scholarly journals Eliminating Neglected Tropical Diseases in Urban Areas: A Review of Challenges, Strategies and Research Directions for Successful Mass Drug Administration

2018 ◽  
Vol 3 (4) ◽  
pp. 122 ◽  
Author(s):  
Alayne Adams ◽  
Myriam Vuckovic ◽  
Eleanor Birch ◽  
Tara Brant ◽  
Stephanie Bialek ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Rural Areas ◽  
Urban Areas ◽  
Neglected Tropical Diseases ◽  
Monitoring And Evaluation ◽  
Population Heterogeneity ◽  
Tropical Diseases ◽  
Urban Settings ◽  
Context Specific

Since 1950, the global urban population grew from 746 million to almost 4 billion and is expected to reach 6.4 billion by mid-century. Almost 90% of this increase will take place in Asia and Africa and disproportionately in urban slums. In this context, concerns about the amplification of several neglected tropical diseases (NTDs) are warranted and efforts towards achieving effective mass drug administration (MDA) coverage become even more important. This narrative review considers the published literature on MDA implementation for specific NTDs and in-country experiences under the ENVISION and END in Africa projects to surface features of urban settings that challenge delivery strategies known to work in rural areas. Discussed under the thematics of governance, population heterogeneity, mobility and community trust in MDA, these features include weak public health infrastructure and programs, challenges related to engaging diverse and dynamic populations and the limited accessibility of certain urban settings such as slums. Although the core components of MDA programs for NTDs in urban settings are similar to those in rural areas, their delivery may need adjustment. Effective coverage of MDA in diverse urban populations can be supported by tailored approaches informed by mapping studies, research that identifies context-specific methods to increase MDA coverage and rigorous monitoring and evaluation.

scholarly journals Costs of Integrated Mass Drug Administration for Neglected Tropical Diseases in Haiti

2011 ◽  
Vol 85 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Ann S. Goldman ◽  
Molly A. Brady ◽  
Luccene Desir ◽  
Abdel Direny ◽  
Roland Oscard ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases

scholarly journals Can we eradicate trachoma? A survey of stakeholders

2020 ◽  
pp. bjophthalmol-2020-315815
Author(s):  
Catherine E Oldenburg ◽  
Solomon Aragie ◽  
Abdou Amza ◽  
Anthony W Solomon ◽  
Jessica Brogdon ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Operational Research ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
Tropical Diseases ◽  
Important Goal ◽  
Tremendous Progress ◽  
Global Eradication

Background/AimsAlthough tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.MethodsWe conducted a survey at the beginning of a trachoma eradication session at the 2019 Coalition for Operational Research on Neglected Tropical Diseases meeting in National Harbor, Maryland, USA. We asked respondents what the most important goal of azithromycin mass drug administration was for trachoma (control, elimination of infection or eradication) and if and when they believed trachoma eradication would occur. We then asked what the biggest obstacles were to global eradication.ResultsFifty-six surveys were returned (95%). Most (91%) participants reported that the most important goal of azithromycin mass drug administration was control or elimination of infection, and 24% of participants reported that global eradication was not possible. Of the 76% who reported a year by which they believed trachoma could be eradicated, most fell between 2040 and 2050. Commonly cited barriers to global eradication included lack of surveillance tools to confirm eradication or monitor for infection recrudescence (32%) and lack of resources (23%).ConclusionsDevelopment of alternative indicators for trachoma surveillance and continued investment in trachoma programmes, particularly focused support in the most heavily affected populations, might increase enthusiasm for the feasibility of eradication.

scholarly journals Understanding the Role of Health Workers in the LF Elimination Program in Kenya: Challenges Faced and Suggestions for Improved Program Performance

2021 ◽  
Vol 3 (1) ◽  
pp. 126-144
Author(s):  
Bridget W Kimani ◽  
Lydiah Wanjiku Kibe ◽  
Collins Okoyo ◽  
Wyckliff P Omondi ◽  
Hadley Matendechero Sultani ◽  
...  
Keyword(s):  
Community Health ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
Program Performance ◽  
Health Extension Workers ◽  
Treatment Coverage ◽  
Study Results ◽  
Community Drug Distributors

