scholarly journals Community-based Guinea worm surveillance in Chad: Evaluating a system at the intersection of human and animal disease

2021 ◽  
Vol 15 (3) ◽  
pp. e0009285
Author(s):  
Beth L. Rubenstein ◽  
Sharon L. Roy ◽  
Karmen Unterwegner ◽  
Sarah Yerian ◽  
Adam Weiss ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Parasitic Infection ◽  
Care Seeking ◽  
Community Based ◽  
Knowledge Community ◽  
Logistic Regression Models ◽  
Guinea Worm ◽  
Visit Frequency ◽  
Community Volunteers ◽  
Changes Over Time

Background Guinea worm is a debilitating parasitic infection targeted for eradication. Annual human cases have dropped from approximately 3,500,000 in 1986 to 54 in 2019. Recent identification of canine cases in Chad threatens progress, and therefore detection, prevention, and containment of canine cases is a priority. We investigated associations between disease knowledge, community engagement, and canine cases in Chad to identify opportunities to improve active surveillance. Methods We surveyed 627 respondents (villagers, local leaders, community volunteers, and supervisors) across 45 villages under active surveillance. Descriptive statistics were analyzed by respondent category. Logistic regression models were fitted to assess the effects of volunteer visit frequency on villager knowledge. Results Knowledge increased with respondents’ associations with the Guinea worm program. Household visit frequency by community volunteers was uneven: 53.0% of villagers reported visits at least twice weekly and 21.4% of villagers reported never being visited. Villagers visited by a volunteer at least twice weekly had better knowledge of Guinea worm symptoms (OR: 1.71; 95% CI: 1.04–2.79) and could name more prevention strategies (OR: 2.04; 95% CI: 1.32–3.15) than villagers visited less frequently. The primary motivation to report was to facilitate care-seeking for people with Guinea worm. Knowledge of animal “containment” to prevent contamination of water, knowledge of rewards for reporting animal cases, and ability to name any reasons to report Guinea worm were each positively correlated with village canine case counts. Conclusions Community volunteers play crucial roles in educating their neighbors about Guinea worm and facilitating surveillance. Additional training and more attentive management of volunteers and supervisors could increase visit frequency and further amplify their impact. Emphasizing links between animal and human cases, the importance of animal containment, and animal rewards might improve surveillance and canine case detection. The surveillance system should be evaluated routinely to expand generalizability of data and monitor changes over time.

scholarly journals Health Seeking Behaviour and Associated Factors among Pulmonary Tuberculosis Suspects in Lay Armachiho District, Northwest Ethiopia: A Community-Based Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Eshetu Haileselassie Engeda ◽  
Berihun Assefa Dachew ◽  
Hiwot Kassa Woreta ◽  
Mengistu Mekonnen Kelkay ◽  
Tesfaye Demeke Ashenafie
Keyword(s):  
Health Care ◽  
Pulmonary Tuberculosis ◽  
Previous History ◽  
Care Facility ◽  
Health Care Facility ◽  
Northwest Ethiopia ◽  
Care Seeking ◽  
Health Seeking ◽  
Community Based ◽  
Modern Health Care

Studies in the northern part of Ethiopia showed high prevalence of undiagnosed cluster of tuberculosis cases within the community which demanded an investigation of the health care seeking behaviour of tuberculosis suspects. A community-based cross-sectional study was conducted in Lay Armachiho district, Northwest Ethiopia. Individuals who had cough for at least two weeks and aged greater than or equal to 15 years were included in the study. Data were collected by interview using pretested and structured questionnaire. Logistic regression was computed and adjusted odds ratio with 95% confidence interval was calculated. Out of the total population surveyed (29, 735), 663 (2.2%) individuals were found to be pulmonary tuberculosis suspects. Majority of the suspects reported that they had visited a modern health care facility. Those aged 15 to 34 and aged 35–54 had secondary educational level and above; those who were civil servants, those who were farmers, those who had previous history of tuberculosis treatment, and those who perceived that they were sick were more likely to visit a modern health care facility. The proportion of respondents who had taken traditional measures was found to be higher than some other districts. Improving the socioeconomic status of the community is recommended.

scholarly journals Community-Based Cluster Randomized Controlled Trial: Empowering Households to Identify and Provide Appropriate Care for Low-Birthweight Newborns in Nepal

2020 ◽  
Author(s):  
Stephen Hodgins ◽  
Binamra Rajbhandari ◽  
Deepak Joshi ◽  
Bharat Ban ◽  
Subarna Khatry ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Care Seeking ◽  
Apparent Effect ◽  
Community Based ◽  
Randomized Controlled ◽  
Appropriate Care ◽  
Cluster Randomized ◽  
Skin To Skin

