1
|
Kamgno J, Tchatchueng-Mbougua JB, Nana-Djeunga HC, Esso L, Zouré HG, Mackenzie CD, Boussinesq M. Community-based door to door census of suspected people living with epilepsy: empowering community drug distributors to improve the provision of care to rural communities in Cameroon. BMC Public Health 2020; 20:871. [PMID: 32503495 PMCID: PMC7275343 DOI: 10.1186/s12889-020-08997-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 05/27/2020] [Indexed: 11/12/2022] Open
Abstract
Background Epilepsy is a severe neurological disorder with huge psychological, social, and economic consequences, including premature deaths and loss of productivity. Sub-Saharan Africa carries the highest burden of epilepsy. The management of epilepsy in Cameroon remains unsatisfactory due to poor identification of cases and a limited knowledge of the distribution of the disease. The objective of this study was to determine whether community drug distributors (CDDs) - volunteers selected by their communities to distribute ivermectin against onchocerciasis and who have been proven efficient to deliver other health interventions such as insecticide-treated bed nets to prevent malaria, vitamin A tablets, and albendazole to treat soil transmitted helminthiasis - can be used to reliably identify people living with epilepsy to promote better management of cases. Methods This study was carried out in three health Districts in Cameroon. An exhaustive house to house census was carried out by trained CDDs under the supervision of local nurses. In each household, all suspected cases of epilepsy were identified. In each health district, five communities were randomly selected for a second census by trained health personnel (research team). The results of the two censuses were compared for verification purposes. Results A total of 53,005 people was registered in the 190 communities surveyed with 794 (1.4%) individuals identified as suspected cases of epilepsy (SCE) by the CDDs. In the 15 communities where the SCE census was verified, the average ratio between the number of suspected cases of epilepsy reported in a community by the research team and that reported by the CDDs was 1.1; this ratio was < 0.8 and > 1.2 in 6 communities. Conclusions The results of this study suggest that CDDs, who are present in about 200,000 communities in 31 Sub Saharan African countries where onchocerciasis is endemic, can be successfully used to assess epilepsy prevalence, and therefore map epilepsy in many African countries.
Collapse
Affiliation(s)
- Joseph Kamgno
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaoundé, Cameroon. .,Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Jules B Tchatchueng-Mbougua
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaoundé, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Service d'épidémiologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroon
| | - Hugues C Nana-Djeunga
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaoundé, Cameroon
| | - Lynda Esso
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaoundé, Cameroon
| | - Honorat G Zouré
- Expanded Special Project for Elimination of NTDs (ESPEN), World Health Organization, African Regional Office, Brazzaville, Republic of Congo
| | - Charles D Mackenzie
- Filarial Programmes Support Unit (FPSU), Liverpool School of Tropical Medicine, Pembroke Place Liverpool, Liverpool, L3 5QA, UK
| | - Michel Boussinesq
- Institut de Recherche pour le Développement (IRD), UMI233/ INSERM U1175/ Université de Montpellier, 911 Avenue Agropolis, 34394, Montpellier Cedex 5, France
| |
Collapse
|
2
|
Bartlett S, Haslam D, Bush S, Haddad D. Elimination through collaboration: success factors in a global consortium. Int Health 2019; 11:24-29. [PMID: 30102360 PMCID: PMC6314149 DOI: 10.1093/inthealth/ihy054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/29/2018] [Indexed: 12/04/2022] Open
Abstract
The Global Trachoma Mapping Project (GTMP) is the largest infectious disease survey ever undertaken. With 60 partners, 2.6 million people were examined across 29 countries for the blinding neglected tropical disease (NTD) trachoma, establishing the prevalence of the disease globally. Such an achievement was only made possible by building a diverse worldwide consortium. This article examines that public–private consortium and attempts to highlight key factors in the success of its development and operation. Two critical factors in the project’s success were the establishment of an evidence-based common approach and urgency around a shared goal. The common approach (the GTMP methodologies, tools and training approach) and the goal (GET2020 through the SAFE strategy) are thoroughly detailed in this article. Transparency at all levels; clear roles for committees, partners, agencies and ministries of health and shared funding played important roles and are explored here. It is hoped that by examining and sharing the positive factors leading to the establishment and work of this specific consortium, other similar initiatives—for NTDs, for health more broadly and for other development areas—will be able to adopt such an approach for effective collaboration.
