Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T17:08:50.353Z Has data issue: false hasContentIssue false

RE-ASSESSING COMMUNITY-DIRECTED TREATMENT: EVIDENCE FROM MAZABUKA DISTRICT, ZAMBIA

Published online by Cambridge University Press:  15 May 2014

H. HALWINDI*
Affiliation:
Department of Public Health, School of Medicine, University of Zambia, Lusaka, Zambia
P. MAGNUSSEN
Affiliation:
DBL-Centre for Health Research and Development, University of Copenhagen, Frederiksberg, Denmark
S. SIZIYA
Affiliation:
Department of Clinical Sciences, School of Medicine, Copperbelt University, Ndola, Zambia
D. W. MEYROWITSCH
Affiliation:
Section of Health Services Research, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
A. OLSEN
Affiliation:
DBL-Centre for Health Research and Development, University of Copenhagen, Frederiksberg, Denmark
*
1Corresponding author. Email: [email protected]

Summary

Cross-sectional surveys with carers, health workers, community drug distributors (CDDs) and neighbourhood health committees were conducted to identify factors associated with utilization of community-directed treatment (ComDT) of soil-transmitted helminths in children aged 12–59 months in Mazabuka district, Zambia. The surveys took place in December 2006 and December 2007. In addition child treatment records were reviewed. The factors that were found to be significantly associated (p<0.05) with treatment of children by the CDDs were: (1) the perception of soil-transmitted helminth infections as having significant health importance, (2) the community-based decision to launch and subsequently implement ComDT, (3) the use of the door-to-door method of drug distribution, (4) CDDs being visited by a supervisor, (5) CDDs receiving assistance in mobilizing community members for treatment, (6) CDDs having access to a bicycle and (7) CDDs having received assistance in collecting drugs from the health centre. Despite the effectiveness of ComDT in raising treatment coverage there are factors in the implementation process that will still affect whether children and their carers utilize the ComDT approach. Identification and understanding of these factors is paramount to achieving the desired levels of utilization of such interventions.

