scholarly journals “Stopping the itch”: mass drug administration for scabies outbreak control covered for over nine million people in Ethiopia

2020 ◽  
Vol 14 (06.1) ◽  
pp. 28S-35S
Author(s):  
Wendemagegn Enbiale ◽  
Tariku Belachew Baynie ◽  
Ashenafie Ayalew ◽  
Tekilehayimanot Gebrehiwot ◽  
Tesfa Getanew ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Large Scale ◽  
Health Workers ◽  
Scale Up ◽  
Monitoring And Evaluation ◽  
National Guidelines ◽  
Awareness Raising ◽  
Treatment Category ◽  
Local Leaders

Introduction: In 2018, the Ethiopian Ministry of Health embarked on a Mass Drug Administration (MDA) campaign that involved over 9 million people in Ethiopia – the largest scabies MDA campaign ever conducted on a global level. We describe its implementation and report on a) numbers screened and identified with scabies, b) treatment category and drug type and c) human resources used, duration, and cost of the campaign. Methodology: The MDA campaign was conducted according to national guidelines and activities including: planning and organization, engagement of local leaders, community mobilisation and advocacy, awareness-raising among health workers, field implementation, and monitoring and evaluation. The campaign was conducted between July and August 2018. Results: The MDA campaign was implemented by about 15,000 people, mostly from the community, over an average of 6 days and reached 9, 057, 427 people. A total of 875,890 (9.7%) scabies cases were detected and 995,471 (11.0%) contacts received treatment. (Contact-to-case ratio = 1.3). Scabies prevalence varied, the highest prevalence was seen in Central Gondar (39.2%), South Gondar (16.7%) and North Gondar (15.0%), these neighbouring zones contributing more than two third of all scabies cases in the region. Of 1,738,304 (93%) who received treatment, 94% received ivermectin, the rest topical permethrin and sulfur. The average coverage capacity of an MDA campaign staff member was 84 people per day. The total cost was 11,696,333 United States Dollars (USD). Cost per 100,000 population = 129,135 USD. Conclusions: This experience of rapid-large scale implementation would be useful to scale up similar interventions and “stop the itch” in other regions of Ethiopia.

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.

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 The Health and Economic Burdens of Lymphatic Filariasis Prior to Mass Drug Administration Programs

2019 ◽  
Vol 70 (12) ◽  
pp. 2561-2567 ◽  
Author(s):  
Christopher G Mathew ◽  
Alison A Bettis ◽  
Brian K Chu ◽  
Mike English ◽  
Eric A Ottesen ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Economic Burden ◽  
Scale Up ◽  
Public Health Problem ◽  
Clinical Disease ◽  
Productivity Costs ◽  
Symptomatic Disease ◽  
Life Years

Abstract Background The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000 with the goal of eliminating lymphatic filariasis (LF) as a public health problem by 2020. Despite considerable progress, the current prevalence is around 60% of the 2000 figure, with the deadline looming a year away. Consequently, there is a continued need for investment in both the mass drug administration (MDA) and morbidity management programs, and this paper aims to demonstrate that need by estimating the health and economic burdens of LF prior to MDA programs starting in GPELF areas. Methods A previously developed model was used to estimate the numbers of individuals infected and individuals with symptomatic disease, along with the attributable number of disability-adjusted life years (DALYs). The economic burden was calculated by quantifying the costs incurred by the health-care system in managing clinical cases, the patients’ out-of-pocket costs, and their productivity costs. Results Prior to the MDA program, approximately 129 million people were infected with LF, of which 43 million had clinical disease, corresponding to a DALY burden of 5.25 million. The average annual economic burden per chronic case was US $115, the majority of which resulted from productivity costs. The total economic burden of LF was estimated at US $5.8 billion annually. Conclusions These results demonstrate the magnitude of the LF burden and highlight the continued need to support the GPELF. Patients with clinical disease bore the majority of the economic burden, but will not benefit much from the current MDA program, which is aimed at reducing transmission. This assessment further highlights the need to scale up morbidity management programs.

scholarly journals Peran Tenaga Pelaksana Eliminasi dalam Pelaksanaan Program Pemberian Obat Secara Massal (POPM) Filariasis di Kota Pekalongan

