scholarly journals THE NATIONAL CAMPAIGN FOR THE MASS TREATMENT OF TRACHOMA: MONITORING COVERAGE AND PRACTICES OF MASS DRUG ADMINISTRATION (MDA) IN YEMEN- FOLLOW-UP STUDY

2021 ◽  
Author(s):  
Essam Yahya A Alshamahi ◽  
Sameha A. Al-Eryani ◽  
Bushra Mohammed Jaadan ◽  
Prof. Dr. Hassan A. Al-Shamahy ◽  
Amal Abdulslam Al Haddad ◽  
...  
Keyword(s):  
Peer Review ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
World Health ◽  
Community Collaboration ◽  
Analysis Tool ◽  
Survey Analysis ◽  
Bacterial Conjunctivitis ◽  
Incorrect Position ◽  
Sensitivity Pattern

Background:  Trachoma is a communicable infection of the eye by certain strains of the Chlamydia trachomatis. It is the principal cause of loss of sight globally. Mass drug administration (MDA) with azithromycin is a foundation stone of World Health Organization (WHO)’s global struggle to eradicate trachoma by 2020.  Aims: The main objectives of the campaign's third monitoring are to check improvement of interventions and improvement of quality across times and activities implemented in seven selected districts of Ibb and Al-Hodeida governorates, Yemen. Methods: A community based cross-sectional coverage survey was performed. 68 divisions were selected per selected districts of the two governorates. A disconnect Results Entry Form for each district surveyed was finished, saved and uploaded directly into the online Coverage Survey Analysis Tool to check improvement of interventions and improvement of quality across times and activities implemented. Results: The national campaign for MDA covers 966 villages in 6 districts of Ibb and Al-Hodeidah governorates by 1932 healthcare workers. A total number of beneficiaries who were monitored from 476 homes reached 3,077, of whom 2,755 (90%, coverage rate) took the dose. The availability rates of trachoma medicines were ranged from 82% to 91% . The improper arrangement of treatment sessions rate was 17%, the incorrect position of the dose pole was 6%, while the correct records of drugs scored the rate of 99%, and the proper storage of drugs rate was 70%.  The community collaboration during the treatment campaign the acceptable rate was 92%, while 3% exhibited unacceptable behaviors towards the treatment campaign. Conclusion: In this survey, the national campaign for MDA in the 966 villages reach the target threshold (i.e. 90%) for effective coverage; with proper rates for the availability of trachoma medicines, good people reactions towards taking treatment,  and  the community collaboration; while bad rates for the improper arrangement of treatment sessions , the incorrect position of the dose pole and  the preparation dosages by MDA team. Hence, programmatic enhancement should be made for the future campaign to achieve the estimated thresholds.                    Peer Review History: Received 8 March 2021; Revised 29 March; Accepted 25 April, Available online 15 May 2021 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Bilge Ahsen KARA,  Ankara Gazi Mustafa Kemal Hospital, Turkey, [email protected] Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, [email protected] Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Similar Articles: BACTERIAL CAUSES AND ANTIMICROBIAL SENSITIVITY PATTERN OF EXTERNAL OCULAR INFECTIONS IN SELECTED OPHTHALMOLOGY CLINICS IN SANA’A CITY BACTERIAL CONJUNCTIVITIS OF ADULTS: CAUSES AND OPHTHALMIC ANTIBIOTIC RESISTANCE PATTERNS FOR THE COMMON BACTERIAL ISOLATES

scholarly journals Antimicrobial Resistance Following Azithromycin Mass Drug Administration: Potential Surveillance Strategies to Assess Public Health Impact

2019 ◽  
Vol 70 (7) ◽  
pp. 1501-1508 ◽  
Author(s):  
Ines Mack ◽  
Mike Sharland ◽  
James A Berkley ◽  
Nigel Klein ◽  
Surbhi Malhotra-Kumar ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Controlled Trial ◽  
Population Level ◽  
Health Impact ◽  
Childhood Mortality ◽  
World Health ◽  
Current Evidence ◽  
Multiresistant Pathogens ◽  
Microbiological Techniques

Abstract The reduction in childhood mortality noted in trials investigating azithromycin mass drug administration (MDA) for trachoma control has been confirmed by a recent large randomized controlled trial. Population-level implementation of azithromycin MDA may lead to selection of multiresistant pathogens. Evidence suggests that repeated azithromycin MDA may result in a sustained increase in macrolide and other antibiotic resistance in gut and respiratory bacteria. Current evidence comes from standard microbiological techniques in studies focused on a time-limited intervention, while MDA implemented for mortality benefits would likely repeatedly expose the population over a prolonged period and may require a different surveillance approach. Targeted short-term and long-term surveillance of resistance emergence to key antibiotics, especially those from the World Health Organization Access group, is needed throughout any implementation of azithromycin MDA, focusing on a genotypic approach to overcome the limitations of resistance surveillance in indicator bacteria.

