Community drug distributors’ experiences and challenges faced in the implementation of community-directed treatment with ivermectin programme for onchocerciasis control in Ulanga, Tanzania

2020 ◽  
Author(s):  
Vivian Mushi
Keyword(s):  
Geographical Location ◽  
Drug Distribution ◽  
Dose Calculation ◽  
Effective Control ◽  
Years Of Experience ◽  
Community Members ◽  
Framework Approach ◽  
Control And Prevention ◽  
Community Drug Distributors ◽  
Onchocerciasis Control

Abstract Background: Community drug distributors (CDDs) have a crucial role in distributing ivermectin for onchocerciasis control and prevention. Their experiences and challenges faced in the implementation of the community-directed treatment with ivermectin (CDTI) programme could potentially affect coverage, consequently leading to persistent transmission. Therefore, this study aimed to explore CDDs experiences and challenges faced in the implementation of the CDTI programme in Ulanga, Tanzania.Methods: A qualitative study was conducted in Ulanga, Tanzania, in 2018. An in-depth interview guide was used to collect data from 5 CDDs above 18 years who were selected purposively. The analysis was performed using a thematic framework approach to generate codes, categories and themes.Results: Out of the five CDDs interviewed, two had 15 to 20 years of experience in the implementation of the CDTI programme, while the remaining CDDs had less than 10 years of experience. The main challenges faced by CDDs in the implementation of the CDTI programme include the geographical location of the hamlets (hard to reach hamlets), long distances between houses, low compliance of community members to medication due to fear of side effects experienced before and mistrust of methods of dose calculation, short time of drug distribution and absence of people from their households as the exercise was conducted when community members were involved in agricultural activities.Conclusions: The use of CDDs in the implementation of the CDTI programme has been successful despite the challenges mentioned. It is now opportune time to address the challenges that CDDs are facing in the implementation of the CDTI programme to ensure effective control of onchocerciasis in the district.

scholarly journals Implementation Challenges of Community Directed Treatment with Ivermectin Program for Control of Onchocerciasis in Ulanga, Tanzania

2021 ◽  
Vol 5 (2) ◽  
pp. 123-128
Author(s):  
Vivian Mushi
Keyword(s):  
Qualitative Data ◽  
Geographical Location ◽  
Drug Distribution ◽  
Dose Calculation ◽  
Cross Sectional Study ◽  
Effective Control ◽  
Community Members ◽  
Cross Sectional ◽  
Community Drug Distributors ◽  
Onchocerciasis Control

Background: Community drug distributors (CDDs) have a crucial role in distributing ivermectin for onchocerciasis control and prevention. Their roles, experiences and challenges faced in the implementation of community-directed treatment with ivermectin (CDTI) programme could potentially affect coverage, consequently leading to persistent transmission. Therefore, this study aimed to explore the experience and the roles which CDDs plays in implementation of community directed treatment with ivermectin program for onchocerciasis control in Ulanga, Tanzania. Methods: A cross-sectional study design was used to collect qualitative data in 2018 in Ulanga district, Tanzania. Five community drug distributors were purposively selected for in-depth interviews. Thematic framework approach for qualitative data analysis was used to generate codes, categories and themes. Results: Out of the five community drug distributors interviewed, two had experience of 15 to 20 years on implementation of the community directed treatment with ivermectin programme while the remaining community drug distributors had experience of less than 10 years. The main challenges faced by CDDs in the implementation of the CDTI programme include; the geographical location of the hamlets (hard to reach hamlets), long distances between houses, low compliance of community members to medication due to fear of side effects experienced before and mistrust of methods of dose calculation, short time of drug distribution and absence of people from their households as the exercise was conducted when community members were involved in agricultural activities. Conclusions: The challenges faced in the implementation of the CDTI programme could negatively affect the distribution and coverage of ivermectin treatment in the Ulanga district. It’s now an opportune time to address the challenges that CDDs are facing in the implementation of the CDTI programme to ensure effective control of onchocerciasis in the district.

