Provider and User Acceptability of Integrated Treatment for the Control of Malaria and Helminths in Saraya, South-Eastern Senegal

Integration of vertical programs for the control of malaria, schistosomiasis, and soil-transmitted helminthiasis has been recommended to achieve elimination of malaria and neglected tropical diseases (NTD) by 2030. This qualitative study was conducted within the context of a randomized controlled trial to explore the perceptions and views of parents/caregivers of at-risk children and healthcare providers to determine their acceptability of the integrated malaria-helminth treatment approach. Randomly selected parents/caregivers of children enrolled in the trial, healthcare providers, trial staff, malaria, and NTD program managers were interviewed using purpose-designed topic guides. Transcripts obtained from the interviews were coded and common themes identified using content analysis were triangulated. Fifty-seven study participants comprising 26 parents/caregivers, 10 study children aged ≥ 10 years, 15 trial staff, four healthcare providers, and two managers from the Senegal Ministry of Health were interviewed. Thirty-eight of the participants (66.7%) were males, and their ages ranged from 10 to 65 years. Overall, the integrated malaria-helminth treatment approach was considered acceptable, but the study participants expressed concerns about the taste, smell, and side effects associated with amodiaquine and praziquantel in the combination package. Reluctance to accept the medications was also observed among children aged 10 to 14 years due to peer influence and gender-sensitive cultural beliefs. Addressing concerns about the taste and smell of amodiaquine and praziquantel is needed to optimize the uptake of the integrated treatment program. Also, culturally appropriate strategies need to be put in place to cater for the inclusion of children aged 10 to 14 years in this approach.

[Economic contribution of gynecological and obstetrical ultrasound in an advanced strategy for the Zinguinchor region]

Aiming to strengthen the accessibility of ultrasound technology to rural populations, an advanced strategy ultrasound programme was implemented in the health districts of Sedhiou, Oussouye, Bignona and Ziguinchor all located within Casamance in Senegal. Within the first year of activity (January 1, 2001-December 31, 2001), the team from the regional health centre (RHC) was dispatched 56 times. Ultrasound scans were performed in the homes of 1,273 patients among which 192 were referred to the RHC for specialised follow-up and treatment. The financial benefit for the RHC totaled 3,120,000 francs; 2,612,500 francs for the district hospital; and 3,561,300 francs for the population at large. The advanced strategy for performing ultrasound scans has therefore been economically profitable at the community level as much as at the level of health structures. Through supporting the activities of the district hospitals, the RHC contributed technical support and increased the potential, not solely for the treatment of disease but for the health services overall. The revenue generated has given managers a greater possibility to improve health care and services. The decentralisation programme and reduction in the cost have decreased the unsatisfied needs in ultrasound services by making the technology more financially and geographically accessible. Thus, by saving input costs in terms of time, transportation and capital, the practice of ultrasound scans in district hospitals has been strengthened and has improved the capacity to provide care and treat the population's health problems. The continuation of this programme is advantageous, but necessitates two complementary actions: enhancing of the technical level and capacity of the district hospitals with the installation of ultrasound technology and equipment, and raising the level of knowledge by training staff in administering ultrasound scans.