scholarly journals Community Drug Distributor Knowledge, Attitudes, and Motivation Surrounding Mass Drug Administration for Soil-Transmitted Helminths in India

2021 ◽  
Vol 9 ◽  
Author(s):  
Kumudha Aruldas ◽  
Saravanakumar Puthupalayam Kaliappan ◽  
Gideon John Israel ◽  
Gokila Palanisamy ◽  
Jabaselvi Johnson ◽  
...  

Background: DeWorm3 is an ongoing multi-country community-based cluster-randomized trial assessing the feasibility of interrupting transmission of soil-transmitted helminths (STH) with community-wide mass drug administration (cMDA). In Tamil Nadu, India, community drug distributors (CDDs) worked with DeWorm3 field staff to counsel community members and deliver door-to-door deworming treatment. As CDDs were likely to influence successful delivery of cMDA, we describe drivers of CDDs' knowledge, attitudes, and motivation toward delivery of cMDA.Methods: In this convergent mixed-methods study, a questionnaire on STH and cMDA was administered to 104 CDDs and 17 focus group discussions (FGDs) were conducted. Key outcomes in the quantitative and qualitative analyses included CDDs' knowledge about STH and cMDA and attitudes toward cMDA for STH. Univariate and multivariable logistic regression analyses were performed to determine the strength of associations between independent and outcome variables. The FGDs were analyzed using a priori thematic coding.Results: CDDs who completed at least secondary school education [adjusted odds ratio (aOR): 2.71, 95% CI: 1.16–6.33] and had prior experience in health programs (aOR: 2.72, 95% CI: 1.15–6.44) were more knowledgeable about STH and cMDA. CDDs belonging to the scheduled castes and scheduled tribes (aOR: 2.37, 95% CI: 1.04–5.39), and to households engaged in a skilled occupation (aOR: 2.77, 95% CI: 1.21–6.34) had a more positive attitude toward cMDA for STH. The FGDs showed that while there were myths and misconceptions about STH, many CDDs believed that the adult population in their communities were infected with STH, and that a door-to-door drug delivery strategy would be optimal to reach adults.Conclusions: Educational and socioeconomic backgrounds and experience in health programs should be considered while designing CDD trainings. Along with cMDA delivery for STH, as CDD do share community myths and misconceptions around STH, they should be proactively addressed during the CDD training to strengthen competency in counseling.

2020 ◽  
Vol 103 (3) ◽  
pp. 1329-1334
Author(s):  
John D. Hart ◽  
Lyson Samikwa ◽  
Feston Sikina ◽  
Khumbo Kalua ◽  
Jeremy D. Keenan ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049734
Author(s):  
Katya Galactionova ◽  
Maitreyi Sahu ◽  
Samuel Paul Gideon ◽  
Saravanakumar Puthupalayam Kaliappan ◽  
Chloe Morozoff ◽  
...  

ObjectiveTo present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination of soil-transmitted helminths.DesignTailored data collection instruments covering resource use, expenditure and operational details were developed for each site. These were populated alongside field activities by on-site staff. Data quality control and validation processes were established. Programmed routines were used to clean, standardise and analyse data to derive costs of cMDA and supportive activities.SettingField site and collaborating research institutions.Primary and secondary outcome measuresA strategy for costing interventions in parallel with field activities was discussed. Interim estimates of cMDA costs obtained with the strategy were presented for one of the trial sites.ResultsThe study demonstrated that it was both feasible and advantageous to collect data alongside field activities. Practical decisions on implementing the strategy and the trade-offs involved varied by site; trialists and local partners were key to tailoring data collection to the technical and operational realities in the field. The strategy capitalised on the established processes for routine financial reporting at sites, benefitted from high recall and gathered operational insight that facilitated interpretation of the estimates derived. The methodology produced granular costs that aligned with the literature and allowed exploration of relevant scenarios. In the first year of the trial, net of drugs, the incremental financial cost of extending deworming of school-aged children to the whole community in India site averaged US$1.14 (USD, 2018) per person per round. A hypothesised at-scale routine implementation scenario yielded a much lower estimate of US$0.11 per person treated per round.ConclusionsWe showed that costing interventions alongside field activities offers unique opportunities for collecting rich data to inform policy toward optimising health interventions and for facilitating transfer of economic evidence from the field to the programme.Trial registration numberNCT03014167; Pre-results.


PLoS Medicine ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. e1002839 ◽  
Author(s):  
Gary J. Weil ◽  
Joshua Bogus ◽  
Michael Christian ◽  
Christine Dubray ◽  
Yenny Djuardi ◽  
...  

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