A Multiple Streams Framework Approach to Access to Domestic Violence Services in an Indigenous Community

2021 ◽  
pp. 107780122110309
Author(s):  
Ismael Hoare ◽  
Ngozichukwuka Agu ◽  
Oluyemisi Falope ◽  
Cienna A. Wesley ◽  
Martha Coulter
Keyword(s):  
Domestic Violence ◽  
Organizational Structures ◽  
Health Department ◽  
Multiple Streams ◽  
Community Members ◽  
Multiple Streams Framework ◽  
Framework Approach ◽  
Using Data ◽  
Domestic Violence Services ◽  
Improve Access

This article focuses on access to domestic violence services within Belize. Using data from community asset mapping, interviews with key informants, and focus groups with community members, the multiple streams framework was used to identify potential areas for intervention to improve access and ameliorate the effects of family violence in Belize. Identified challenges to accessing limited domestic violence resources were mainly confidentiality concerns and mistrust. Existing laws and regulations, organizational structures, and policies and plans also influenced access. Women's groups, nongovernmental organizations, and the health department can play a crucial role in improving access to domestic violence services.

Ethical Guidelines in Pandemic Influenza: Recommendations of the Ethics Subcommittee of the Advisory Committee of the Director, Centers for Disease Control and Prevention

2009 ◽  
Vol 3 (S2) ◽  
pp. S185-S192 ◽  
Author(s):  
Kathy Kinlaw ◽  
Drue H. Barrett ◽  
Robert J. Levine
Keyword(s):  
Decision Making ◽  
Disease Control ◽  
Advisory Committee ◽  
Pandemic Influenza ◽  
Ethical Decision Making ◽  
Antiviral Drug ◽  
Drug Distribution ◽  
Ethical Considerations ◽  
Control And Prevention ◽  
Centers For Disease Control

ABSTRACTBecause of the importance of including ethical considerations in planning efforts for pandemic influenza, in February 2005 the Centers for Disease Control and Prevention requested that the Ethics Subcommittee of the Advisory Committee to the Director develop guidance that would serve as a foundation for decision making in preparing for and responding to pandemic influenza. Specifically, the ethics subcommittee was asked to make recommendations regarding ethical considerations relevant to decision making about vaccine and antiviral drug distribution prioritization and development of interventions that would limit individual freedom and create social distancing. The ethics subcommittee identified a number of general ethical considerations including identification of clear goals for pandemic planning, responsibility to maximize preparedness, transparency and public engagement, sound science, commitment to the global community, balancing individual liberty and community interests, diversity in ethical decision making, and commitment to justice. These general ethical considerations are applied to the issues of vaccine and antiviral drug distribution and use of community mitigation interventions. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S185–S192)

scholarly journals Social and Behaviour Change Communication Intervention Improves Coverage and Acceptance of Ivermectin Mass Drug Administration in Onchocerciasis Endemic Communities in Ghana: A Quasi Experimental Design

2021 ◽  
Author(s):  
Francis Adjei Osei ◽  
Sam Newton ◽  
Isaac Nyanor ◽  
Eugene Osei-Yeboah ◽  
Evans Xorse Amuzu ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Uptake Rate ◽  
Drug Distribution ◽  
Total Sample ◽  
Behaviour Change Communication ◽  
Community Members ◽  
Major Barrier ◽  
Change Communication

Abstract BackgroundPoor community awareness and social mobilization serve as a major barrier by increasing absenteeism and downplaying the relevance of the ivermectin mass distribution by community members. Inadequate awareness also creates confusion among community members especially when one intervention is mistaken for the other. MethodsWe designed a targeted Social and Behaviour Change Communication (SBCC) intervention with clearly defined and tailored messages of ivermectin MDA program targeting onchocerciasis in endemic communities in Ghana. Quasi experiment was conducted with a total sample size of 2008 at baseline and 2113 at endline. ResultsAt baseline, 63.9% respondents did not receive Ivermectin during the previous year (2019) MDA programme and more than half of them (53.3%) were not aware of the drug distribution. The communities that received the intervention at endline revealed a significantly higher increase in coverage (SATT=0.123, 95% CI=0. 0.073, 0.173, p<0.001). At baseline, uptake rate of 91.0% was recorded. Post the intervention, there was an increase in the proportion of respondents who ingested the MDA drugs (ivermectin) from 91.0% to 95.45%. Previous uptake of MDA drugs (AOR=10.67; 95%CI: 5.59-20.38, p<0.001), Perceived benefit of MDA drug (AOR=4.13; 95%CI: 1.69-10.15, p<0.001) and being aware of the MDA programme (AOR=2.28; 95%CI: 1.00-5.02, p=0.049) was associated with improved receipt of Ivermectin. ConclusionThe findings of this study reveal that SBCC intervention improves ivermectin coverage and uptake rate in mass drug administration. Further research with technological innovations which can enhance SBCC is recommended taking hind sight of the limitations of the study due to the COVID-19 pandemic.

