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社区赋权在印度南部消除淋巴丝虫病中的作用。

Role of community empowerment in the elimination of lymphatic filariasis in south India.

作者信息

Rajendran R, Sunish I P, Munirathinam A, Ashok Kumar V, Tyagi B K

机构信息

Centre for Research in Medical Entomology (ICMR), 4-Sarojini Street, Chinna Chokkikulam, Madurai-625 002, India.

出版信息

Trop Biomed. 2010 Apr;27(1):68-78.

Abstract

The World Health Assembly in 1997 has targeted the elimination of lymphatic filariasis (LF) by 2020, and in India the goal has been set for the year 2015 by annual single dose mass drug administration (MDA). The role of community empowerment in enhancing the drug compliance and bringing out the function of various methods used to disseminate the information on MDA to the villagers is focused. A longitudinal survey was carried out in nine villages in Tirukoilur block of Villupuram district, Tamil Nadu for filarial infection variables like microfilaraemia, antigenaemia, transmission indices before and after each MDA, to determine the drug impact. Prior to each MDA, health education campaigns with different approaches were carried out with community as the leading player. These IEC approaches were assessed after 4 MDAs for its perception in the community. After four rounds of MDA, there was a significant decline in the filarial infection variables. The microfilaraemia and antigenaemia declined by 59% and 67% respectively. The transmission indices lowered by 89% and 94% (in resting and landing catch of mosquitoes respectively). The decline in these variables, with a drug consumption rate of >80% was achieved due to the effective IEC campaigns prior to each MDA. After 4 MDAs almost 97% of the respondents were aware of lymphatic filariasis. The KAP survey in the rural villages revealed that the dissemination of MDA message through autorickshaw was the most effective, followed by school students' rally. Empowerment of community through the members of women self help groups and school students were observed to be integral to mass drug administration campaigns for the enhancement of drug compliance, thus leading to LF elimination.

摘要

1997年世界卫生大会设定目标,到2020年消除淋巴丝虫病(LF),而在印度,通过每年单剂量群体服药(MDA)已将目标年份定为2015年。重点关注社区赋权在提高药物依从性以及发挥各种用于向村民传播MDA信息的方法的作用方面的意义。在泰米尔纳德邦维鲁布尔姆县蒂鲁科伊勒尔区的9个村庄开展了一项纵向调查,以了解每次MDA前后的丝虫感染变量,如微丝蚴血症、抗原血症、传播指数,从而确定药物效果。在每次MDA之前,以社区为主导开展了不同方式的健康教育活动。在4次MDA之后,对这些信息、教育和宣传(IEC)方式在社区中的认知情况进行了评估。经过四轮MDA,丝虫感染变量显著下降。微丝蚴血症和抗原血症分别下降了59%和67%。传播指数分别下降了89%和94%(分别针对蚊虫的静息捕捉和着陆捕捉)。由于每次MDA之前开展了有效的IEC活动,在药物服用率>80%的情况下实现了这些变量的下降。经过4次MDA后,几乎97%的受访者知晓淋巴丝虫病。农村地区的知识、态度和实践(KAP)调查显示,通过机动三轮车传播MDA信息最为有效,其次是在校学生集会。通过妇女自助小组和在校学生成员对社区进行赋权被认为是群体服药运动提高药物依从性从而消除淋巴丝虫病的不可或缺的因素。

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