scholarly journals From Informed Consent to Adherence: Factors Influencing Involvement in Mass Drug Administration With Ivermectin for Malaria Elimination in The Gambia

2020 ◽  
Author(s):  
Alexandra E. Fehr ◽  
Claudia Nieto-Sanchez ◽  
Joan Muela ◽  
Fatou Jaiteh ◽  
Omar Ceesay ◽  
...  
Keyword(s):  
Decision Making ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Social Dynamics ◽  
The Gambia ◽  
World Health ◽  
Cross Sectional Survey ◽  
Enabling Factors ◽  
Cross Sectional ◽  
Medication Costs

Abstract Background: The World Health Organization (WHO) recommends consideration of mass drug administration (MDA) for malaria control in low-endemic settings approaching elimination. However, MDA remains a controversial strategy, as multiple individual, social, and operational factors have shown to affect its acceptability at local levels. This is further complicated by inconsistent definitions of key indicators derived from individual and community involvement — coverage, adherence, and compliance— that cast doubts about the actual and potential epidemiological impact of MDA on disease control. This study aimed to identify limitations and enabling factors impacting involvement at different stages of a large cluster-randomized trial assessing the effect of combining dihydroartemisinin-piperaquine (DP) and ivermectin (IVM) in malaria transmission in The Gambia. Methods: This social science study used a mixed-methods approach. Qualitative data were collected in intervention and control villages through ethnographic methods, including in-depth interviews (IDIs), focus group discussions (FGDs), and participant observation conducted with trial participants and decliners, community leaders, and field staff. A cross-sectional survey was conducted in the intervention villages after the first year of MDA. Both strands of the study explored malaria knowledge and opinions, social dynamics influencing decision-making, as well as perceived risks, burdens, and benefits associated with this MDA.Results: 157 IDIs and 11 FGDs were conducted, and 864 respondents were included in the survey. Barriers and enabling factors to involvement were differentially influential at the various stages of the MDA. Issues of social influence, concerns regarding secondary effects of the medication, costs associated with malaria, and acceptability of the implementing organization, among other factors, differently affected the decision-making processes throughout the trial. Rather than a linear trajectory, involvement in this MDA trial was subjected to multiple revaluations from enrolment and consent to medicine intake and adherence to treatment. Conclusions: Our study went beyond the individual factors often associated with coverage and adherence, and found that nuanced social dynamics greatly influence the decision-making process at all phases of the trial. These issues need to be consider for MDA implementation strategies and inform discussions about more accurate ways of reporting on critical effectiveness indicators.

scholarly journals From informed consent to adherence: factors influencing involvement in mass drug administration with ivermectin for malaria elimination in The Gambia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexandra Fehr ◽  
Claudia Nieto-Sanchez ◽  
Joan Muela ◽  
Fatou Jaiteh ◽  
Omar Ceesay ◽  
...  
Keyword(s):  
Decision Making ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Social Dynamics ◽  
The Gambia ◽  
World Health ◽  
Cross Sectional Survey ◽  
Enabling Factors ◽  
Cross Sectional ◽  
Medication Costs

Abstract Background The World Health Organization (WHO) recommends consideration of mass drug administration (MDA) for malaria control in low-endemic settings approaching elimination. However, MDA remains a controversial strategy, as multiple individual, social, and operational factors have shown to affect its acceptability at local levels. This is further complicated by inconsistent definitions of key indicators derived from individual and community involvement—coverage, adherence, and compliance—that cast doubts about the actual and potential epidemiological impact of MDA on disease control and elimination. This study aimed to identify limitations and enabling factors impacting involvement at different stages of a large cluster-randomized trial assessing the effect of combining dihydroartemisinin-piperaquine (DP) and ivermectin (IVM) in malaria transmission in The Gambia. Methods This social science study used a mixed-methods approach. Qualitative data were collected in intervention and control villages through ethnographic methods, including in-depth interviews (IDIs), focus group discussions (FGDs), and participant observation conducted with trial participants and decliners, community leaders, and field staff. A cross-sectional survey was conducted in the intervention villages after the first year of MDA. Both strands of the study explored malaria knowledge and opinions, social dynamics influencing decision-making, as well as perceived risks, burdens, and benefits associated with this MDA. Results 157 IDIs and 11 FGDs were conducted, and 864 respondents were included in the survey. Barriers and enabling factors to involvement were differentially influential at the various stages of the MDA. Issues of social influence, concerns regarding secondary effects of the medication, costs associated with malaria, and acceptability of the implementing organization, among other factors, differently affected the decision-making processes throughout the trial. Rather than a linear trajectory, involvement in this MDA trial was subjected to multiple revaluations from enrolment and consent to medicine intake and adherence to treatment. Conclusions This study went beyond the individual factors often associated with coverage and adherence, and found that nuanced social dynamics greatly influence the decision-making process at all phases of the trial. These issues need to be consider for MDA implementation strategies and inform discussions about more accurate ways of reporting on critical effectiveness indicators.