Ukrainian Strategy and Action Plan for the Prevention of Healthcare Association Infections (HAIs) and Antimicrobial Resistance

2018 ◽  
Vol 2 (2-3) ◽  
pp. 6-23
Author(s):  
A.G. Salmanov
Keyword(s):  
Antimicrobial Resistance ◽  
Infection Control ◽  
Medical Care ◽  
Action Plan ◽  
Medical Personnel ◽  
Laboratory Diagnosis ◽  
Training System ◽  
Hospital Environment ◽  
Effective Control ◽  
Control And Prevention

The Ukrainian Strategy and Action Plan for the Prevention of Healthcare Association Infections (HAIs) and An- timicrobial Resistance defines the purpose, principles and main directions of the improvement of the National system for control and prevention of HAI and AMR pathogens of these infections, mechanisms of its functioning, as well as expected socio-economic impact. Action plan underscores the need for an effective «One Health» approach involving coordination among numer- ous international sectors and actors, including human and veterinary medicine, agriculture, environment, and well-informed consumers. The Action Plan recognizes and addresses both the variable resources nations have to combat antimicrobial resistance. The main objectives of the Ukrainian Action Plan is to improve the regulatory, legal and methodological support system of prevention of Healthcare-associated Infections (HAI), laboratory diagnosis and monitoring of AMR pathogens infections, training system for medical personnel in these fields. We are talking about the introduction of modern approaches and optimization of controls and prevention of HAI, preventing of transmission of multi re- sistance pathogens in healthcare institutions, improving the effectiveness of disinfection and sterilization measures. It is planned to create a unified system of laws and regulations that will ensure effective control and prevention of HAI and AMR, and investigation of outbreaks when they occur and ensuring of adequate compensation to victims; to prepare a standard on infection control with the compliance of mandatory requirements aimed at preventing HAI and AMR in healthcare institutions based on their profile; to create in healthcare institutions the methods of epidemiological diagnostic, based on standard criteria for determining of nosocomial infection cases by anatomic localization of infection. In addition, it is necessary to optimize the list of indications for microbiological and clinical research material and objects of hospital environment, rules of sampling and shipping of samples of biological material in the laboratory. And to develop target prevention programs for HAI and AMR at the national (country), regional and municipal levels. To implement modern technologies on infection control and monitoring of AMR in health care institutions. As a result of the Ukrainian Action Plan is expected to reduce the number of infections caused by resistant strains of microorganism’s mortality, disability and complications from infections associated with medical care, increase the employment potential of the nation by reducing temporary and permanent loss of working ability as a result of population diseases. Also, it is necessary to increase safety of patients and staff while providing medical care.

How Chinese Herbal Medicine Prevents Epidemics: From Ancient Pestilences to COVID-19 Pandemic

2021 ◽  
pp. 1-28
Author(s):  
Xia-Qiu Wu ◽  
Wei-Na Zhang ◽  
Ming-Zhao Hao ◽  
Xi-Ping Liu ◽  
Jing Xiao ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Disease Prevention ◽  
Herbal Medicines ◽  
Effective Control ◽  
Patent Medicines ◽  
Chinese Herbal ◽  
Control And Prevention ◽  
Chinese Patent ◽  
Ancient Times ◽  
Prevention Methods