Abstract Background: Most newborn deaths occur among those of low birthweight (LBWt), due to prematurity &/or impaired fetal growth. Simple practices can mitigate this risk. In low-income country settings where many births occur at home, strategies are needed that empower mothers to determine if their babies are higher risk and take protective measures. Earlier studies suggest that foot-length may be a good proxy for birthweight. An earlier Nepal study found a 6.9cm cut-off performed relatively well, differentiating normal from low birthweight.Methods: Community-based, cluster-randomized controlled trial. Objective: to determine whether family-administered screening, with targeted messages improves care practices known to mitigate LBWt risks. Participants: pregnant women participating in a parent trial in rural Nepal. Women were given a 6.9cm card to assess whether the baby’s foot is small; if so, to call number on the card for advice. Follow-up visits were made over 2 weeks following the birth, assessing for: reported skin-to-skin thermal care, and care-seeking outside the home; restricting to low birthweight (using 2 cutoffs: 2,500g and 2,000g). Randomization: 17 clusters intervention, 17 control. The study also documented steps along the presumed causal chain from intervention through behavioral impact.Results: 2,022 into intervention, 2,432 into control. Intervention arm: 519 with birthweight <2,500g (vs. 663 among controls), of which 503 were available for analysis (vs. 649 among controls). No significant difference on care-seeking; for those <2,500g RR 1.13 (95%CI: 0.97-1.131). More of those in the intervention arm reported skin-to-skin thermal care than among controls; for those <2,500g RR 2.50 (95%CI: 2.01-3.1). Process measures suggest this apparent effect cannot be attributed to the intervention; the card performed poorly as a proxy for LBWt, misclassifying 84.5% of those <2,000 as normal.Conclusions: Although the trial found an apparent effect on one key behavioral outcome, this cannot be attributed to the intervention; most likely it was a result of pure chance. Other approaches are needed for identifying at-risk babies in such settings, and targeting them for appropriate care messaging.Trial registration : clinicaltrials.gov identifier: NCT02802332, registered 16 June 2016, https://clinicaltrials.gov/ct2/show/NCT02802332

Understanding Active Surveillance for Prostate Cancer

2021 ◽  
pp. OP.20.00929
Author(s):  
Lillian Y. Lai ◽  
Vahakn B. Shahinian ◽  
Mary K. Oerline ◽  
Samuel R. Kaufman ◽  
Ted A. Skolarus ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Guideline Development ◽  
Multinomial Logistic Regression ◽  
Specific Antigen ◽  
National Sample ◽  
Logistic Regression Models ◽  
Radiation Oncologists ◽  
Medical Oncologists ◽  
Testing Patterns

PURPOSE: To assess how active surveillance for prostate cancer is apportioned across specialties and how testing patterns and transition to treatment vary by specialty. METHODS: We used a 20% national sample of Medicare claims to identify men diagnosed with prostate cancer from 2010 through 2016 initiating surveillance (N = 13,048). Patients were assigned to the physician responsible for the bulk of surveillance care based on billing patterns. Freedom from treatment was assessed by specialty of the responsible physician (urology, radiation oncology, medical oncology, and primary care). Multinomial logistic regression models were used to examine associations between specialty and treatment patterns. RESULTS: Urologists were responsible for surveillance in 93.7% of patients in 2010 and 96.2% of patients in 2016 ( P for trend = .01). Testing patterns varied by specialty. For example, patients of medical oncologists had more frequent prostate-specific antigen testing compared with patients of urologists (1.85 v 2.39 tests per year, respectively; P < .01). Three years after diagnosis, a significantly smaller proportion of patients managed by radiation oncologists (64.3%) remained on surveillance compared with patients managed by other physicians (75.8%-79.5%; P < .01). Although radiation was the most common treatment among all men who transitioned to treatment, a disproportionate percentage of patients followed by radiation oncologists (28.9%) ultimately underwent radiation compared with patients followed by other physicians (15.1%-15.4%; P < .01). CONCLUSION: Nontrivial percentages of patients on active surveillance are managed by physicians outside of urology. Given the interspecialty variations observed, efforts to strengthen the evidence underlying surveillance pathways and to engage other specialties in guideline development are needed.

