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青少年对印度开展社区范围大规模驱虫药物治疗项目的看法。

Adolescents' Perspective Regarding a Community-Wide Mass Drug Administration Program for Soil-Transmitted Helminths in India.

机构信息

The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.

Department of Global Health, University of Washington, Seattle, Washington.

出版信息

Am J Trop Med Hyg. 2024 Mar 12;110(4):681-686. doi: 10.4269/ajtmh.23-0676. Print 2024 Apr 3.

Abstract

This study was undertaken to understand the perspective of adolescents in endemic communities of India regarding soil-transmitted helminth (STH) infections and community-wide mass drug administration (cMDA). A multicountry community-based cluster-randomized trial, the Deworm3 trial, tested the feasibility of interrupting STH transmission with cMDA, where all individuals aged 1-99 are treated empirically with albendazole. Using a guideline based on the Consolidated Framework for Implementation Research, eight focus group discussions were conducted among 57 adolescents from the trial site in India and analyzed on ATLAS.ti 8.0 software using an a priori thematic codebook. Adolescents believed that adults could be a source of STH infection because they were not routinely dewormed like the children through the national deworming program. Perceived benefits of cMDA for all were better health and increased work efficiency. Perceived barriers to adults' participation in cMDA was their mistrust about the program, fear of side effects, perceived low risk of infection, and absence during drug distribution. To encourage adult participation in cMDAs, adolescents suggested community outreach activities, engaging village influencers and health workers, and tailoring drug distribution to when adults would be available. Adolescents were confident in their ability to be change agents within their households for treatment compliance. Adolescents provided insights into potential barriers and solutions to improve adult participation in cMDA, identified best practices of cMDA delivery, and suggested that they have unique roles as change agents to increase their household participation in cMDA.

摘要

本研究旨在了解印度流行地区青少年对土壤传播性蠕虫(STH)感染和社区范围大规模药物驱虫(cMDA)的看法。Deworm3 试验是一项多国家社区为基础的整群随机试验,测试了通过 cMDA 中断 STH 传播的可行性,即对所有 1-99 岁的个体进行经验性的阿苯达唑治疗。使用基于综合实施研究框架的指南,在印度试验点对 57 名青少年进行了八次焦点小组讨论,并使用 ATLAS.ti 8.0 软件进行分析,采用预先设定的主题代码本。青少年认为成年人可能是 STH 感染的来源,因为他们不像儿童那样通过国家驱虫计划定期驱虫。认为 cMDA 对所有人的好处是更好的健康和提高工作效率。成年人参与 cMDA 的障碍是他们对该计划的不信任、对副作用的恐惧、对感染风险的低认知和药物分发期间的缺席。为了鼓励成年人参与 cMDAs,青少年建议开展社区外展活动,动员乡村影响者和卫生工作者,并在成年人有时间的时候进行药物分发。青少年对自己在家庭中提高治疗依从性的能力充满信心。青少年提供了潜在障碍和解决方案的见解,以提高成年人参与 cMDA 的程度,确定了 cMDA 提供的最佳实践,并建议他们作为变革推动者具有独特的作用,可以提高他们家庭参与 cMDA 的程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ea0/10993849/9783a90bf86b/ajtmh.23-0676f1.jpg

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