Collapse
Affiliation(s)
- Sarah Bartlett
- Sightsavers, 2803 Saint Philip Street, New Orleans, LA, USA
| | - Dominic Haslam
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, UK
| | - Simon Bush
- Sightsavers, Densu Point, 3 Wawa Avenue, Accra, Ghana
| | - Danny Haddad
- Orbis International, 520 8th Avenue #12, New York, NY, USA
| |
Collapse
|
3
|
Colebunders R, Basáñez MG, Siling K, Post RJ, Rotsaert A, Mmbando B, Suykerbuyk P, Hopkins A. From river blindness control to elimination: bridge over troubled water. Infect Dis Poverty 2018; 7:21. [PMID: 29587844 PMCID: PMC5872540 DOI: 10.1186/s40249-018-0406-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An estimated 25 million people are currently infected with onchocerciasis (a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted by Simulium vectors), and 99% of these are in sub-Saharan Africa. The African Programme for Onchocerciasis Control closed in December 2015 and the World Health Organization has established a new structure, the Expanded Special Project for the Elimination of Neglected Tropical Diseases for the coordination of technical support for activities focused on five neglected tropical diseases in Africa, including onchocerciasis elimination. AIMS In this paper we argue that despite the delineation of a reasonably well-defined elimination strategy, its implementation will present particular difficulties in practice. We aim to highlight these in an attempt to ensure that they are well understood and that effective plans can be laid to solve them by the countries concerned and their international partners. CONCLUSIONS A specific concern is the burden of disease caused by onchocerciasis-associated epilepsy in hyperendemic zones situated in countries experiencing difficulties in strengthening their onchocerciasis control programmes. These difficulties should be identified and programmes supported during the transition from morbidity control to interruption of transmission and elimination.
Collapse
Affiliation(s)
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK
| | - Katja Siling
- Institute of Tropical Medicine, Antwerp, Belgium
- London School of Hygiene & Tropical Medicine, London, UK
| | - Rory J. Post
- London School of Hygiene & Tropical Medicine, London, UK
- Liverpool John Moores University, Liverpool, UK
| | - Anke Rotsaert
- Global Health Institute, University of Antwerp, Antwerp, Belgium
| | - Bruno Mmbando
- National Institute for Medical Research, Tanga, Tanzania
| | | | - Adrian Hopkins
- Neglected and Disabling diseases of Poverty Consultant, Gravesend, Kent, UK
| |
Collapse
|
4
|
|
5
|
King CH. Editorial Commentary:Defining the Necessary Next Steps for Effective Control of Helminthic Infections. Clin Infect Dis 2015; 62:208-9. [DOI: 10.1093/cid/civ833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 09/10/2015] [Indexed: 11/13/2022] Open
|
6
|
Dunn C, Callahan K, Katabarwa M, Richards F, Hopkins D, Withers PC, Buyon LE, McFarland D. The Contributions of Onchocerciasis Control and Elimination Programs toward the Achievement of the Millennium Development Goals. PLoS Negl Trop Dis 2015; 9:e0003703. [PMID: 25996946 PMCID: PMC4440802 DOI: 10.1371/journal.pntd.0003703] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the "big three" diseases--namely HIV, tuberculosis (TB), and malaria--has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda.