Community-based active surveillance for rabies in Machakos District, Kenya

2000 ◽  
Vol 44 (1-2) ◽  
pp. 73-85 ◽  
Author(s):  
P.M. Kitala ◽  
J.J. McDermott ◽  
M.N. Kyule ◽  
J.M. Gathuma
Keyword(s):  
Active Surveillance ◽  
Community Based

scholarly journals Use of Informal Support as a Predictor of Home- and Community-Based Services Utilization

2020 ◽  
Vol 76 (1) ◽  
pp. 133-140
Author(s):  
Kristen N Robinson ◽  
Heather L Menne ◽  
Raphael Gaeta
Keyword(s):  
Older Adults ◽  
Informal Caregivers ◽  
Behavioral Model ◽  
Study Data ◽  
Informal Support ◽  
Health Services Use ◽  
Community Based ◽  
Logistic Regression Models ◽  
Andersen Behavioral Model ◽  
Community Based Services

Abstract Objectives Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS. Method Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not. Results For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone. Discussion Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.

scholarly journals 2483

2017 ◽  
Vol 1 (S1) ◽  
pp. 80-80
Author(s):  
Clara Pelfrey ◽  
Katrice Cain ◽  
Mary Ellen Lawless ◽  
Earl Pike ◽  
Ashwini Sehgal
Keyword(s):  
Evaluation System ◽  
Expert Knowledge ◽  
Healthcare Providers ◽  
Consult Service ◽  
Community Members ◽  
Community Based ◽  
Knowledge Community ◽  
Community Based Research ◽  
Research Outcomes ◽  
Study Population

OBJECTIVES/SPECIFIC AIMS: This study describes the design, operation, and evaluation of a community-based research (CBR) consult service within the setting of a Clinical and Translational Science Award (CTSA) institution. To our knowledge, there are no published evaluations of a CBR consult service at a CTSA hub. METHODS/STUDY POPULATION: A CBR consult service was created to support faculty, healthcare providers/research coordinators, trainees, community-based organizations, and community members. A framework was developed to assess the stages of client engagement and to foster clear articulation of client needs and challenges. A developmental evaluation system was integrated with the framework to track progress, store documents, continuously improve the consult service, and assess research outcomes. RESULTS/ANTICIPATED RESULTS: This framework provides information on client numbers, types, services used, and successful outreach methods. Tracking progress reveals reasons that prevent clients from completing projects and facilitates learning outcomes relevant to clients and funding agencies. Clients benefit from the expert knowledge, community connections, and project guidance provided by the consult service team, increasing the likelihood of study completion and achieving research outcomes. DISCUSSION/SIGNIFICANCE OF IMPACT: Our evaluation suggests that clients benefit by (1) gaining the collective knowledge of the experts comprising the team, (2) learning the process of doing CBR, including the required steps to reach completion, and (3) gaining a project management mentality promoting translational research outcomes. This study offers a framework by which CTSA institutions can expand their capacity to conduct and evaluate CBR while addressing challenges that inhibit community engagement.

scholarly journals Active surveillance of American tegumentary leishmaniasis in endemic areas in rural Bolivia

2012 ◽  
Vol 45 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Vladimir Luna Tedesqui ◽  
Guido Noel Chuquimia Calleja ◽  
Rolando Parra ◽  
Javier Palacios Pabón ◽  
Márcio Neves Bóia ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Demographic Data ◽  
High Rate ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
La Paz ◽  
Mucocutaneous Leishmaniasis ◽  
Tegumentary Leishmaniasis ◽  
American Tegumentary Leishmaniasis

INTRODUCTION: American tegumentary leishmaniasis (ATL), including mucocutaneous leishmaniasis (MCL) and localized cutaneous leishmaniasis (LCL), is endemic in Bolivia. We describe the results of active surveillance of ATL from 2001 to 2006 and assess demographic data related to ATL epidemiology in the Yungas valleys. METHODS: Community-based active ATL surveillance was performed by the institutions SERVIR, CÁRITAS, and the Health Services Department of La Paz, whose files were reviewed retrospectively. A cross-sectional survey was carried out to assess demographic data in two communities. RESULTS: Two thousand nine hundred nine cases of ATL were detected from 2001 to 2006: 2,488 (85.5%) corresponded to LCL and 421 (14.5%) to MCL. A reduction in the proportion of mucosal cases was observed between 2001 and 2006. The proportion of MCL cases increased with age and was higher among males (15.5% versus 12.1%, p=0.018). The rate of positivity via direct observation of the parasite in dermal scrapings and in parasite cultivation was significantly higher for LCL than for MCL (p<0.001 and p=0.009, respectively). The rate of reactivity in the leishmanin skin test was higher in the group with mucosal lesions (p=0.012). The cross-sectional survey showed that 40% of the families had emigrated from the Altiplano. CONCLUSIONS: It is necessary to undertake continuous case detection of ATL in the area, where the disease presents a high rate of mucosal cases. Increasing incidence seems to be associated with immigration and continuous deforestation to expand the crop-growing areas.

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