scholarly journals A community survey of coverage and adverse events following country-wide triple-drug mass drug administration for lymphatic filariasis elimination, Samoa 2018

2020 ◽  
Vol 14 (11) ◽  
pp. e0008854
Author(s):  
Gabriela A. Willis ◽  
Helen J. Mayfield ◽  
Therese Kearns ◽  
Take Naseri ◽  
Robert Thomsen ◽  
...  
Keyword(s):  
Adverse Events ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Total Population ◽  
Community Survey ◽  
World Health ◽  
Cross Sectional ◽  
Eligible Population ◽  
Health Organization

The Global Programme to Eliminate Lymphatic Filariasis has made considerable progress but is experiencing challenges in meeting targets in some countries. Recent World Health Organization guidelines have recommended two rounds of triple-drug therapy with ivermectin, diethylcarbamazine (DEC), and albendazole (IDA), in areas where mass drug administration (MDA) results with two drugs (DEC and albendazole) have been suboptimal, as is the case in Samoa. In August 2018, Samoa was the first country in the world to implement countrywide triple-drug MDA. This paper aims to describe Samoa’s experience with program coverage and adverse events (AEs) in the first round of triple-drug MDA. We conducted a large cross-sectional community survey to assess MDA awareness, reach, compliance, coverage and AEs in September/October 2018, 7–11 weeks after the first round of triple-drug MDA. In our sample of 4420 people aged ≥2 years (2.2% of the population), age-adjusted estimates indicated that 89.0% of the eligible population were offered MDA, 83.9% of the eligible population took MDA (program coverage), and 80.2% of the total population took MDA (epidemiological coverage). Overall, 83.8% (2986/3563) reported that they did not feel unwell at all after taking MDA. Mild AEs (feeling unwell but able to do normal everyday things) were reported by 13.3% (476/3563) and moderate or severe AEs (feeling unwell and being unable to do normal everyday activities such as going to work or school) by 2.9% (103/3563) of participants. This study following the 2018 triple-drug MDA in Samoa demonstrated a high reported program awareness and reach of 90.8% and 89.0%, respectively. Age-adjusted program coverage of 83.9% of the total population showed that MDA was well accepted and well tolerated by the community.

scholarly journals Parents’ Decision-making for Childhood Immunization and Prevention of Childhood Diseases – A Cross-Sectional Survey

2021 ◽  
Author(s):  
Jonas KEMEUGNI NGANDJON ◽  
Alfred Laengler ◽  
Thomas Ostermann ◽  
Virgile Kenmoue
Keyword(s):  
Decision Making ◽  
Low Income ◽  
Childhood Vaccination ◽  
World Health ◽  
Low Income Countries ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Vaccination Programs ◽  
Health Authorities

Abstract Background The childhood vaccination program (EPI) is claimed by the World Health Organization (WHO) to be the most cost-effective intervention to reduce child mortality. Therefore, in low-income countries governments and health authorities invest in vaccination programs to reach herd immunity. However, despite the resources allocated to the EPI, epidemics preventable through vaccines are still reported in these countries. In Cameroon, the Foumbot district in the West region has witnessed measles epidemics since 2010 and in 2013 a polio outbreak was reported. Methods The design of this study is a cross-sectional survey. A total of 160 mothers of children between the ages of 12 to 23 months were selected by simple random sampling technique. Pre-tested structured questionnaire was used for data collection. Data was analyzed using SPSS statistical software. Results The outcome of this survey shows that 60% of the children studied were completely vaccinated, 37.75% were partially vaccinated, and 1.25% had not received any vaccine. The logistic regression analysis shows that a poor knowledge of infectious diseases (OR=0.3) was a significant predictor of partial and no vaccination status in children. Conclusion Parents’ decision-making for EPI was based on the information and experiences available in the community. Therefore, parents who are poorly educated on VPDs and living in a community with missing information and misinformation about vaccination will probably not complete the EPI. Public health authorities should invest in health education programs with the goal of developing skills for health- seeking behavior in individuals and communities.

scholarly journals Correction: An impact evaluation of two rounds of mass drug administration on the prevalence of active trachoma: A clustered cross sectional survey

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222660
Author(s):  
Asrat Genet Amnie ◽  
Paul Emerson ◽  
Deborah McFarland ◽  
Jonathon King ◽  
Emmanuel Miri ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Impact Evaluation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Active Trachoma

scholarly journals An impact evaluation of two rounds of mass drug administration on the prevalence of active trachoma: A clustered cross sectional survey

