The awareness of neglected tropical diseases in a sample of medical and nursing students in Cairo University, Egypt: A cross-sectional study

Mamba³

et al. 2021

Preprint

Background Mass drug administration (MDA) is one of the key interventions recommended by WHO for prevention and control of neglected tropical diseases. In Malawi, MDA is widely carried out annually since 2012 for prevention and control of schistosomiasis and soil transmitted helminths (STH). No study has been carried out to assess effectiveness of the approach and to document perceptions of health providers and beneficiaries regarding use of MDA. This study aimed to examine perceived strengths and weaknesses, successes and failures, as well as health providers’ and beneficiaries’ perspectives of implementing the strategy in Malawi. Methods As a cross-sectional implementation research, the study was carried out in three southern Malawi districts of Chiradzulu, Mangochi and Zomba. In each district, four health centres and 16 villages were randomly selected to participate. A mixed-methods approach to data collection focusing on quantitative data for coverage and knowledge, attitudes and practices assessments; and qualitative data for assessing perceptions of health providers and beneficiaries regarding MDA was used. Quantitative data were processed and analyzed using IBM SPSS software version 26 while qualitative data were analysed using NVivo 12 for Windows. Results Knowledge levels about schistosomiasis and STH in the districts varied according to disease aspects asked about. Majority are more knowledgeable about what schistosomiasis is (78%) and whether STH are treatable with drugs (97%); with least knowledgeable about the organism that transmits schistosomiasis (18%), types of schistosomiasis (11%) and what causes STH (20%). In 2018 and 2019 the districts registered high coverage rates for praziquantel and albendazole using community-based MDA (73%-100%) and using school-based MDA (75%-91%). Both the health authorities and community members perceived the MDA approach as good because it brings treatment closer to people. Conclusion With the high MDA coverage obtained in schools and communities, the implementation of MDA in the target districts is satisfactory. There are, however, several challenges including disproportionate knowledge levels, which are hampering progress towards attainment of the 2030 global NTD goals. There is a need for promotion of community participation and partnerships as well as implementation of other recommended interventions for sustainable prevention and control of schistosomiasis and STH.

Section: Community Participation In Mda Deliverysupporting

confidence: 86%

Section: Community Participation In Mda Deliverymentioning

confidence: 93%

An Assessment of Implementation of Mass Drug Administration for Prevention and Control of Schistosomiasis and Soil-Transmitted Helminths in Selected Southern Malawi Districts

Makaula¹,

Mamba³

et al. 2021

Preprint

“…This may have challenged the people in fully understanding these diseases, and for them to appreciate the importance of MDA and other control measures. The findings agree with other studies done in Malawi [7], Philippines [27], Nigeria [28], Egypt [29], Cameroon [30], Papua New Guinea [31] and Turkey [32] demonstrating that despite implementation of numerous activities towards the control of NTDs, there was little sensitization of the general public in order to increase awareness of the diseases. The need to engage the public in schistosomiasis and STH prevention and control activities has become imperative in the context of morbidity reduction through MDA delivery and community participation.…”

Section: Discussionsupporting

confidence: 90%

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

Makaula

Mamba

et al. 2022

Preprint

Preventive chemotherapy using mass drug administration (MDA) is one of the key interventions recommended by WHO, to control neglected tropical diseases. In Malawi, health workers distribute anti-helminthic drugs annually with most support from donors. The mean community coverage of MDA from 2018 to 2020 were high at 87% for praziquantel and 82% for albendazole, however posing a sustainability challenge once donor support diminishes. This study was conducted to compare use of the community-directed intervention (CDI) approach with the use of health workers in delivery of MDA. It was carried out in three districts, where cross-sectional, mixed-methods approach to data collection during baseline and follow-up assessments was used. Knowledge levels were high for what schistosomiasis is (65% - 88%) and what STH are (32% - 83%); and low for what causes schistosomiasis (32% - 58%), causes of STH (7% - 37%), intermediate organisms for schistosomiasis (13% - 33%) and types of schistosomiasis (2% - 26%). At follow-up, increases in praziquantel coverage were registered in control (86% to 89%) and intervention communities (83% to 89%); decreases were recorded for control (86% to 53%) and intervention schools (79% to 59%). Assessment of the costs for implementation of the study indicated that most resources were used at community (51%), health centre (29%) and district levels (19%). The intervention arm used more resources at health centre (27%) and community levels (44%) than the control arm at 2% and 4% respectively. Health workers and community members perceived the use of the CDI approach as a good initiative and more favorable over the standard practice of delivering MDA. The use of the CDI in delivery of MDA campaigns against schistosomiasis and STH is feasible, increases coverage and is acceptable in intervention communities. This could be a way forward addressing the sustainability concern when donor support wanes.

“…The need to engage the public in NTD prevention and control activities has become imperative in the context of morbidity reduction through MDA delivery and community participation [ 51 ]. An increase in the awareness of community members regarding schistosomiasis and STH is important for them to understand these diseases and to play a central role in their prevention and control [ 52 ]. This study has found that knowledge levels about schistosomiasis and STH varied disproportionately among survey respondents according to aspects asked about and district.…”

Section: Discussionmentioning

confidence: 99%

An assessment of implementation and effectiveness of mass drug administration for prevention and control of schistosomiasis and soil-transmitted helminths in selected southern Malawi districts

Makaula¹,

Mamba

et al. 2022

BMC Health Serv Res

Background Mass drug administration (MDA) is one of the key interventions recommended by WHO for prevention and control of neglected tropical diseases (NTD). In Malawi, MDA is widely carried out annually since 2009 for prevention and control of schistosomiasis and soil-transmitted helminths (STH). No study has been carried out to assess effectiveness of the MDA approach and to document perceptions of health providers and beneficiaries regarding use of MDA. This study was done to understand how well MDA is being implemented and to identify opportunities for improvement in MDA delivery in Malawi. Methods Designed as a cross-sectional and multi-methods research, the study was carried out in three southern Malawi districts of Chiradzulu, Mangochi and Zomba. In each district, four health centres and 16 villages were randomly selected to participate. A mixed-methods approach to data collection focusing on quantitative data for coverage and knowledge, attitudes and practices assessments; and qualitative data for assessing perceptions of health providers and beneficiaries regarding MDA was used. Quantitative data were processed and analyzed using IBM SPSS software version 26 while qualitative data were analysed using NVivo 12 for Windows. Results Knowledge levels about schistosomiasis and STH in the districts varied according to disease aspects asked about. Majority are more knowledgeable about what schistosomiasis is (78%) and whether STH are treatable with drugs (97%); with least knowledgeable about the organism that transmits schistosomiasis (18%), types of schistosomiasis (11%) and what causes STH (20%). In 2018 and 2019 the districts registered high coverage rates for praziquantel and albendazole using community-based MDA (73–100%) and using school-based MDA (75–91%). Both the health authorities and community members perceived the MDA approach as good because it brings treatment closer to people. Conclusion With the high MDA coverage obtained in communities and schools, the effectiveness of MDA in the target districts is satisfactory. There are, however, several challenges including disproportionate knowledge levels, which are hampering progress towards attainment of the 2030 global NTD goals. There is a need for promotion of community participation and partnerships as well as implementation of other recommended interventions for sustainable prevention and control of schistosomiasis and STH.