2020 ◽  
Vol 19 (1) ◽  
pp. 14-18
Author(s):  
Herlysse Jorghi Jorghi ◽  
Praba Ginandjar ◽  
Nissa Kusariana ◽  
Lintang Dian Saraswati
Keyword(s):  
Family Member ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Research Method ◽  
Health Workers ◽  
Family Members ◽  
Cross Sectional ◽  
Target Family ◽  
The Given

Latar belakang: Penyakit Filariasis merupakan penyakit yang disebabkan oleh cacing filaria. Kota Pekalonganmerupakan kota dengan endemis filariasis dan telah dilakukan Program Pemberian Obat secara Massal (POPM) sejak tahun 2011 hingga 2015, Namun, hasil Survei Darah Jari (SDJ) menunjukkan nilai Mikrofilaria Rate di Kota  Pekalongan  masih  >  1%.  Penelitian  ini  bertujuan  untuk  menggambarkan  peran  Tenaga  Pelaksana Eliminasi (TPE) filariasis dan hambatan yang ditemui pada pelaksanaan POPM di Kota Pekalongan.Metode: Penelitian ini merupakan penelitian cross sectiona. Jumlah sampel 95 orang petugas TPE dengan menggunakan simple ramdom sampling. Pengumpulan data dengan wawancara menggunakan kuesioner.  Hasil: Hasil penelitian menunjukkan bahwa EP dalam memilih anggota keluarga target yang akan dirawat adalah optimal (63,2%). EP dalam membantu puskesmas menentukan dosis dan pemberian obat-obatan untuk masing-masing keluarga yang dibantu (52,6%). EP dalam merekam keluarga yang dibantu yang minum obat pada kartu sudah optimal (55,8%). EP dalam memantau dan mencatat reaksi perawatan yang mungkin timbul dan melaporkan kepada petugas kesehatan adalah optimal (61,1%).Simpulan: Peran tenaga pelaksana eliminasi TPE di Kota Pekalongan dalam menyeleksi anggota keluarga binaan yang akan diobati, dalam membantu puskesmas menentukan dosis dan pemberian obat pada setiap keluarga binaan, dalam pencatatan keluarga binaan yang meminum obat pada kartu, dan dalam pengawasan dan pencatatan reaksi pengobatan yang mungkin timbul serta pelaporan kepada petugas kesehatan sudah optimalKata kunci: Filariasis, Tenaga Pelaksana EliminasiABSTRACT Title: The role of Elimination Personnel (EP) implementing filariasis MDA in Pekalongan City Background: Filariasis is a disease caused by filarial worms, Pekalongan City has carried out filariasis MDA (Mass Drug Administration) since 2011-2015. However, the results of the Finger Blood Survey (SDJ) showed that the microfilaria rate was > 1%. This study aims to describe the role of Elimination Personnel (EP) and the obstacles faced in implementing filariasis MDA in Pekalongan City.Method: This study used a cross sectional research method. Sampling in this study used simple random side, total 95 respondents. Data obtained by structure interviews using questionnaires.Result: The results showed that EP in selecting the target family members to be treated is optimal (63.2%). EP in helping puskesmas determine the dosage and administration of medicines for each of the assisted families (52.6%). EP in recording the assisted families who drank the medicine on the card was optimal (55.8%). EP in monitoring and recording treatment reactions that may arise and reporting to health workers was optimal (61.1%).Conclusion: The roles of TPE elimination workers of Pekalongan City were optimum, such as selecting family member who will be treated, helping Puskesmas in deciding the dosage and giving the medicine to every treated family, record of treated family who take the medicine in the given card, and in the supervision and record of medical reaction that might happen and reporting it to health workers.Keywords: Filariasis, Elimination Personnel  

scholarly journals Princess PrEP program: the first key population-led model to deliver pre-exposure prophylaxis to key populations by key populations in Thailand

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 542 ◽  
Author(s):  
Nittaya Phanuphak ◽  
Thanthip Sungsing ◽  
Jureeporn Jantarapakde ◽  
Supabhorn Pengnonyang ◽  
Deondara Trachunthong ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Scale Up ◽  
Incidence Rates ◽  
Key Populations ◽  
National Guidelines ◽  
Condomless Sex ◽  
Key Population ◽  
Exposure Prophylaxis

