Mass drug administration campaigns: comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected Southern Malawi districts

被引:1
作者
Makaula, Peter [1 ,2 ]
Kayuni, Sekeleghe Amos [2 ,3 ,4 ]
Mamba, Kondwani Chidzammbuyo [5 ]
Bongololo, Grace [1 ]
Funsanani, Mathias [1 ]
Juziwelo, Lazarus Tito [6 ]
Musaya, Janelisa [2 ,7 ]
Furu, Peter [8 ]
机构
[1] Res Hlth Environm & Dev, POB 345, Mangochi, Malawi
[2] Malawi Liverpool Wellcome Res Programme, Private Bag 30096, Blantyre 3, Malawi
[3] Med Clin Ltd, Med Aid Soc Malawi MASM, Area 12 Med Clin,POB 31659, Lilongwe 3, Malawi
[4] Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, England
[5] Mangochi Dist Council, Dist Hlth Off, POB 42, Mangochi, Malawi
[6] Minist Hlth, Natl Schistosomiasis & Soil Transmitted Helminths, Community Hlth Sci Unit, Private Bag 65, Lilongwe, Malawi
[7] Kamuzu Univ Hlth Sci, Dept Pathol, Private Bag 360, Blantyre 3, Malawi
[8] Univ Copenhagen, Dept Publ Hlth, Global Hlth Sect, 5 Oster Farimagsgade, DK-1014 Copenhagen K, Denmark
关键词
Mass drug administration; Community-directed intervention; Neglected tropical diseases; Schistosomiasis; Soil-transmitted helminths; HAEMATOBIUM INFECTION; PRAZIQUANTEL; COVERAGE;
D O I
10.1186/s12913-023-10489-5
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
BackgroundMass drug administration is one of the key interventions recommended by WHO to control certain NTDs. With most support from donors, health workers distribute antihelminthic drugs annually in Malawi. Mean community coverage of MDA from 2018 to 2020 was high at 87% for praziquantel and 82% for albendazole. However, once donor support diminishes sustaining these levels will be challenging. This study intended to compare the use of the community-directed intervention approach with the standard practice of using health workers in delivery of MDA campaigns.MethodsThis was a controlled implementation study carried out in three districts, where four health centres and 16 villages in each district were selected and randomly assigned to intervention and control arms which implemented MDA campaigns using the CDI approach and the standard practice, respectively. Cross-sectional and mixed methods approach to data collection was used focusing on quantitative data for coverage and knowledge levels and qualitative data to assess perceptions of health providers and beneficiaries at baseline and follow-up assessments. Quantitative and qualitative data were analyzed using IBM SPSS software version 26 and NVivo 12 for Windows, respectively.ResultsAt follow-up, knowledge levels increased, majority of the respondents were more knowledgeable about what schistosomiasis was (41%-44%), its causes (41%-44%) and what STH were (48%-64%), while knowledge on intermediate host for schistosomiasis (19%-22%), its types (9%-13%) and what causes STH (15%-16%) were less known both in intervention and control arm communities. High coverage rates for praziquantel were registered in intervention (83%-89%) and control (86%-89%) communities, intervention (59%-79) and control (53%-86%) schools. Costs for implementation of the study indicated that the intervention arm used more resources than the control arm. Health workers and community members perceived the use of the CDI approach as a good initiative and more favorable over the standard practice.ConclusionsThe use of the CDI in delivery of MDA campaigns against schistosomiasis and STH appears feasible, retains high coverages and is acceptable in intervention communities. Despite the initial high costs incurred, embedding into community delivery platforms could be considered as a possible way forward addressing the sustainability concern when current donor support wanes.Trial registrationPan-African Clinical Trials Registry PACTR202102477794401, date: 25/02/2021.
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页数:15
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