The ongoing coronavirus disease 2019 (COVID-19) pandemic calls for effective control and prevention. Chinese medicine (CM) has developed systematic theories and approaches for infectious disease prevention over 2000 years. Here, we review and analyze Chinese herbal medicines (CHM) used in infectious disease prevention from ancient pestilences to modern epidemics and pandemics to share cumulative preventive medical experience. A total of 829 formulas, including 329 herbs from 189 ancient books, 131 formulas with 152 herbs, and 13 Chinese patent medicines (CPM) from 30 official Chinese prevention programs used in ancient epidemics, SARS, influenza and COVID-19 prevention, were reviewed and analyzed. Preventive CHM mainly has four functions and can be taken orally or applied externally. CHM that kill pathogens (Realgar [Xionghuang], Cyrtomium Fortunei J. Sm[Guanzhong]) were commonly used externally for disinfection in ancient prevention while CHM tonifying Qi (Astragali Radix [Huangq], Glycyrrhizae Radix et Rhizoma [Gancao]) are used for modern prevention. Taking CHM that expel pathogens (Realgar [Xionghuang], Lonicerae Japonicae Flos[Jinyinhua]) and CHM eliminating dampness (Atractylodis Rhizoma [Cangzhu], Pogostemonis Herba[Guanghuoxiang]) have been commonly used from ancient times to COVID-19. Damp toxins are a common characteristic of infectious diseases such as SARS and COVID-19. Thus, taking CHM expelling damp toxins and tonifying Qi are the main methods for SARS and COVID-19 prevention. CHM with different approaches have been widely used in infectious disease prevention from ancient times to the present. Multiple CM prevention methods may provide new perspectives for future pandemics.

scholarly journals Drawing Comparisons between SARS-CoV-2 and the Animal Coronaviruses

2020 ◽  
Vol 8 (11) ◽  
pp. 1840
Author(s):  
Souvik Ghosh ◽  
Yashpal S. Malik
Keyword(s):  
Immune Responses ◽  
Current Knowledge ◽  
Effective Control ◽  
Tissue Tropism ◽  
Prevention Strategies ◽  
Host Immune Responses ◽  
Clinical Presentations ◽  
Control And Prevention ◽  
Diversity Transmission ◽  
Complex Origin

The COVID-19 pandemic, caused by a novel zoonotic coronavirus (CoV), SARS-CoV-2, has infected 46,182 million people, resulting in 1,197,026 deaths (as of 1 November 2020), with devastating and far-reaching impacts on economies and societies worldwide. The complex origin, extended human-to-human transmission, pathogenesis, host immune responses, and various clinical presentations of SARS-CoV-2 have presented serious challenges in understanding and combating the pandemic situation. Human CoVs gained attention only after the SARS-CoV outbreak of 2002–2003. On the other hand, animal CoVs have been studied extensively for many decades, providing a plethora of important information on their genetic diversity, transmission, tissue tropism and pathology, host immunity, and therapeutic and prophylactic strategies, some of which have striking resemblance to those seen with SARS-CoV-2. Moreover, the evolution of human CoVs, including SARS-CoV-2, is intermingled with those of animal CoVs. In this comprehensive review, attempts have been made to compare the current knowledge on evolution, transmission, pathogenesis, immunopathology, therapeutics, and prophylaxis of SARS-CoV-2 with those of various animal CoVs. Information on animal CoVs might enhance our understanding of SARS-CoV-2, and accordingly, benefit the development of effective control and prevention strategies against COVID-19.

RE-ASSESSING COMMUNITY-DIRECTED TREATMENT: EVIDENCE FROM MAZABUKA DISTRICT, ZAMBIA

2014 ◽  
Vol 47 (1) ◽  
pp. 28-44 ◽  
Author(s):  
H. HALWINDI ◽  
P. MAGNUSSEN ◽  
S. SIZIYA ◽  
D. W. MEYROWITSCH ◽  
A. OLSEN
Keyword(s):  
Health Workers ◽  
Health Centre ◽  
Drug Distribution ◽  
Implementation Process ◽  
Community Members ◽  
Community Based ◽  
Cross Sectional ◽  
Child Treatment ◽  
Helminth Infections ◽  
Significant Health

