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Saili K, de Jager C, Masaninga F, Chisanga B, Sinyolo A, Chiwaula J, Chirwa J, Hamainza B, Chanda E, Bakyaita NN, Mutero CM. Community perceptions, acceptability, and the durability of house screening interventions against exposure to malaria vectors in Nyimba district, Zambia. BMC Public Health 2024; 24:285. [PMID: 38267927 PMCID: PMC10809574 DOI: 10.1186/s12889-024-17750-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND House screening remains conspicuously absent in national malaria programs despite its recognition by the World Health Organization as a supplementary malaria vector-control intervention. This may be attributed, in part, to the knowledge gap in screen durability or longevity in local climatic conditions and community acceptance under specific cultural practices and socio-economic contexts. The objectives of this study were to assess the durability of window and door wire mesh screens a year after full house screening and to assess the acceptability of the house screening intervention to the participants involved. METHODS This study was conducted in Nyimba district, Zambia and used both quantitative and qualitative methods of data collection and analysis. Both direct observation and questionnaires were employed to assess the durability of the screens and the main reasons for damage. Findings on damage were summarized as percentages. Focus group discussions were used to assess people's knowledge, perceptions, and acceptability of the closing eaves and house screening intervention. Deductive coding and inductive coding were used to analyse the qualitative data. RESULTS A total of 321 out of 400 (80.3%) household owners of screened houses were interviewed. Many window screens (90.3%) were intact. In sharp contrast, most door screens were torn (n = 150; 46.7%) or entirely removed (n = 55; 17.1%). Most doors (n = 114; 76%) had their wire mesh damaged or removed on the bottom half. Goats (25.4%), rust (17.6%) and children (17.1%) were cited most as the cause of damage to door screens. The focus group discussion elicited positive experiences from the participants following the closing of eaves and screening of their windows and doors, ranging from sleeping peacefully due to reduced mosquito biting and/or nuisance and having fewer insects in the house. Participants linked house screening to reduced malaria in their households and community. CONCLUSION This study demonstrated that in rural south-east Zambia, closing eaves and screening windows and doors was widely accepted. Participants perceived that house screening reduced human-vector contact, reduced the malaria burden and nuisance biting from other potentially disease carrying insects. However, screened doors are prone to damage, mainly by children, domestic animals, rust, and termites.
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Affiliation(s)
- Kochelani Saili
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, P.O. Box 30772-00100, Kenya.
- School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa.
| | - Christiaan de Jager
- School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
| | | | - Brian Chisanga
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, P.O. Box 30772-00100, Kenya
- Development Economics Group, Wageningen University and Research, Wageningen, Netherlands
| | - Andy Sinyolo
- National Malaria Elimination Centre, Lusaka, Zambia
| | | | - Jacob Chirwa
- National Malaria Elimination Centre, Lusaka, Zambia
| | | | - Emmanuel Chanda
- World Health Organization, Regional Office, Brazzaville, Congo
| | | | - Clifford Maina Mutero
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, P.O. Box 30772-00100, Kenya
- School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
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Bourmaud A, Benoist Y, Tinquaut F, Allary C, Ramone-Louis J, Oriol M, Kalecinski J, Dutertre V, Lechopier N, Pommier M, Rousseau S, Dumas A, Amiel P, Regnier V, Buthion V, Chauvin F. Patient navigation for colorectal cancer screening in deprived areas: the COLONAV cluster randomized controlled trial. BMC Cancer 2023; 23:21. [PMID: 36609248 PMCID: PMC9817361 DOI: 10.1186/s12885-022-10169-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/29/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation. METHODS A cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months. RESULTS Twenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07-1.41], p = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57-0.96], p = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators' abilities to adapt their modus operandi, and facilitating attachment structure. CONCLUSION The ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care. TRIAL REGISTRATION clinicaltrials.gov NCT02369757 24/02/2015.
