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The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya

BACKGROUND: Lymphatic filariasis (LF), a neglected tropical disease (NTD) and leading cause of global disability, is endemic in 32 countries in Africa with almost 350 million people requiring regular drug administration, and only 16 countries achieving target coverage. Community Drug Distributors (C...

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Autores principales: Kusi, Caroline, Steinmann, Peter, Merten, Sonja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050125/
https://www.ncbi.nlm.nih.gov/pubmed/32114985
http://dx.doi.org/10.1186/s40249-020-0638-1
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author Kusi, Caroline
Steinmann, Peter
Merten, Sonja
author_facet Kusi, Caroline
Steinmann, Peter
Merten, Sonja
author_sort Kusi, Caroline
collection PubMed
description BACKGROUND: Lymphatic filariasis (LF), a neglected tropical disease (NTD) and leading cause of global disability, is endemic in 32 countries in Africa with almost 350 million people requiring regular drug administration, and only 16 countries achieving target coverage. Community Drug Distributors (CDDs) are critical for the success of NTD programs, and the distribution of medicines during mass drug administration (MDA) in Africa; however they could also be a weak link. The primary aim of this study is to explore and describe perceptions of CDDs during MDA for LF in Mvita sub-county in Mombasa county and Kaloleni sub-county in Kilifi county, Kenya; and provide recommendations for the effective engagement of communities and CDDs in low-resource settings. METHODS: In September 2018, we conducted six focus group discussions with community members in each sub-county, three with men aged 18–30, 31–50, and 51 years and above and three with women stratified into the same age groups. In each sub-county, we also conducted semi-structured interviews with nine community health extension workers (CHEWs), the national LF focal point, the county NTD focal points, and seven community leaders. Content analysis of the data was conducted, involving a process of reading, coding, and displaying data in order to develop a codebook. RESULTS: We found that several barriers and facilitators impact the engagement between CDDs and community members during MDA. These barriers include poor communication and trust between CDDs and communities; community distrust of the federal government; low community knowledge and perceived risk of LF, poor timing of MDA, fragmented supervision of CDDs during MDA; and CDD bias when distributing medicines. We also found that CDD motivation was a critical factor in their ability to successfully meet MDA targets. It was acknowledged that directly observed treatment and adequate health education were often not executed by CDDs. The involvement of community leaders as informal supervisors of CDDs and community members improves MDA. CONCLUSIONS: In order to achieve global targets around the elimination of LF, CDDs and communities must be effectively engaged by improving planning and implementation of MDA.
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spelling pubmed-70501252020-03-05 The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya Kusi, Caroline Steinmann, Peter Merten, Sonja Infect Dis Poverty Research Article BACKGROUND: Lymphatic filariasis (LF), a neglected tropical disease (NTD) and leading cause of global disability, is endemic in 32 countries in Africa with almost 350 million people requiring regular drug administration, and only 16 countries achieving target coverage. Community Drug Distributors (CDDs) are critical for the success of NTD programs, and the distribution of medicines during mass drug administration (MDA) in Africa; however they could also be a weak link. The primary aim of this study is to explore and describe perceptions of CDDs during MDA for LF in Mvita sub-county in Mombasa county and Kaloleni sub-county in Kilifi county, Kenya; and provide recommendations for the effective engagement of communities and CDDs in low-resource settings. METHODS: In September 2018, we conducted six focus group discussions with community members in each sub-county, three with men aged 18–30, 31–50, and 51 years and above and three with women stratified into the same age groups. In each sub-county, we also conducted semi-structured interviews with nine community health extension workers (CHEWs), the national LF focal point, the county NTD focal points, and seven community leaders. Content analysis of the data was conducted, involving a process of reading, coding, and displaying data in order to develop a codebook. RESULTS: We found that several barriers and facilitators impact the engagement between CDDs and community members during MDA. These barriers include poor communication and trust between CDDs and communities; community distrust of the federal government; low community knowledge and perceived risk of LF, poor timing of MDA, fragmented supervision of CDDs during MDA; and CDD bias when distributing medicines. We also found that CDD motivation was a critical factor in their ability to successfully meet MDA targets. It was acknowledged that directly observed treatment and adequate health education were often not executed by CDDs. The involvement of community leaders as informal supervisors of CDDs and community members improves MDA. CONCLUSIONS: In order to achieve global targets around the elimination of LF, CDDs and communities must be effectively engaged by improving planning and implementation of MDA. BioMed Central 2020-03-02 /pmc/articles/PMC7050125/ /pubmed/32114985 http://dx.doi.org/10.1186/s40249-020-0638-1 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kusi, Caroline
Steinmann, Peter
Merten, Sonja
The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya
title The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya
title_full The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya
title_fullStr The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya
title_full_unstemmed The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya
title_short The fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal Kenya
title_sort fight against lymphatic filariasis: perceptions of community drug distributors during mass drug administration in coastal kenya
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050125/
https://www.ncbi.nlm.nih.gov/pubmed/32114985
http://dx.doi.org/10.1186/s40249-020-0638-1
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