SummaryCross-sectional surveys with carers, health workers, community drug distributors (CDDs) and neighbourhood health committees were conducted to identify factors associated with utilization of community-directed treatment (ComDT) of soil-transmitted helminths in children aged 12–59 months in Mazabuka district, Zambia. The surveys took place in December 2006 and December 2007. In addition child treatment records were reviewed. The factors that were found to be significantly associated (p<0.05) with treatment of children by the CDDs were: (1) the perception of soil-transmitted helminth infections as having significant health importance, (2) the community-based decision to launch and subsequently implement ComDT, (3) the use of the door-to-door method of drug distribution, (4) CDDs being visited by a supervisor, (5) CDDs receiving assistance in mobilizing community members for treatment, (6) CDDs having access to a bicycle and (7) CDDs having received assistance in collecting drugs from the health centre. Despite the effectiveness of ComDT in raising treatment coverage there are factors in the implementation process that will still affect whether children and their carers utilize the ComDT approach. Identification and understanding of these factors is paramount to achieving the desired levels of utilization of such interventions.

scholarly journals A Systematic Review to Examine the Evidence in Developing Social Prescribing Interventions That Apply a Co-Productive, Co-Designed Approach to Improve Well-Being Outcomes in a Community Setting

2021 ◽  
Vol 18 (8) ◽  
pp. 3896
Author(s):  
Gwenlli Thomas ◽  
Mary Lynch ◽  
Llinos Haf Spencer
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Community Setting ◽  
Well Being ◽  
Community Members ◽  
Assessment Development ◽  
Social Prescribing ◽  
Framework Approach ◽  
Meta Analyses ◽  
Sustainable Health

This systematic review aims to investigate the evidence in applying a co-design, co-productive approach to develop social prescribing interventions. A growing body of evidence suggests that co-production and co-design are methods that can be applied to engage service users as knowledgeable assets who can contribute to developing sustainable health services. Applying the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted. Peer-reviewed articles were sought using electronic databases, experts and grey literature. The review search concluded with eight observational studies. Quality appraisal methods were influenced by the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) Framework approach. A narrative thematic synthesis of the results was conducted. The evidence suggests that a co-design and co-productive social prescribing can lead to positive well-being outcomes among communities. Barriers and facilitators of co-production and co-design approach were also highlighted within the evidence. The evidence within this review confirms that a co-production and co-design would be an effective approach to engage stakeholders in the development and implementation of a SP intervention within a community setting. The evidence also implies that SP initiatives can be enhanced from the outset, by drawing on stakeholder knowledge to design a service that improves health and well-being outcomes for community members.

The role of the bovine respiratory bacterial microbiota in health and disease

2020 ◽  
Vol 21 (2) ◽  
pp. 168-171
Author(s):  
Trevor W. Alexander ◽  
Edouard Timsit ◽  
Samat Amat
Keyword(s):  
Pathogenic Bacteria ◽  
Management Practices ◽  
Respiratory Health ◽  
Feedlot Cattle ◽  
Effective Control ◽  
Future Application ◽  
Sequencing Technologies ◽  
Control And Prevention ◽  
Pathogen Colonization ◽  
Respiratory Microbiota

AbstractIncreased antimicrobial resistance in bovine respiratory bacterial pathogens poses a threat to the effective control and prevention of bovine respiratory disease (BRD). As part of continued efforts to develop antimicrobial alternatives to mitigate BRD, the microbial community residing within the respiratory tract of feedlot cattle has been increasingly studied using next-generation sequencing technologies. The mucosal surfaces of upper and lower respiratory tracts of cattle are colonized by a diverse and dynamic microbiota encompassing commensal, symbiotic, and pathogenic bacteria. While a direct causal relationship between respiratory microbiota and the development of BRD in feedlot cattle has not been fully elucidated, increasing evidence suggests that the microbiota contributes to respiratory health by providing colonization resistance against pathogens and maintaining homeostasis. Certain management practices such as weaning, transportation, feed transition, and antibiotic application can disrupt the respiratory microbiota, potentially altering pathogen colonization. Microbiota-based approaches, including bacterial therapeutics that target restoring the normal respiratory microbiota, may provide new methods for mitigating BRD in feedlot cattle in place of antibiotics. In addition, the distinct bacterial respiratory microbial communities observed in BRD-affected and healthy feedlot cattle may allow for future application of microbiota-based techniques used in the diagnosis of BRD.

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