Background:In 2017,the Centre for Global Health(CGH)at the University of Oslo in collaboration with the Coalition for Epidemic Preparedness Innovations(CEPI)and the Norwegian Agency for Development Cooperation(Norad)h...Background:In 2017,the Centre for Global Health(CGH)at the University of Oslo in collaboration with the Coalition for Epidemic Preparedness Innovations(CEPI)and the Norwegian Agency for Development Cooperation(Norad)held a meeting to discuss together with leading figures in disease control,research and development the issue of neglected tropical diseases and emerging/re-emerging infectious diseases.This commentary has taken up this discussion and the conclusions drawn at this meeting to make a case for the opportunity the Sustainable Development Goals(SDGs)provide in highlighting the interconnectedness of factors that are relevant in the successful fight against neglected tropical diseases(NTDs)and emerging infectious diseases(EIDS).Main body:Despite NTDs being endemic and EIDS being epidemic,in order to prevent both disease groups effectively,it is important to appreciate that they share essential health determining faaors,namely:neglect,poverty,a lack of access to clean water and sanitation facilities and an absence of or severely limited provision of healthcare as well as in many cases a zoonotic nature.Instead of looking to"simple disease management for the answer,the SDGs help to understand the interplay of multiple priority areas and thereby help to promote a more holistic approach to addressing these two disease groups.Conclusions:Their commonalities mean that the Global Health community should leverage opportunities and efforts in the prevention and elimination of both NTDs and EIDs.Doing so using a One Health approach is considered to offer a"public health best-buy".Concrete solutions are proposed.展开更多
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...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-struaured 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.展开更多
文摘Background:In 2017,the Centre for Global Health(CGH)at the University of Oslo in collaboration with the Coalition for Epidemic Preparedness Innovations(CEPI)and the Norwegian Agency for Development Cooperation(Norad)held a meeting to discuss together with leading figures in disease control,research and development the issue of neglected tropical diseases and emerging/re-emerging infectious diseases.This commentary has taken up this discussion and the conclusions drawn at this meeting to make a case for the opportunity the Sustainable Development Goals(SDGs)provide in highlighting the interconnectedness of factors that are relevant in the successful fight against neglected tropical diseases(NTDs)and emerging infectious diseases(EIDS).Main body:Despite NTDs being endemic and EIDS being epidemic,in order to prevent both disease groups effectively,it is important to appreciate that they share essential health determining faaors,namely:neglect,poverty,a lack of access to clean water and sanitation facilities and an absence of or severely limited provision of healthcare as well as in many cases a zoonotic nature.Instead of looking to"simple disease management for the answer,the SDGs help to understand the interplay of multiple priority areas and thereby help to promote a more holistic approach to addressing these two disease groups.Conclusions:Their commonalities mean that the Global Health community should leverage opportunities and efforts in the prevention and elimination of both NTDs and EIDs.Doing so using a One Health approach is considered to offer a"public health best-buy".Concrete solutions are proposed.
文摘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-struaured 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.
