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社区视角下加纳三个热点地区在经过 15 轮大规模药物治疗后淋巴丝虫病持续传播的情况:定性评估。

Community perspectives on persistent transmission of lymphatic filariasis in three hotspot districts in Ghana after 15 rounds of mass drug administration: a qualitative assessment.

机构信息

Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O Box LG 581, Legon-Accra, Ghana.

Department of Sociology and Anthropology, University of Cape Coast, Cape Coast, Ghana.

出版信息

BMC Public Health. 2018 Feb 13;18(1):238. doi: 10.1186/s12889-018-5157-7.

Abstract

BACKGROUND

The Global Program for the Elimination of Lymphatic Filariasis (GPELF) started operation in 2000 and aimed at eliminating the disease by the year 2020, following 5-6 rounds of effective annual Mass Drug Administration (MDA). The MDA programme took off in Ghana in 2001 and has interrupted transmission in many areas while it has persisted in some areas after 10 or more rounds of MDA. This study was to appreciate community members' perspectives on MDA after over 15 years of implementation. Findings will inform strategies to mobilise community members to participate fully in MDA to enhance the disease elimination process.

METHODS

This was a qualitative study, employing key-informant in-depth-interviews. Respondents were selected based on their recognition by community members as opinion leaders and persons who were knowledgeable about the topic of interest in the community. A snowball sampling technique was used to select respondents.

RESULTS

Respondents were well informed about the MDA with most of them saying, it has been implemented for over 12 years. They were aware that the MDA was for the treatment/control of LF (elephantiasis). It came to light that MDA compliance was affected by five related barriers. These are; Medication, Personal, Health system, Disease and Social structure related barriers. Adverse effects of the drugs and the fact that many people perceived that they were not susceptibility to the infection have grossly affected the ingestion of the drugs.

CONCLUSION

There is a need for community mobilization and promotional activities to explain the expected adverse reactions associated with the drugs to the people. Also the importance of why every qualified person in the community must comply with MDA must be emphasized.

摘要

背景

全球消灭淋巴丝虫病规划(GPELF)于 2000 年开始运作,目标是在经过 5-6 轮有效年度大规模药物治疗(MDA)后,于 2020 年消灭该病。MDA 项目于 2001 年在加纳启动,在许多地区已经中断了传播,但在进行了 10 轮或更多轮 MDA 后,它在一些地区仍在持续。本研究旨在了解社区成员在实施 15 年多后的 MDA 看法。研究结果将为动员社区成员充分参与 MDA 以增强消除疾病进程的策略提供信息。

方法

这是一项定性研究,采用了关键知情者深入访谈的方法。根据社区成员对作为意见领袖和对社区感兴趣的话题有知识的人的认可来选择受访者。采用滚雪球抽样技术选择受访者。

结果

受访者对 MDA 有很好的了解,大多数人表示,它已经实施了 12 年以上。他们知道 MDA 是用于治疗/控制淋巴丝虫病(象皮病)的。研究结果表明,MDA 依从性受到五个相关障碍的影响。这些是药物相关、个人相关、卫生系统相关、疾病相关和社会结构相关的障碍。药物的不良反应以及许多人认为他们不易受到感染的影响,极大地影响了药物的摄入。

结论

需要进行社区动员和宣传活动,向人们解释与药物相关的预期不良反应。还必须强调社区中每个合格的人都必须遵守 MDA 的重要性。

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