Type
Articles
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

African Program for Onchocerciasis Control (1998) Community-Directed Treatment with Ivermectin: A Practical Guide for Trainers of Community-Directed Distributors. APOC, Ouagadougou.Google Scholar
Albonico, M., Allen, H., Chitsulo, L., Engels, D., Gabrielli, A-F.et al. (2008) Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy. PLoS Neglected Tropical Diseases 2(3), e126. doi: 10.1371/journal.pntd.0000126CrossRefGoogle ScholarPubMed
Amazigo, U., Okeibunor, J., Matovu, V., Zouré, H., Bump, J. & Seketeli, A. (2007) Performance of predictors: evaluating sustainability in community-directed treatment projects of the African programme for onchocerciasis control. Social Science & Medicine 64, 20702082.Google Scholar
Amazigo, U. V., Brieger, W. R., Katabarwa, M., Akogun, O., Ntep, M., Boatin, B.et al. (2002a) The challenges of community-directed treatment with ivermectin (CDTI) within the African Programme for Onchocerciasis Control (APOC). Annals of Tropical Medicine and Parasitology 96(1), S4158.Google Scholar
Amazigo, U. V., Obono, O. M., Dadzie, K. Y., Remme, J., Jiya, J., Nyomugyenyi, R.et al. (2002b) Monitoring community-directed treatment programmes for sustainability: lessons from African Programme for Onchocerciasis control (APOC). Annals of Tropical Medicine and Parasitology 96(1), S7592.CrossRefGoogle ScholarPubMed
Atack, J. & Margo, R. A. (2011) The impact of access to rail transportation on agricultural improvement. Journal of Transport and Land Use 2, 518.Google Scholar
Brieger, W. R., Otusanya, S. A., Oke, G. A., Oshiname, F. O. & Adeniyi, J. D. (2002) Factors associated with coverage in community-directed treatment with ivermectin for onchocerciasis control in Oyo State, Nigeria. Tropical Medicine and Parasitology 7(1), 1118.Google ScholarPubMed
Burnham, G. & Mebrahtu, T. (2004) Review: the delivery of ivermectin (Mectizan). Tropical Medicine and International Health 9(4), A2644.Google Scholar
Emukah, E. C., Enyinnaya, U., Olaniran, N. S., Akpan, E. A., Hopkins, D. R., Miri, E. S.et al. (2008) Factors affecting the attrition of community-directed distributors of ivermectin, in an onchocerciasis-control programme in the Imo and Abia states of south-eastern Nigeria. Annals of Tropical Medicine and Parasitology 102(1), 4551.Google Scholar
Geissler, P. W. (1998) Worms are our life. Part 1: Perceptions of worms among Luo people in Western Kenya. Anthropology and Medicine 5, 6979.Google Scholar
Halwindi, H. (2002) Soil transmitted helminths: an ethnographic study of the community perspective, lay beliefs and practices in Ngombe, Zambia. MPhil thesis, University of Oslo.Google Scholar
Halwindi, H., Magnussen, P., Siziya, S., Handema, R., Meyrowitsch, D. W. & Olsen, A. (2010) Effect on treatment coverage of adding community-directed treatment to the health facility-based approach of delivering anthelminthic drugs to under-five children during child health week in Mazabuka district, Zambia. International Health 2, 253261.Google Scholar
Halwindi, H., Magnussen, P., Siziya, S., Handema, R., Meyrowitsch, D. & Olsen, A. (2011) Impact of community-directed treatment on soil transmitted helminth infections in children aged 12 to 59 months in Mazabuka District, Zambia. Parasitology 138, 15781585.CrossRefGoogle Scholar
Katabarwa, N. M., Habomugisha, P. & Richards, F. O. Jr (2002a) Implementing community-directed treatment with ivermectin for the control of onchocerciasis in Uganda (1997–2000): an evaluation. Annals of Tropical Medicine and Parasitology 96(1), 6173.Google Scholar
Katabarwa, N. M., Habomugisha, P., Richards, F. O. Jr & Hopkins, D. (2005) Community-directed interventions strategy enhances efficient and effective integration of health care delivery and development activities in rural disadvantaged communities of Uganda. Tropical Medicine and International Health 10(4), 312321.Google Scholar
Katabarwa, N. M. & Mutubazi, D. (2000) Controlling onchocerciasis by community-directed, ivermectin-treatment programmes in Uganda: why do some communities succeed and others fail? Annals of Tropical Medicine and Parasitology 94(4), 343352Google Scholar
Katabarwa, N. M., Mutabazi, D. & Richards, F. O. Jr (2000) Controlling onchocerciasis by community-directed, ivermectin-treatment programmes in Uganda: why do some communities succeed and others fail? Annals of Tropical Medicine and Parasitology 94(4), 343352.Google Scholar
Katabarwa, N. M., Richards, F. O. Jr & Ndyomugyenyi, R. (2002b) In rural Ugandan communities the traditional kinship/clan system is vital to the success and sustainment of the African Programme for Onchocerciasis Control. Annals of Tropical Medicine and Parasitology 94(5), 485495.Google Scholar
Katabarwa, N. M., Richards, F. O. Jr & Rakers, L. (2004) Kinship structure and health-care improvement in sub-Saharan Africa. Lancet 26, 363(9427), 2194.Google Scholar
Madon, T., Hofman, K. J., Kupfer, L. & Glass, R. I. (2008) Public health implementation science. Science 218, 17281729.Google Scholar
Morse, J. M. & Field, P. A. (1995) Qualitative Research Methods for Health Professionals. Sage Publications, Thousand Oaks, London, New Delhi.Google Scholar
Ndyomugyenyi, R. & Kabatereine, N. (2003) Integrated community-directed treatment for the control of onchocerciasis, schistosomiasis and intestinal helminths infections in Uganda: advantages and disadvantages. Tropical Medicine and International Health 8, 9971004.Google Scholar
Nuwaha, F., Okware, J. & Ndyomungyenyi, R. (2005) Predictors of compliance with community-directed ivermectin treatment in Uganda: quantitative results. Tropical Medicine and International Health 10(7), 659667.Google Scholar
Panter-Brick, C., Clarke, S. E., Lomas, H., Pinder, M. & Lindsay, S. W. (2006) Culturally compelling strategies for behavior change: a social ecology model and case study in malaria prevention. Social Science & Medicine 62(11), 28102825.CrossRefGoogle ScholarPubMed
Parker, M. & Allen, T. (2011) Does mass administration for the integrated treatment of neglected tropical diseases really work? Assessing evidence for control of scistosomiasis and soil transmitted helminths in Uganda. Health Research Policy and Systems 9, 3.Google Scholar
Parker, M. & Allen, T. (2013) Will mass drug administration eliminate lymphatic filariasis? Evidence from Northern Coastoal Tanzania. Journal of Biosocial Science 45(4), 517545.CrossRefGoogle ScholarPubMed
Ramaiah, K. D., Vijay Kumar, K. N. & Ramu, K. (1996) Knowledge and beliefs about transmission, prevention and control of lymphatic filariasis in rural areas of south India. Tropical Medicine and International Health 4, 433438.CrossRefGoogle Scholar
Rosenstock, I. M. (1966) Why people use health services. Milbank Memorial Fund Quarterly 44(3), 94127.Google Scholar
TDR (2007) Fostering an Effective Global Research Effort on Infectious Diseases of Poverty in which Disease Endemic Countries Play a Vital Role. TDR business plan 2008–2013. UNICEF/UNDP/World Bank/WHO.Google Scholar
TDR (2008) Community-Directed Interventions for Major Health Problems in Africa. A multi-country study final report. UNICEF/UNDP/World Bank/WHO.Google Scholar
Ulin, P. R., Elizabeth, T. R., Tolley, E. E. (2005) Qualitative Methods in Public Health: A Field Guide for Applied Research. Jossey-Brass, USA, p. 91.Google Scholar
World Health Organization (1996) Report of the WHO Informal Consultation on the Use of Chemotherapy for Control of Morbidity due to Soil-Transmitted Nematodes in Humans. Geneva, 29 April–1st May 1996. WHO/CTD/SIP/96.2, Geneva.Google Scholar