Collapse
Affiliation(s)
- Caitlin Dunn
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Kelly Callahan
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Moses Katabarwa
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Frank Richards
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Donald Hopkins
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - P. Craig Withers
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
| | - Lucas E. Buyon
- Health Programs, The Carter Center, Atlanta, Georgia, United States of America
- College of Arts and Sciences, Emory University, Atlanta, Georgia, United States of America
| | - Deborah McFarland
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| |
Collapse
|
7
|
Cross C, Olamiju F, Richards F, Bush S, Hopkins A, Haddad D. From River Blindness to Neglected Tropical Diseases--Lessons Learned in Africa for Programme Implementation and Expansion by the Non-governmental Partners. PLoS Negl Trop Dis 2015; 9:e0003506. [PMID: 25974037 PMCID: PMC4431851 DOI: 10.1371/journal.pntd.0003506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - Frank Richards
- The Carter Center, Atlanta, Georgia, United States of America
| | | | - Adrian Hopkins
- Mectizan Donation Programme, Atlanta, Georgia, United States of America
| | - Danny Haddad
- Emory Global Vision Initiative, Atlanta, Georgia, United States of America
| |
Collapse
|
8
|
Keating J, Yukich JO, Mollenkopf S, Tediosi F. Lymphatic filariasis and onchocerciasis prevention, treatment, and control costs across diverse settings: a systematic review. Acta Trop 2014; 135:86-95. [PMID: 24699086 DOI: 10.1016/j.actatropica.2014.03.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 03/21/2014] [Accepted: 03/23/2014] [Indexed: 11/18/2022]
Abstract
The control and eventual elimination of neglected tropical disease (NTD) requires the expansion of interventions such as mass drug administration (MDA), vector control, diagnostic testing, and effective treatment. The purpose of this paper is to present the evidence base for decision-makers on the cost and cost-effectiveness of lymphatic filariasis (LF) and onchocerciasis prevention, treatment, and control. A systematic review of the published literature was conducted. All studies that contained primary or secondary data on costs or cost-effectiveness of prevention and control were considered. A total of 52 papers were included for LF and 24 papers were included for onchocerciasis. Large research gaps exist on the synergies and cost of integrating NTD prevention and control programs, as well as research on the role of health information systems, human resource systems, service delivery, and essential medicines and technology for elimination. The literature available on costs and cost-effectiveness of interventions is also generally older, extremely focal geographically and of limited usefulness for developing estimates of the global economic burden of these diseases and prioritizing among various intervention options. Up to date information on the costs and cost-effectiveness of interventions for LF and onchocerciasis prevention are needed given the vastly expanded funding base for the control and elimination of these diseases.
Collapse
Affiliation(s)
- Joseph Keating
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States; Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States.
| | - Joshua O Yukich
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States; Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States.
| | - Sarah Mollenkopf
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States.
| | - Fabrizio Tediosi
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4001 Basel, Switzerland; University of Basel, Switzerland; Centre for Research on Health and Social Care Management (CERGAS), Università Bocconi, Milan, Italy.
| |
Collapse
|
9
|
Meredith SEO, Cross C, Amazigo UV. Empowering communities in combating river blindness and the role of NGOs: case studies from Cameroon, Mali, Nigeria, and Uganda. Health Res Policy Syst 2012; 10:16. [PMID: 22574885 PMCID: PMC3453498 DOI: 10.1186/1478-4505-10-16] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 05/10/2012] [Indexed: 11/24/2022] Open
Abstract
The control of onchocerciasis is not only a major success story in global health, but also one of the best examples of the power of public-private partnership at the international level as well as at the national level. The onchocerciasis story is also a leading example of the contribution of a group of called Non-Governmental Development Organizations (NGDO) to operational research which resulted in important changes in treatment strategies and policies.The four case studies presented here illustrate some key contributions the NGDOs made to the development of "community directed treatment with ivermectin" -CDTI, in Africa, which became the approved methodology within the African Programme for Onchocerciasis Control (APOC). The partnership between the international, multilateral, government institutions and the NGDO Coordination Group was the backbone of the APOC programme's structure and facilitated progress and scale-up of treatment programmes. Contributions included piloting community-based methodology in Mali and Nigeria; research, collaboration and coordination on treatment strategies and policies, coalition building, capacity building of national health workforce and advocacy at the national and international level. While the Onchocerciasis Control Programme (OCP) and APOC provided leadership, the NGDOs working with the national health authorities played a major role in advocacy evolving the community methodology which led to achieving and maintaining- treatments with ivermectin for at least 20 years and strengthening community health systems.