The Kenyan Ministry of Health and its partners through the Division of Vector-Borne and Neglected Tropical Diseases, is in charge of the Lymphatic Filariasis Mass Drug Administration programme. This is implemented through the national, county, and sub-county neglected tropical diseases coordinators. The current study sought to understand the roles, challenges faced and suggestions of how program performance can be improved by the community health extension workers, county and sub-county neglected tropical diseases coordinators. Two wards of the Kaloleni sub-county; Kilifi County were purposively selected. In 2015, Kaloleni and Kayafungo wards had a treatment coverage of 58% and 54% respectively; 62% and 39% respectively in 2016, all below the recommended minimum treatment coverage of 65%.  Qualitative data was collected through sixteen in-depth interviews with community health extension workers and two semi-structured interviews with the county and sub-county neglected tropical diseases coordinators. Data were analysed by QSR NVIVO version 10 according to identified themes. The study results show the various roles in planning and implementation of the program include; supply chain management; health information education communication and records management; health workforce training and management, leadership and governance, and service delivery. Challenges faced included insufficiency of drugs supplied and information education communication materials, the inadequacy of community drug distributors selected and trained, poor facilitation for training and supervision of community drug distributors, limited duration of the mass drug administration, and delayed reporting due to poor network coverage. The results of this study show that the community health extension workers, county and sub-county neglected tropical diseases coordinators are not fully involved in program leadership and governance, a role that is taken up at the national level. They should be involved in all the stages of the mass drug administration program to create ownership to improve the program performance

scholarly journals Gender equity in mass drug administration for neglected tropical diseases: data from 16 countries

2019 ◽  
Vol 11 (5) ◽  
pp. 370-378 ◽  
Author(s):  
Daniel A Cohn ◽  
Maureen P Kelly ◽  
Kalpana Bhandari ◽  
Kathryn L Zoerhoff ◽  
Wilfrid E Batcho ◽  
...  
Keyword(s):  
Gender Equity ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
The Sustainable Development ◽  
Substantial Progress ◽  
Development Goals ◽  
Disaggregated Data ◽  
All Diseases

Abstract Background Gender equity in global health is a target of the Sustainable Development Goals and a requirement of just societies. Substantial progress has been made towards control and elimination of neglected tropical diseases (NTDs) via mass drug administration (MDA). However, little is known about whether MDA coverage is equitable. This study assesses the availability of gender-disaggregated data and whether systematic gender differences in MDA coverage exist. Methods Coverage data were analyzed for 4784 district-years in 16 countries from 2012 through 2016. The percentage of districts reporting gender-disaggregated data was calculated and male–female coverage compared. Results Reporting of gender-disaggregated coverage data improved from 32% of districts in 2012 to 90% in 2016. In 2016, median female coverage was 85.5% compared with 79.3% for males. Female coverage was higher than male coverage for all diseases. However, within-country differences exist, with 64 (3.3%) districts reporting male coverage >10 percentage points higher than female coverage. Conclusions Reporting of gender-disaggregated data is feasible. And NTD programs consistently achieve at least equal levels of coverage for women. Understanding gendered barriers to MDA for men and women remains a priority.

scholarly journals RUMOURS, RIOTS AND THE REJECTION OF MASS DRUG ADMINISTRATION FOR THE TREATMENT OF SCHISTOSOMIASIS IN MOROGORO, TANZANIA

2016 ◽  
Vol 48 (S1) ◽  
pp. S16-S39 ◽  
Author(s):  
Julie Hastings
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
Urinary Schistosomiasis ◽  
School Aged Children ◽  
Biomedical Intervention ◽  
Resource Poor ◽  
The Village ◽  
Programme Staff

SummaryIn 2008 in Morogoro region, Tanzania, mass drug administration (MDA) to school-aged children to treat two neglected tropical diseases (NTDs) – urinary schistosomiasis and soil-transmitted helminths – was suspended by the Ministry of Health and Social Welfare after riots broke out in schools where drugs were being administered. This article discusses why this biomedical intervention was so vehemently rejected, including an eyewitness account. As the protest spread to the village where I was conducting fieldwork, villagers accused me of bringing medicine into the village with which to ‘poison’ the children and it was necessary for me to leave immediately under the protection of the Tanzanian police. The article examines the considerable differences between biomedical and local understandings of one of these diseases, urinary schistosomiasis. Such a disjuncture was fuelled further by the apparent rapidity of rolling out MDA and subsequent failures in communication between programme staff and local people. Rumours of child fatalities as well as children’s fainting episodes and illnesses following treatment brought about considerable conjecture both locally and nationally that the drugs had been either faulty, counterfeit, hitherto untested on humans or part of a covert sterilization campaign. The compelling arguments by advocates of MDA for the treatment of NTDs rest on the assumption that people suffering from these diseases will be willing to swallow the medicine. However, as this article documents, this is not always the case. For treatment of NTDs to be successful it is not enough for programmes to focus on economic and biomedical aspects of treatment, rolling out ‘one size fits all’ programmes in resource-poor settings. It is imperative to develop a biosocial approach: to consider the local social, biological, historical, economic and political contexts in which these programmes are taking place and in which the intended recipients of treatment live their lives. If this is not done, the world’s poor will continue to be neglected.

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