scholarly journals A comparison of three types of targeted, community-based methods aimed at promoting early detection of new leprosy cases in rural parts of three endemic states in India

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261219
Author(s):  
Karthikeyan Govindasamy ◽  
Annamma S. John ◽  
Vivek Lal ◽  
Mohammad Arif ◽  
Raju Moturu Solomon ◽  
...  

Background India achieved elimination of leprosy nationally in 2005, but since then the number of patients with grade 2 disability at diagnosis increased steadily indicating delay in diagnosis. Therefore, there was a need for public health interventions which can increase case finding in their earlier stage. The objective of this study is to compare the effectiveness of three such community-based interventions; 1) Enhancement of community awareness on leprosy; 2) Education and motivation of “Index” leprosy cases; and 3) Involvement of Non-Formal Health Practitioners (NFHPs) to promote early detection of new cases of leprosy. Methodology/principal findings Three community-based interventions were implemented between April 2016 and March 2018, embedded within the National Leprosy Eradication Program (NLEP) of India. Interventions were 1) increasing awareness through involvement of Gram Panchayat (local government) in the community regarding early signs of leprosy (Awareness), 2) providing health education and motivating newly diagnosed leprosy patients to bring suspects from their contacts (Index) and 3) training local non-formal health practitioners (NFHP). Each intervention was implemented in a group of ten blocks (sub-division of district) with an additional ten blocks as control (with no intervention). The main outcomes were number of new cases detected and number of grade 2 disability among them. They were obtained from the routine NLEP information system and compared between these interventions. On an average, there was an addition of 1.98 new cases in Awareness blocks, 1.13 in NFHP blocks and 1.16 cases in Index intervention blocks per month per block after adjusting for changes in control blocks during the same period. In terms of ratio, there was a 61%, 40% and 41% increase in case notification in awareness, Index and NFHP intervention, respectively. Overall, the percentage of grade 2 disability across intervention blocks declined. Conclusion The Awareness intervention appears to be more effective in detection of new cases, compared to Index case motivation and sensitization of NFHPs. However, it is important to stress that while selecting strategies to increase early diagnosis it is important to determine, which is the most appropriate for each context or area and must be decided depending on the local context.

2018 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Dariya Mukamusoni ◽  
Eleazar Ndabarora

Several studies have reported dramatic increase of the prevalence of diabetes mellitus in Africa, and barriers to early detection and treatment, which are cost-effective strategies to prevent and control diabetes mellitus and combat its morbidity and premature mortality. The paper aimed to review the literature on the prevalence of diabetes mellitus and determinants of early detection in Africa. MeSH terms in the PUBMED Medline, LISTA (EBSCO), Cochrane, and Google Scholar in order to identify recent literature published from the year 2012 to 2017. Seven articles were reviewed, and high increase of the prevalence of diabetes mellitus in Africa was found. Evidences of cost-effectiveness with early detection and treatment were found; however, early detection is hindered by several factors that need to be addressed. In addition, the paucity of articles on early detection of diabetes mellitus and community-based prevention and control programs was observed. There is an increasing prevalence of diabetes mellitus in Africa, and there is paucity of evidences on the determinants of early detection and treatment program. Operational studies and community-based interventions aiming to community sensation and screening for diabetes mellitus are highly recommended.


Author(s):  
Abirami Srivarathan ◽  
Rikke Lund ◽  
Ulla Christensen ◽  
Maria Kristiansen

Emerging evidence points towards a lower quality of life, fragile social relations and suboptimal health behavior and status of residents living in social housing areas characterized by ethnic diversity and socioeconomic deprivation. Community-based health promotion interventions developed in collaboration with the target group and adjusted to the local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in deprived social housing areas. This study explores residents’ perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analyzed with focuses on participation in an everyday life context, concepts of othering, and territorial stigmatization. Engagement in the intervention was motivated by the need to establish and enhance social relations, and to explore the world outside the housing area. However, barriers including cultural and language differences among residents, and competing contextual factors, challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in deprived social housing areas. However, adequate support and efforts to overcome the identified barriers are needed.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Srivarathan ◽  
R Lund ◽  
U Christensen ◽  
M Kristiansen

Abstract Emerging evidence points towards lower quality of life, more fragile social relations and suboptimal health behaviour and health status of residents living in social housing areas characterized by ethnic diversity and socioeconomic disadvantage. Residents from social housing areas are less likely to engage in health promotion interventions compared to the rest of society. Community-based health promotion interventions developed in collaboration with the target group and adjusted to local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in social housing areas. This study explores resident perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. Engagement was the key foundation for the designing and implementation of the intervention by the use of graphic facilitation. The intervention consisted of social outings to different sights and historical landmarks in Denmark. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analysed with a focus on participation in an everyday life context and by concepts of othering and territorial stigmatization. Engagement in the intervention was motivated by a need for establishing and enhancing social relations, and exploring the world outside the housing area. However, barriers including cultural and language differences among residents and competing contextual factors challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in social housing areas. Nevertheless, it is necessary to understand the motives and barriers to ensure feasible and relevant health promotion interventions and future engagement among residents living in social housing areas.


2021 ◽  
pp. 104973152098696
Author(s):  
Camilla Kin-Ming Lo ◽  
Yuet Wing Cho

Purpose: This review seeks to summarize selected literature on existing findings on the impacts of community-based interventions on the actual reduction of child maltreatment and to identify the core components of the interventions. Methods: This study systematically searched electronic databases, including PsycInfo, Medline, and Web of Science. The findings of the selected studies were summarized using narrative synthesis. Results: A total of four studies met the inclusion criteria of this study. The studies showed declines in child maltreatment incidences reported by child protective services and hospitals during the study periods. Four major components and approaches were identified among the selected interventions, including (1) the involvement of community members, (2) partnerships with community institutions, (3) multidisciplinary collaboration, and (4) responsiveness to the needs of the communities involved. Conclusions: The results of this review support the need for further development of community-based interventions using a hybrid approach.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mei Chan ◽  
Melinda Gray ◽  
Christine Burns ◽  
Louisa Owens ◽  
Susan Woolfenden ◽  
...  

Abstract Objective We conducted a systematic review and meta-analysis to determine the effectiveness of comprehensive community-based interventions with ≥ 2 components in improving asthma outcomes in children. Methods A systematic search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), Cochrane Library and hand search of reference collections were conducted to identify any research articles published in English between 2000 and 2019. All studies reporting community-based asthma interventions with ≥ 2 components (e.g., asthma self-management education, home environmental assessment or care coordination etc.) for children aged ≤ 18 years were included. Meta-analyses were performed using random-effects model to estimate pooled odds ratio (OR) with 95% confidence intervals (CIs). Results Of the 2352 studies identified, 21 studies were included in the final analysis: 19 pre-post interventions, one randomised controlled trial (RCT) and one retrospective study. Comprehensive asthma programs with multicomponent interventions were associated with significant reduction in asthma-related Emergency Department (ED) visits (OR = 0.26; 95% CI 0.20–0.35), hospitalizations (OR = 0.24; 95% CI 0.15–0.38), number of days (mean difference = − 2.58; 95% CI − 3.00 to − 2.17) and nights with asthma symptoms (mean difference = − 2.14; 95% CI − 2.94 to − 1.34), use of short-acting asthma medications/bronchodilators (BD) (OR = 0.28; 95% CI 0.16–0.51), and increase use of asthma action plan (AAP) (OR = 8.87; 95% CI 3.85–20.45). Conclusion Community-based asthma care using more comprehensive approaches may improve childhood asthma management and reduce asthma related health care utilization.


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