scholarly journals The contribution of mass drug administration to global health: past, present and future

2014 ◽  
Vol 369 (1645) ◽  
pp. 20130434 ◽  
Author(s):  
Joanne P. Webster ◽  
David H. Molyneux ◽  
Peter J. Hotez ◽  
Alan Fenwick
Keyword(s):  
Global Health ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
World Health Organisation ◽  
Essential Medicines ◽  
World Health ◽  
Diagnostic Tools ◽  
Preventive Chemotherapy ◽  
High Coverage

Mass drug administration (MDA) is a means of delivering safe and inexpensive essential medicines based on the principles of preventive chemotherapy, where populations or sub-populations are offered treatment without individual diagnosis. High-coverage MDA in endemic areas aims to prevent and alleviate symptoms and morbidity on the one hand and can reduce transmission on the other, together improving global health. MDA is the recommended strategy of the World Health Organisation to control or eliminate several neglected tropical diseases (NTDs). More than 700 million people now receive these essential NTD medicines annually. The combined cost of integrated NTD MDA has been calculated to be in the order of $0.50 per person per year. Activities have recently been expanded due, in part, to the proposed attempt to eliminate certain NTDs in the coming two decades. More than 1.9 billion people need to receive MDA annually across several years if these targets are to be met. Such extensive coverage will require additional avenues of financial support, expanded monitoring and evaluation focusing on impact and drug efficacy, as well as new diagnostic tools and social science strategies to encourage adherence. MDA is a means to help reduce the burden of disease, and hence poverty, among the poorest sector of populations. It has already made significant improvements to global health and productivity and has the potential for further successes, particularly where incorporated into sanitation and education programmes. However logistical, financial and biological challenges remain.

scholarly journals From Informed Consent to Adherence: Factors Influencing Involvement in Mass Drug Administration With Ivermectin for Malaria Elimination in The Gambia

2020 ◽  
Author(s):  
Alexandra E. Fehr ◽  
Claudia Nieto-Sanchez ◽  
Joan Muela ◽  
Fatou Jaiteh ◽  
Omar Ceesay ◽  
...  
Keyword(s):  
Decision Making ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Social Dynamics ◽  
The Gambia ◽  
World Health ◽  
Cross Sectional Survey ◽  
Enabling Factors ◽  
Cross Sectional ◽  
Medication Costs

Abstract Background: The World Health Organization (WHO) recommends consideration of mass drug administration (MDA) for malaria control in low-endemic settings approaching elimination. However, MDA remains a controversial strategy, as multiple individual, social, and operational factors have shown to affect its acceptability at local levels. This is further complicated by inconsistent definitions of key indicators derived from individual and community involvement — coverage, adherence, and compliance— that cast doubts about the actual and potential epidemiological impact of MDA on disease control. This study aimed to identify limitations and enabling factors impacting involvement at different stages of a large cluster-randomized trial assessing the effect of combining dihydroartemisinin-piperaquine (DP) and ivermectin (IVM) in malaria transmission in The Gambia. Methods: This social science study used a mixed-methods approach. Qualitative data were collected in intervention and control villages through ethnographic methods, including in-depth interviews (IDIs), focus group discussions (FGDs), and participant observation conducted with trial participants and decliners, community leaders, and field staff. A cross-sectional survey was conducted in the intervention villages after the first year of MDA. Both strands of the study explored malaria knowledge and opinions, social dynamics influencing decision-making, as well as perceived risks, burdens, and benefits associated with this MDA.Results: 157 IDIs and 11 FGDs were conducted, and 864 respondents were included in the survey. Barriers and enabling factors to involvement were differentially influential at the various stages of the MDA. Issues of social influence, concerns regarding secondary effects of the medication, costs associated with malaria, and acceptability of the implementing organization, among other factors, differently affected the decision-making processes throughout the trial. Rather than a linear trajectory, involvement in this MDA trial was subjected to multiple revaluations from enrolment and consent to medicine intake and adherence to treatment. Conclusions: Our study went beyond the individual factors often associated with coverage and adherence, and found that nuanced social dynamics greatly influence the decision-making process at all phases of the trial. These issues need to be consider for MDA implementation strategies and inform discussions about more accurate ways of reporting on critical effectiveness indicators.

