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Improving drug delivery strategies for lymphatic filariasis elimination in urban areas in Ghana
- Source :
- PLoS Neglected Tropical Diseases, Vol 11, Iss 5, p e0005619 (2017), PLoS Neglected Tropical Diseases
- Publication Year :
- 2017
- Publisher :
- Public Library of Science (PLoS), 2017.
-
Abstract
- The Global Program to Eliminate Lymphatic Filariasis (GPELF) advocates for the treatment of entire endemic communities, in order to achieve its elimination targets. LF is predominantly a rural disease, and achieving the required treatment coverage in these areas is much easier compared to urban areas that are more complex. In Ghana, parts of the Greater Accra Region with Accra as the capital city are also endemic for LF. Mass Drug Administration (MDA) in Accra started in 2006. However, after four years of treatment, the coverage has always been far below the 65% epidemiologic coverage for interrupting transmission. As such, there was a need to identify the reasons for poor treatment coverage and design specific strategies to improve the delivery of MDA. This study therefore set out to identify the opportunities and barriers for implementing MDA in urban settings, and to develop appropriate strategies for MDA in these settings. An experimental, exploratory study was undertaken in three districts in the Greater Accra region. The study identified various types of non-rural settings, the social structures, stakeholders and resources that could be employed for MDA. Qualitative assessment such as in-depth interviews (IDIs) and focus group discussions (FGDs) with community leaders, community members, health providers, NGOs and other stakeholders in the community was undertaken. The study was carried out in three phases: pre-intervention, intervention and post-intervention phases, to assess the profile of the urban areas and identify reasons for poor treatment coverage using both qualitative and quantitative research methods. The outcomes from the study revealed that, knowledge, attitudes and practices of community members to MDA improved slightly from the pre-intervention phase to the post-intervention phase, in the districts where the interventions were readily implemented by health workers. Many factors such as adequate leadership, funding, planning and community involvement, were identified as being important in improving implementation and coverage of MDA in the study districts. Implementing MDA in urban areas therefore needs to be given significant consideration and planning, if the required coverage rates are to be achieved. This paper, presents the recommendations and strategies for undertaking MDA in urban areas.<br />Author summary The control of lymphatic filariasis depends on the treatment of entire endemic communities, ensuring that a greater proportion of the population is treated. In urban areas, this can be very difficult to achieve. In Ghana, parts of the Greater Accra Region, where the capital city is located, are also endemic for lymphatic filariasis. Treatment in these areas started in 2006, but the proportion of people treated has continuously been below the required programmatic coverage levels. To understand the reasons behind this, a study was undertaken in three endemic districts. The study was carried out in three stages; pre-treatment, treatment and post-treatment. Individuals and groups of people were interviewed in the pre-treatment phase, following which their concerns were used to plan and execute treatment activities. After treatment, some individuals were again interviewed to assess the effectiveness of the interventions. The results showed that the knowledge and behavior of community members towards the disease and treatment activities improved from the pre-treatment to the post-treatment reviews. Many factors were identified including, financial, management and leadership issues that should be considered when planning treatment activities in urban areas.
- Subjects :
- Health Knowledge, Attitudes, Practice
Urban Population
Psychological intervention
Surveys
Ghana
0302 clinical medicine
Quantitative research
Medicine and Health Sciences
Public and Occupational Health
030212 general & internal medicine
Lymphatic filariasis
Geographic Areas
Drug Distribution
Geography
Pharmaceutics
lcsh:Public aspects of medicine
Middle Aged
Sports Science
Filariasis
Infectious Diseases
Health Education and Awareness
Helminth Infections
Research Design
Social structure
Research Article
Urban Areas
Neglected Tropical Diseases
Adult
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
030231 tropical medicine
Exploratory research
Research and Analysis Methods
Interviews as Topic
03 medical and health sciences
Young Adult
Elephantiasis, Filarial
Adverse Reactions
Drug Therapy
Environmental health
medicine
Parasitic Diseases
Humans
Pharmacokinetics
Disease Eradication
Sports and Exercise Medicine
Mass drug administration
Exercise
Pharmacology
Survey Research
business.industry
Lymphatic Filariasis
Public Health, Environmental and Occupational Health
Biology and Life Sciences
lcsh:RA1-1270
Physical Activity
medicine.disease
Tropical Diseases
Focus group
Antiparasitic agent
Health Care
Filaricides
Physical Fitness
Earth Sciences
business
Subjects
Details
- Language :
- English
- ISSN :
- 19352735 and 19352727
- Volume :
- 11
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- PLoS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....654490f7e59a46bb898f92cb5cb817b2