Community-driven interventions can revolutionise control of neglected tropical diseases

Amazigo, Uche; Leak, S.G.A.; Zouré, Honorat; Njepuome, N; Lusamba-Dikassa, Paul-Samson

doi:10.1016/j.pt.2012.03.002

Cited by 49 publications

(45 citation statements)

References 31 publications

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“…Already many LF Elimination Programmes across Africa use the community-directed treatment with ivermectin (CDTi) strategy developed by APOC, as a platform to distribute MDA [1]. It seems sensible to extend this to include ITNs and other interventions in the remote hard-to-reach, co-endemic areas where CDTi already operates [78,81]. Finer scale mapping, using the micro-stratification overlap mapping (MOM) approach, could be used to identify the populations most at risk, so that ITNs distributions can be specifically targeted [19].…”

Section: Discussionmentioning

confidence: 99%

Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?

2013

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BackgroundThe Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000, and nearly all endemic countries in the Americas, Eastern Mediterranean and Asia-Pacific regions have now initiated the WHO recommended mass drug administration (MDA) campaign to interrupt transmission of the parasite. However, nearly 50% of the LF endemic countries in Africa are yet to implement the GPELF MDA strategy, which does not include vector control. Nevertheless, the recent scale up in insecticide treated /long lasting nets (ITNs/LLINs) and indoor residual spraying (IRS) for malaria control in Africa may significantly impact LF transmission because the parasite is transmitted mainly by Anopheles mosquitoes. This study examined the magnitude, geographical extent and potential impact of vector control in the 17 African countries that are yet to or have only recently started MDA.MethodsNational data on mosquito bed nets, ITNs/LLINs and IRS were obtained from published literature, national reports, surveys and datasets from public sources such as Demographic Health Surveys, Malaria Indicator Surveys, Multiple Indicator Cluster Surveys, Malaria Report, Roll Back Malaria and President’s Malaria Initiative websites. The type, number and distribution of interventions were summarised and mapped at sub-national level. and compared with known or potential LF distributions, and those which may be co-endemic with Loa loa and MDA is contraindicated.ResultsAnalyses found that vector control activities had increased significantly since 2005, with a three-fold increase in ITN ownership and IRS coverage. However, coverage varied dramatically across the 17 countries; some regions reported >70% ITNs ownership and regular IRS activity, while others had no coverage in remote rural populations where the risk of LF was potentially high and co-endemic with high risk L.loa.ConclusionsDespite many African countries being slow to initiate MDA for LF, the continued commitment and global financial support for NTDs, and the concurrent expansion of vector control activities for malaria, is promising. It is not beyond the capacity of GPELF to reach its target of global LF elimination by 2020, but monitoring and evaluating the impact of these activities over the next decade will be critical to its success.

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Section: Discussionmentioning

confidence: 99%

Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?

2013

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“…Evidence of the feasibility, cost-effectiveness and effective scaling up of control measures in community-driven interventions is mounting [43], [44]. However, community misunderstanding of disease control tools still poses a challenge to the success of such interventions.…”

Section: Discussionmentioning

confidence: 99%

Community Acceptance of Tsetse Control Baits: A Qualitative Study in Arua District, North West Uganda

et al. 2013

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BackgroundThere is renewed vigour in efforts to eliminate neglected tropical diseases including sleeping sickness (human African trypanosomiasis or HAT), including attempts to develop more cost-effective methods of tsetse control. In the West Nile region of Uganda, newly designed insecticide-treated targets are being deployed over an area of ∼500 km2. The operational area covers villages where tsetse control has not been conducted previously. The effectiveness of the targets will depend, in part, on their acceptance by the local community.Methodology/Principal FindingsWe assessed knowledge, perceptions and acceptance of tsetse baits (traps, targets) in villages where they had or had not been used previously. We conducted sixteen focus group discussions with male and female participants in eight villages across Arua District. Discussions were audio recorded, translated and transcribed. We used thematic analysis to compare the views of both groups and identify salient themes.Conclusions/SignificanceDespite the villages being less than 10 km apart, community members perceived deployed baits very differently. Villagers who had never seen traps before expressed fear, anxiety and panic when they first encountered them. This was related to associations with witchcraft and “ghosts from the river” which are traditionally linked with physical or mental illness, death and misfortune. By contrast, villagers living in areas where traps had been used previously had positive attitudes towards them and were fully aware of their purpose and benefits. The latter group reported that they had similar negative perceptions when tsetse control interventions first started a decade ago. Our results suggest that despite their proximity, acceptance of traps varies markedly between villages and this is related to the duration of experience with tsetse control programs. The success of community-based interventions against tsetse will therefore depend on early engagements with communities and carefully designed sensitization campaigns that reach all communities, especially those living in areas new to such interventions.

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“…In addition to infectious disease [38], family planning and maternal and child health are areas in which the integration of vertical and horizontal care has been reported [11, 39, 40]. Although the vertical approach may also yield positive “spill-over,” in which focused health initiatives in one disease area or population also benefit the health system as a whole [41]; the diagonal approach embraces these broader impacts as a primary aim instead of as a welcome externality.…”

Section: Horizontal and Vertical Approaches: Benefits And Limitationsmentioning

confidence: 99%

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Patel

Hoyler

Maine

et al. 2012

Plastic Surgery International

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Global cleft surgery missions have provided much-needed care to millions of poor patients worldwide. Still, surgical capacity in low- and middle-income countries is generally inadequate. Through surgical missions, global cleft care has largely ascribed to a vertical model of healthcare delivery, which is disease specific, and tends to deliver services parallel to, but not necessarily within, the local healthcare system. The vertical model has been used to address infectious diseases as well as humanitarian emergencies. By contrast, a horizontal model for healthcare delivery tends to focus on long-term investments in public health infrastructure and human capital and has less often been implemented by humanitarian groups for a variety of reasons. As surgical care is an integral component of basic healthcare, the plastic surgery community must challenge itself to address the burden of specific disease entities, such as cleft lip and palate, in a way that sustainably expands and enriches global surgical care as a whole. In this paper, we describe a diagonal care delivery model, whereby cleft missions can enrich surgical capacity through integration into sustainable, local care delivery systems. Furthermore, we examine the applications of diagonal development to cleft care specifically and global surgical care more broadly.

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Community-driven interventions can revolutionise control of neglected tropical diseases

Cited by 49 publications

References 31 publications

Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?

Can malaria vector control accelerate the interruption of lymphatic filariasis transmission in Africa; capturing a window of opportunity?

Community Acceptance of Tsetse Control Baits: A Qualitative Study in Arua District, North West Uganda

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

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