scholarly journals Stopping azithromycin mass drug administration for trachoma: A systematic review

2021 ◽  
Vol 15 (7) ◽  
pp. e0009491
Author(s):  
Hamidah Mahmud ◽  
Emma Landskroner ◽  
Abdou Amza ◽  
Solomon Aragie ◽  
William W. Godwin ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
World Health ◽  
Chlamydia Infection ◽  
Measurement Tool ◽  
Infection Prevalence ◽  
Qualitative Synthesis ◽  
Active Trachoma ◽  
Published Evidence ◽  
Over Time

The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1–9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regions with low prevalence of active trachoma may have little if any ocular chlamydia, and, thus, may not benefit from azithromycin treatment. Understanding what happens to active trachoma and ocular chlamydia prevalence after stopping azithromycin MDA may improve future treatment decisions. We systematically reviewed published evidence for community prevalence of both active trachoma and ocular chlamydia after cessation of azithromycin distribution. We searched electronic databases for all peer-reviewed studies published before May 2020 that included at least 2 post-MDA surveillance surveys of ocular chlamydia and/or the active trachoma marker, trachomatous inflammation–follicular (TF) prevalence. We assessed trends in the prevalence of both indicators over time after stopping azithromycin MDA. Of 140 identified studies, 21 met inclusion criteria and were used for qualitative synthesis. Post-MDA, we found a gradual increase in ocular chlamydia infection prevalence over time, while TF prevalence generally gradually declined. Ocular chlamydia infection may be a better measurement tool compared to TF for detecting trachoma recrudescence in communities after stopping azithromycin MDA. These findings may guide future trachoma treatment and surveillance efforts.

scholarly journals A community survey of coverage and adverse events following country-wide triple-drug mass drug administration for lymphatic filariasis elimination, Samoa 2018

2020 ◽  
Vol 14 (11) ◽  
pp. e0008854
Author(s):  
Gabriela A. Willis ◽  
Helen J. Mayfield ◽  
Therese Kearns ◽  
Take Naseri ◽  
Robert Thomsen ◽  
...  
Keyword(s):  
Adverse Events ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Total Population ◽  
Community Survey ◽  
World Health ◽  
Cross Sectional ◽  
Eligible Population ◽  
Health Organization

The Global Programme to Eliminate Lymphatic Filariasis has made considerable progress but is experiencing challenges in meeting targets in some countries. Recent World Health Organization guidelines have recommended two rounds of triple-drug therapy with ivermectin, diethylcarbamazine (DEC), and albendazole (IDA), in areas where mass drug administration (MDA) results with two drugs (DEC and albendazole) have been suboptimal, as is the case in Samoa. In August 2018, Samoa was the first country in the world to implement countrywide triple-drug MDA. This paper aims to describe Samoa’s experience with program coverage and adverse events (AEs) in the first round of triple-drug MDA. We conducted a large cross-sectional community survey to assess MDA awareness, reach, compliance, coverage and AEs in September/October 2018, 7–11 weeks after the first round of triple-drug MDA. In our sample of 4420 people aged ≥2 years (2.2% of the population), age-adjusted estimates indicated that 89.0% of the eligible population were offered MDA, 83.9% of the eligible population took MDA (program coverage), and 80.2% of the total population took MDA (epidemiological coverage). Overall, 83.8% (2986/3563) reported that they did not feel unwell at all after taking MDA. Mild AEs (feeling unwell but able to do normal everyday things) were reported by 13.3% (476/3563) and moderate or severe AEs (feeling unwell and being unable to do normal everyday activities such as going to work or school) by 2.9% (103/3563) of participants. This study following the 2018 triple-drug MDA in Samoa demonstrated a high reported program awareness and reach of 90.8% and 89.0%, respectively. Age-adjusted program coverage of 83.9% of the total population showed that MDA was well accepted and well tolerated by the community.

scholarly journals The promise, problems and pitfalls of mass drug administration for malaria elimination: a qualitative study with scientists and policymakers

2018 ◽  
Vol 11 (3) ◽  
pp. 166-176 ◽  
Author(s):  
Nils Kaehler ◽  
Bipin Adhikari ◽  
Phaik Yeong Cheah ◽  
Nicholas P J Day ◽  
Daniel H Paris ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Malaria Elimination ◽  
Artemisinin Resistance ◽  
Malaria Prevention ◽  
Evidence Base ◽  
World Health ◽  
Pilot Studies ◽  
Target Populations ◽  
Health Organization