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Affiliation(s)
- A. Bourmaud
- grid.10988.380000 0001 2173 743XClinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019 Paris, France ,grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
| | - Y. Benoist
- grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - F. Tinquaut
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - C. Allary
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - J. Ramone-Louis
- grid.72960.3a0000 0001 2188 0906COACTIS EA 4161 - Centre de Recherche en Gestion - Research Center in Management Science ISH and Faculty of Economics and Management, Lumière Lyon 2 University, Lyon, France
| | - M. Oriol
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - J. Kalecinski
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
| | - V. Dutertre
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France
| | - N. Lechopier
- Lyon1 University, Lyon, France ,grid.15140.310000 0001 2175 9188UMR S2HEP, French Education Institute, Ecole Normale Supérieure de Lyon, Lyon, France
| | - M. Pommier
- grid.15140.310000 0001 2175 9188UMR S2HEP, French Education Institute, Ecole Normale Supérieure de Lyon, Lyon, France
| | - S. Rousseau
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - A. Dumas
- grid.10988.380000 0001 2173 743XClinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019 Paris, France ,grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - P. Amiel
- grid.10988.380000 0001 2173 743XClinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019 Paris, France ,grid.14925.3b0000 0001 2284 9388Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France
| | - V. Regnier
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
| | - V. Buthion
- grid.72960.3a0000 0001 2188 0906COACTIS EA 4161 - Centre de Recherche en Gestion - Research Center in Management Science ISH and Faculty of Economics and Management, Lumière Lyon 2 University, Lyon, France
| | - F. Chauvin
- grid.457361.2Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055 Saint-Etienne, France ,grid.7849.20000 0001 2150 7757Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France
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Bourmaud A, Piot de Villars E, Renault-Teissier E. [Patient partnership and patient education in oncology]. Bull Cancer 2021; 109:588-597. [PMID: 34782118 DOI: 10.1016/j.bulcan.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Over the last 40years, the French health system has opened up to patient engagement. Society has recognised the legitimacy of the patient as a decision-maker in his or her own health and as an expert in his or her illness. This is true at the individual level in the context of doctor-patient relationship, and at the organisational level within institutions, in decision-making or academic groups. The aim of this study is to present the concepts of patient-partnership, patient education and to illustrate the different functions that patient-partners can take within the organisation of patient education programmes, and in the field of oncology. METHOD A narrative review of the literature was carried out to extract relevant and recent seminal articles to address these points. RESULTS The Montreal model establishes the patient partner as a full care actor. He can thus contribute his expertise in many fields of application: care, research or teaching. The aim of patient education is to empower the patient in the management of his or her disease, treatment and the consequences of these on daily life. The patient partner has a full place in this system where he can accompany his peers, but also collaborate with the educational team to develop new programmes, evaluate them and even conduct research. The implementation of these systems consists of getting individuals with different cultures and operating methods to work together. It is a process that requires time, effort and attention to each other.
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Affiliation(s)
- Aurelie Bourmaud
- Universitary hospital Robert-Debré, université de Paris, Clinical epidemiology unit, Inserm ECEVE, 1123 Paris, France.
| | | | - Evelyne Renault-Teissier
- Pain unit, DISSPO, douleur et soins palliatifs, universitary comprehensive cancer institut, Institut Curie, Paris, France
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Ford JA, Jones A, Wong G, Clark A, Porter T, Steel N. Access to primary care for socio-economically disadvantaged older people in rural areas: exploring realist theory using structural equation modelling in a linked dataset. BMC Med Res Methodol 2018; 18:57. [PMID: 29914411 PMCID: PMC6006834 DOI: 10.1186/s12874-018-0514-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 05/31/2018] [Indexed: 11/29/2022] Open
Abstract
Background Realist approaches seek to answer questions such as ‘how?’, ‘why?’, ‘for whom?’, ‘in what circumstances?’ and ‘to what extent?’ interventions ‘work’ using context-mechanism-outcome (CMO) configurations. Quantitative methods are not well-established in realist approaches, but structural equation modelling (SEM) may be useful to explore CMO configurations. Our aim was to assess the feasibility and appropriateness of SEM to explore CMO configurations and, if appropriate, make recommendations based on our access to primary care research. Our specific objectives were to map variables from two large population datasets to CMO configurations from our realist review looking at access to primary care, generate latent variables where needed, and use SEM to quantitatively test the CMO configurations. Methods A linked dataset was created by merging individual patient data from the English Longitudinal Study of Ageing and practice data from the GP Patient Survey. Patients registered in rural practices and who were in the highest deprivation tertile were included. Three latent variables were defined using confirmatory factor analysis. SEM was used to explore the nine full CMOs. All models were estimated using robust maximum likelihoods and accounted for clustering at practice level. Ordinal variables were treated as continuous to ensure convergence. Results We successfully explored our CMO configurations, but analysis was limited because of data availability. Two hundred seventy-six participants were included. We found a statistically significant direct (context to outcome) or indirect effect (context to outcome via mechanism) for two of nine CMOs. The strongest association was between ‘ease of getting through to the surgery’ and ‘being able to get an appointment’ with an indirect mediated effect through convenience (proportion of the indirect effect of the total was 21%). Healthcare experience was not directly associated with getting an appointment, but there was a statistically significant indirect effect through convenience (53% mediated effect). Model fit indices showed adequate fit. Conclusions SEM allowed quantification of CMO configurations and could complement other qualitative and quantitative techniques in realist evaluations to support inferences about strengths of relationships. Future research exploring CMO configurations with SEM should aim to collect, preferably continuous, primary data. Electronic supplementary material The online version of this article (10.1186/s12874-018-0514-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John A Ford
- Norwich Medical School, University of East Anglia, Chancellor's Drive, Norwich, UK.
| | - Andy Jones
- Norwich Medical School, University of East Anglia, Chancellor's Drive, Norwich, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Allan Clark
- Norwich Medical School, University of East Anglia, Chancellor's Drive, Norwich, UK
| | - Tom Porter
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Nick Steel
- Norwich Medical School, University of East Anglia, Chancellor's Drive, Norwich, UK
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