family support in exclusive breastfeeding.

Preschool Services for the Visually Handicapped: A National Survey

1978 ◽  
Vol 72 (2) ◽  
pp. 59-66 ◽  
Author(s):  
Linda Felix ◽  
Susan Jay Spungin
Keyword(s):  
Parent Involvement ◽  
National Survey ◽  
Selection Criteria ◽  
Program Planning ◽  
National Study ◽  
Future Research ◽  
Record Keeping ◽  
Assessment Program ◽  
Parent Groups ◽  
Visually Handicapped

A national study of preschool programs serving the visually handicapped was made for the purpose of compiling national lists of programs and parent groups as well as to compile programmatic information in the following areas: program objectives, staffing, selection criteria, referral procedures, assessment, program planning, parent involvement and record keeping. The information is intended to guide states in the development of new programs or the restructuring of old ones, as well as serve as a basis for future research.

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