Abstract Background The emergence of artemisinin resistance in the Greater Mekong Subregion (GMS) has prompted urgent containment measures. One possible approach is mass drug administration (MDA). This article explores attitudes towards and perceptions of MDA for malaria elimination among policymakers and leading malariologists. Methods Thirty-two semistructured interviews (SSI) were conducted with policymakers (n=17) and principal investigators (n=15) selected based on their involvement in malaria prevention, control and elimination in the GMS. Interviews were audio recorded and transcribed for qualitative content (thematic) analysis using NVivo (QSR International, Doncaster, Victoria, Australia). Results Researchers and policymakers described reluctance and consequently delays to pilot MDA for malaria elimination. Most policymakers and some researchers reported concerns around the evidence base, citing a lack of data on its effectiveness and appropriate target populations. There were also worries about promoting resistance. Other issues included a previous lack of support from the World Health Organization, past MDAs, the remoteness of target populations and challenges explaining the rationale for MDA. Conclusions The complex rationale for MDA for malaria elimination, mistaking pilot studies for implementation, past experiences with MDA, difficulties in selecting appropriate sites and the WHO’s lack of clear backing undermined the support for MDA for malaria elimination.

scholarly journals The Added Value of Water, Sanitation, and Hygiene Interventions to Mass Drug Administration for Reducing the Prevalence of Trachoma: A Systematic Review Examining

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Anyess Travers ◽  
Sheryl Strasser ◽  
Stephanie L. Palmer ◽  
Christine Stauber
Keyword(s):  
Systematic Review ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Added Value ◽  
World Health ◽  
Sanitation And Hygiene ◽  
Pubmed Database ◽  
Health Organization ◽  
Hygiene Education ◽  
The Impact

Trachoma is the leading cause of infectious blindness worldwide. The SAFE strategy, the World Health Organization-recommended method to eliminate blinding trachoma, combines developments in water, sanitation, surgery, and antibiotic treatment. Current literature does not focus on the comprehensive effect these components have on one another. The present systematic review analyzes the added benefit of water, sanitation, and hygiene education interventions to preventive mass drug administration of azithromycin for trachoma. Trials were identified from the PubMed database using a series of search terms. Three studies met the complete criteria for inclusion. Though all studies found a significant change in reduction of active trachoma prevalence, the research is still too limited to suggest the impact of the “F” and “E” components on trachoma prevalence and ultimately its effects on blindness.

scholarly journals Lymphatic filariasis elimination endgame in an urban Indian setting: the roles of surveillance and residual microfilaremia after mass drug administration

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Anjali Modi ◽  
Keshav G. Vaishnav ◽  
Kailash Kothiya ◽  
Neal Alexander
Keyword(s):  
High Risk ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Risk Groups ◽  
Primary School Children ◽  
World Health ◽  
Urban Indian ◽  
Indian Setting ◽  
The Impact

Abstract Background To secure the gains of lymphatic filariasis (LF) elimination programs, attention is needed to the ‘residual microfilaremia phase’, in which high-risk populations may be crucial. The present study documents the impact of mass drug administration (MDA) in the urban Indian setting of Surat City, with high rates of in-migration. Methods Epidemiological assessment included National Filaria Control Program (NFCP) and World Health Organization recommended routine and pre-MDA microfilaremia surveys respectively. Routine filaria surveys were conducted around the year in approximately 2000–4000 people per month, while pre-MDA surveys were carried out annually among approximately 4000 people from four fixed and four random sites. In 2016, Transmission Assessment Survey (TAS) was done in primary school children. The outcomes were microfilaremia (Mf) and antigen prevalence; more specifically, microfilaremia according to place of birth, in pre-MDA and routine night blood smears (NBS) collected from 2008 to 2015. Prevalence ratios and confidence intervals were calculated. Results A total of 25 480 pre-MDA and 306 198 routine NBS were examined during the study. In 2008, the Mf prevalence in the routine survey was 63/18 814 (0.33%), declining to 23/39 717 (0.06%) in 2016. Pre-MDA surveys showed a similar decrease from 47/4184 (1.1%) in 2008 to 12/4042 (0.3%) in 2015. In those born outside Surat, microfilaremia decreased below transmission thresholds, but remained more than treble that of the remainder of the population, in both the pre-MDA surveys [prevalence ratio: 3.17, 95% confidence interval (CI): 1.15–8.72], and the routine surveys (3.31, 95% CI: 1.47–7.48). Though the TAS results indicated that MDA endpoints had been reached, sub-group analysis identified that 90% of antigenemic children were from families of high-risk groups. Conclusions Extensive long-term epidemiological monitoring suggests that all the urban population, including high-risk groups, have benefitted from the ELF program. To prevent re-establishment of infection in large urban areas with unsanitary conditions conducive to filarial vector breeding, there is need to identify residual microfilaremia by customized surveys in addition to pre-MDA monitoring and TAS. The present findings can be used to develop strategies to prioritize screening, surveillance and plan treatment of high-risk groups after achieving MDA endpoints.