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0201911 ◽  
Author(s):  
Asrat Genet Amnie ◽  
Paul Emerson ◽  
Deborah McFarland ◽  
Jonathon King ◽  
Emmanuel Miri ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Impact Evaluation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Active Trachoma

scholarly journals Coverage evaluation surveys following soil-transmitted helminthiasis and schistosomiasis mass drug administration in Wolaita Zone of Ethiopia—The Geshiyaro project

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260722
Author(s):  
Ewnetu Firdawek Liyew ◽  
Melkie Chernet ◽  
Habtamu Belay ◽  
Rosie Maddren ◽  
Toby Landeryou ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Cross Sectional Study ◽  
World Health ◽  
Size Analysis ◽  
Preventive Chemotherapy ◽  
Cross Sectional ◽  
Change Communication ◽  
Sanitation And Hygiene ◽  
Health Organization

Introduction The Geshiyaro project aims to break transmission of soil-transmitted helminths and schistosomiasis in the Wolaita Zone of Ethiopia through a combination of two interventions: behavior change communication (BCC) for increased water, sanitation and hygiene (WaSH) infrastructure use alongside preventive chemotherapy (PC) using albendazole (ALB) and praziquantel (PZQ), targeted to reach 90% treatment coverage. Coverage evaluation surveys (CES) were conducted post-treatment, and the resultant survey coverage was compared to reported administrative coverage. This provided a secondary confirmation of the Geshiyaro project coverages, and is used to monitor the success of each Mass Drug Administration (MDA) round. Methods A community-based cross-sectional study was conducted in 13 woredas (districts) of the Wolaita Zone. All eligible individuals from the selected households were invited for an interview. The study design, sample size, analysis and report writing were conducted according to the World Health Organization (WHO) CES guidelines for PC. Results The study interviewed a total of 3,568 households and 18,875 individuals across 13 woredas in the Wolaita Zone. Overall, the survey coverage across all studied woredas was 81.5% (95% CI; 80.9–82.0%) for both ALB and PZQ. Reported administrative coverage across all studied woredas was higher than survey coverage, 92.7% and 91.2% for ALB and PZQ, respectively. A significant portion of individuals (17.6%) were not offered PC. The predominant reason for not achieving the target coverage of 90% was beneficiary absenteeism during MDA (6.6% ALB, 6.8% PZQ), followed by drug distributors failing to reach all households (4.7% ALB, 4.8% PZQ), and beneficiaries not informed of the program (1.3% ALB, 1.7% PZQ). Conclusion Programmatic actions will need to be taken during the next MDA campaign to achieve the targeted Geshiyaro project coverage threshold across data collection and program engagement. Adequate training and supervision on recording and reporting administrative coverage should be provided, alongside improved social mobilization of treated communities to increase participation, and strengthened institutional partnerships and communication.

MORBIDITY PATTERN AMONG ADOLESCENT SCHOOL GIRLS IN RURAL AND URBAN SCHOOL OF JHANSI (U.P.)- A COMPARATIVE CROSS-SECTIONAL SURVEY

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Shubhanshu Gupta ◽  
Sanjeev Kumar ◽  
Piyush D Swami ◽  
Anjana Niranjan
Keyword(s):  
Health Status ◽  
Adolescent Girls ◽  
Low Socioeconomic Status ◽  
Optimal Level ◽  
Cross Sectional Study ◽  
World Health ◽  
World Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural And Urban

Background: According to World Health Organization, adolescents constitute about one fifth of the world population, and in India they constitute about 21% of the total population. Most of the surveys show that health status of adolescent girls is at sub-optimal level. Objectives: To assess nutritional status and morbidity pattern among the adolescent girls and to suggest measures for improvement of health status of adolescent girls.  Method: A community based cross-sectional study was carried out among 250 adolescent schoolgirls in Rural and urban field practice area of Jhansi school from January 2017 to July 2014. Results: Among the various morbidities eye problem was seen in maximum no of adolescent girls. Eye problem was present in 44.8% of adolescent girls followed by respiratory 14.7% and ear 13.06% disease. Skin disease was present in 3.2% of adolescent girls, which was more in rural girls 6.7% than in urban girls 1.7%, may be due to better hygienic practice in urban schoolgirls. Conclusions: Rural background, low socioeconomic status, illiteracy, birth rate and order, income and number of members in a family have shown to be significant determinants of morbidity pattern in the adolescent girls. Keywords: Adolescent, anemia, morbidity, vaginal discharge.

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.

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