Background No data are available on the feasibility of pre-exposure prophylaxis (PrEP) delivered by trained key population (KP) community health workers. Herein we report data from the KP-led Princess PrEP program serving men who have sex with men (MSM) and transgender women (TGW) in Thailand. Methods: From January 2016 to December 2017, trained MSM and TGW community health workers delivered same-day PrEP service in community health centres, allowing clients to receive one PrEP bottle to start on the day of HIV-negative testing. Visits were scheduled at Months 1 and 3, and every 3 months thereafter. Uptake, retention and adherence to PrEP services and changes in risk behaviours over time are reported. Results: Of 1467 MSM and 230 TGW who started PrEP, 44.1% had had condomless sex in the past 3 months. At Months 1, 3, 6, 9 and 12, retention was 74.2%, 64.0%, 56.2%, 46.7% and 43.9% respectively (lower in TGW than MSM at all visits; P<0.001), with adherence to at least four PrEP pills per week self-reported by 97.4%, 96.8%, 96.5%, 97.5% and 99.5% of respondents respectively (no difference between MSM and TGW). Logistic regression analysis identified age >25 years, being MSM and having at least a Bachelors degree significantly increased retention. Condomless sex did not change over the 12-month period (from 47.2% to 45.2%; P=0.20). New syphilis was diagnosed in 4.9% and 3.0% of PrEP clients at Months 6 and 12 (cf. 7.0% at baseline; P=0.007). Among PrEP adherers and non-adherers, there were one and six HIV cases of seroconversion respectively, which resulted in corresponding HIV incidence rates (95% confidence interval) of 0.27 (0.04–1.90) and 1.36 (0.61–3.02) per 100 person-years. Conclusion: Our KP-led PrEP program successfully delivered PrEP to MSM and TGW. Innovative retention supports are needed, especially for TGW and those who are young or with lower education levels. To scale-up and sustain KP-led PrEP programs, strong endorsement from international and national guidelines is necessary.

scholarly journals Multidimensional complexities of filariasis control in an era of large-scale mass drug administration programmes: a can of worms

2014 ◽  
Vol 7 (1) ◽  
pp. 363 ◽  
Author(s):  
David H Molyneux ◽  
Adrian Hopkins ◽  
Mark H Bradley ◽  
Louise A Kelly-Hope
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Large Scale

scholarly journals A tale of ‘politics and stars aligning’: analysing the sustainability of scaled up digital tools for front-line health workers in India

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005041
Author(s):  
Neha S Singh ◽  
Kerry Scott ◽  
Asha George ◽  
Amnesty Elizabeth LeFevre ◽  
Rajani Ved
Keyword(s):  
Service Delivery ◽  
State Government ◽  
Large Scale ◽  
Health Workers ◽  
Digital Health ◽  
Scale Up ◽  
Government Procurement ◽  
Digital Tools ◽  
Front Line ◽  
Data Governance

IntroductionIndia has become a lighthouse for large-scale digital innovation in the health sector, particularly for front-line health workers (FLHWs). However, among scaled digital health solutions, ensuring sustainability remains elusive. This study explores the factors underpinning scale-up of digital health solutions for FLHWs in India, and the potential implications of these factors for sustainability.MethodsWe assessed five FLHW digital tools scaled at the national and/or state level in India. We conducted in-depth interviews with implementers, technology and technical partners (n=11); senior government stakeholders (n=5); funders (n=1) and evaluators/academics (n=3). Emergent themes were grouped according to a broader framework that considered the (1) digital solution; (2) actors; (3) processes and (4) context.ResultsThe scale-up of digital solutions was facilitated by their perceived value, bounded adaptability, support from government champions, cultivation of networks, sustained leadership and formative research to support fit with the context and population. However, once scaled, embedding digital health solutions into the fabric of the health system was hampered by challenges related to transitioning management and ownership to government partners; overcoming government procurement hurdles; and establishing committed funding streams in government budgets. Strong data governance, continued engagement with FLHWs and building a robust evidence base, while identified in the literature as critical for sustainability, did not feature strongly among respondents. Sustainability may be less elusive once there is more consensus around the roles played between national and state government actors, implementing and technical partners and donors.ConclusionThe use of digital tools by FLHWs offers much promise for improving service delivery and health outcomes in India. However, the pathway to sustainability is bespoke to each programme and should be planned from the outset by investing in people, relationships and service delivery adjustments to navigate the challenges involved given the dynamic nature of digital tools in complex health systems.

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