scholarly journals Potential use of antibodies to provide an earlier indication of lymphatic filariasis resurgence in post-mass drug administration surveillance, American Samoa

2021 ◽  
Author(s):  
Angela M. Cadavid Restrepo ◽  
Katherine Gass ◽  
Kimberly Y. Won ◽  
Meru Sheel ◽  
Keri Robinson ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
American Samoa ◽  
School Level ◽  
World Health ◽  
Chi Squared ◽  
Health Organization ◽  
Potential Use

AbstractObjectivesUnder the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted seven rounds of mass drug administration between 2000 and 2006. The territory passed transmission assessment surveys (TAS) in 2011 (TAS-1) and 2015 (TAS-2) based on World Health Organization guidelines. In 2016, the territory failed TAS-3, indicating resurgence. This study aims to determine if antibodies (Ab) may have provided a timelier indication of LF resurgence in American Samoa.MethodsWe examined school-level Ag and Ab status (presence/absence of Ag- and Ab- positive children) and prevalence of single and combined Ab responses to Wb123, Bm14, Bm33 Ags at each TAS. Pearson’s chi-squared tests and logistic regression were used to examine associations between school-level Ab prevalence in TAS-1 and TAS-2 and school-level Ag status in TAS-3.ResultsSchools with higher prevalence of Wb123 Ab in TAS-2 had higher odds of being Ag-positive in TAS-3 (odds ratio [OR] 24.5, 95% CI:1.2-512.7). Schools that were Ab-positive for WB123 plus Bm14, Bm33 or both Bm14 and Bm33 in TAS-2 had higher odds of being Ag-positive in TAS-3 (OR 16.0-24.5).ConclusionAnti-filarial Abs could provide earlier signals of resurgence and enable a timelier response. The promising role of Abs in post-MDA surveillance and decision making should be further investigated in other settings.

scholarly journals Current status of Schistosoma mansoni infection among previously treated rural communities in the Abbey and Didessa Valleys, Western Ethiopia: Implications for sustainable control

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247312
Author(s):  
Alemayehu Assefa ◽  
Berhanu Erko ◽  
Svein Gunnar Gundersen ◽  
Girmay Medhin ◽  
Nega Berhe
Keyword(s):  
Public Health ◽  
Schistosoma Mansoni ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Problem ◽  
Public Health Problem ◽  
World Health ◽  
Current Status ◽  
Mass Treatment ◽  
Western Ethiopia

Background Schistosoma constitutes a major public health problem and developmental challenges in the majority of developing and subtropical regions. The World Health Organization has set guidelines for the control and elimination of schistosomiasis. Ethiopia is providing school-based Mass Drug Administration (MDA) at the study areas of the Abbey and Didessa Valleys of western Ethiopian since 2015. Moreover, mass treatment was already done in the same villages 30 years ago. However, the current Schistosoma mansoni infection status among humans and snails in the study areas is not known. Hence, the present study aims to determine the current status. Methods A community-based cross-sectional study was conducted in the three communities; Chessega, Agallu Metti and Shimala in Schistosoma mansoni endemic areas of the Abbey and Didessa valleys in Western Ethiopia. Using the list of households obtained from the Kebele administration, a systematic sampling technique was used to select households in each village. Results Even though the area is under the Ethiopian national Mass Drug Administration campaign, the present study reports prevalence above 50%. Although the majority of the infections were moderate, we found that 13% had heavy infection, above 400 eggs per gram of stool, which is at the same level as before the treatment campaign 30 years ago. The infection was significantly higher among those below 12 years of age, among non-attending school-age children and daily laborers. Conclusion Schistosoma mansoni infection is still a public health problem in the study areas, despite control efforts already 30 years ago and present mass treatment in the last years. We suggest making the mass treatment campaign just early after the rainy season, when the snails are washed away. This should be supplemented with provisions of clean water, sanitation, and hygiene (WASH) and reduction of water contact and possible snail control efforts’ to prevent reinfection.

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