Collapse
|
10
|
Bush S, Hopkins A. Public-private partnerships in neglected tropical disease control: the role of nongovernmental organisations. Acta Trop 2011; 120 Suppl 1:S169-72. [PMID: 21470555 DOI: 10.1016/j.actatropica.2011.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 11/24/2010] [Accepted: 01/18/2011] [Indexed: 10/18/2022]
Abstract
Successful public-private partnerships for health control have usually included nongovernmental development organisations (NGDOs), and these have long been in the forefront of pinpointing particular social and health issues. The immensely successful control and elimination programmes for onchocerciasis are a case in point. NGDOs were the driving force in early advocacy for onchocerciasis control in West Africa, leading eventually to the remarkably effective and long lasting partnership of the Onchocerciasis Control Programme (OCP). With the donation of Mectizan(®), NGDOs were the driving force in developing onchocerciasis control in non-OCP countries, especially programmes for community based action. These were, further modified by the African Programme for Onchocerciasis Control (APOC) to become the successful Community Directed Interventions. NGDOs came together to coordinate activities in partnership with the World Health Organisation (WHO). Innovations by NGDOs led to integration of mass drug administration for Vitamin A deficiency and then for other parasitic diseases, leading to the current trend of preventive chemotherapy. The success of the NGDO Group for Onchocerciasis Control has led to the creation of similar groups for trachoma control and lymphatic filariasis elimination. These groups have now come together to form an NGDO Network for Neglected Tropical Disease control.
Collapse
|
11
|
Brown KH, Peerson JM, Baker SK, Hess SY. Preventive Zinc Supplementation among Infants, Preschoolers, and Older Prepubertal Children. Food Nutr Bull 2009; 30:S12-40. [DOI: 10.1177/15648265090301s103] [Citation(s) in RCA: 204] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Zinc supplementation trials carried out among children have produced variable results, depending on the specific outcomes considered and the initial characteristics of the children who were enrolled. We completed a series of meta-analyses to examine the impact of preventive zinc supplementation on morbidity; mortality; physical growth; biochemical indicators of zinc, iron, and copper status; and indicators of behavioral development, along with possible modifying effects of the intervention results. Zinc supplementation reduced the incidence of diarrhea by ∼20%, but the impact was limited to studies that enrolled children with a mean initial age greater than 12 months. Among the subset of studies that enrolled children with mean initial age greater than 12 months, the relative risk of diarrhea was reduced by 27%. Zinc supplementation reduced the incidence of acute lower respiratory tract infections by ∼15%. Zinc supplementation yielded inconsistent impacts on malaria incidence, and too few trials are currently available to allow definitive conclusions to be drawn. Zinc supplementation had a marginal 6% impact on overall child mortality, but there was an 18% reduction in deaths among zinc-supplemented children older than 12 months of age. Zinc supplementation increased linear growth and weight gain by a small, but highly significant, amount. The interventions yielded a consistent, moderately large increase in mean serum zinc concentrations, and they had no significant adverse effects on indicators of iron and copper status. There were no significant effects on children's behavioral development, although the number of available studies is relatively small. The available evidence supports the need for intervention programs to enhance zinc status to reduce child morbidity and mortality and to enhance child growth. Possible strategies for delivering preventive zinc supplements are discussed.
Collapse
|
12
|
Haddad D. The NGDO Co-ordination Group for Onchocerciasis Control. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2008; 102 Suppl 1:35-8. [PMID: 18718153 DOI: 10.1179/136485908x337472] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Since the beginning of the donation of Mectizan by Merck & Co., Inc., non-governmental development organizations (NGDO) have been actively involved in the mass distribution of this drug to control onchocerciasis. In 2006, the network of NGDO involved in onchocerciasis control assisted in the treatment of over 62 million people. The current strategy that is used for distribution in Africa, community-directed treatment with ivermectin (CDTI), is very well suited for integration with other health activities. NGDO have been the pioneers in integrating comprehensive eye care, insecticide-treated nets for malaria, the control of multiple 'neglected' tropical diseases, and vitamin-A supplementation. These expanded activities bring with them new challenges, which need to be addressed by all partners and where the NGDO will play an active role.
Collapse
Affiliation(s)
- D Haddad
- Helen Keller International, Regional Office for Africa, P.O. Box 29.898, Dakar - Yoff, Senegal.
| |
Collapse
|