Effectiveness of community and health services-organized drug delivery strategies for elimination of lymphatic filariasis in rural areas of Tamil Nadu, India.
Identifieur interne : 000830 ( Ncbi/Merge ); précédent : 000829; suivant : 000831Effectiveness of community and health services-organized drug delivery strategies for elimination of lymphatic filariasis in rural areas of Tamil Nadu, India.
Auteurs : K D Ramaiah [Inde] ; K N Vijay Kumar ; A V Chandrakala ; D J Augustin ; N C Appavoo ; P K DasSource :
- Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2001.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Agents de santé communautaire, Diéthylcarbamazine (administration et posologie), Enfant, Enfant d'âge préscolaire, Femelle, Filaricides (administration et posologie), Filariose lymphatique (), Filariose lymphatique (traitement médicamenteux), Humains, Inde, Mâle, Nourrisson, Personnel de santé, Prestations des soins de santé, Services de santé communautaires, Services de santé ruraux, Sujet âgé, Évaluation de programme.
- MESH :
- administration et posologie : Diéthylcarbamazine, Filaricides.
- traitement médicamenteux : Filariose lymphatique.
- Adolescent, Adulte, Adulte d'âge moyen, Agents de santé communautaire, Enfant, Enfant d'âge préscolaire, Femelle, Filariose lymphatique, Humains, Inde, Mâle, Nourrisson, Personnel de santé, Prestations des soins de santé, Services de santé communautaires, Services de santé ruraux, Sujet âgé, Évaluation de programme.
- Wicri :
- geographic : Inde.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Child, Child, Preschool, Community Health Services, Community Health Workers, Delivery of Health Care, Diethylcarbamazine (administration & dosage), Elephantiasis, Filarial (drug therapy), Elephantiasis, Filarial (prevention & control), Female, Filaricides (administration & dosage), Health Personnel, Humans, India, Infant, Male, Middle Aged, Program Evaluation, Rural Health Services.
- MESH :
- chemical , administration & dosage : Diethylcarbamazine, Filaricides.
- geographic : India.
- drug therapy : Elephantiasis, Filarial.
- prevention & control : Elephantiasis, Filarial.
- Adolescent, Adult, Aged, Child, Child, Preschool, Community Health Services, Community Health Workers, Delivery of Health Care, Female, Health Personnel, Humans, Infant, Male, Middle Aged, Program Evaluation, Rural Health Services.
Abstract
Lymphatic filariasis (LF) is targeted for global elimination. Repeated annual single-dose mass treatment with antifilarials has been recommended as the principal strategy to achieve LF elimination. This requires an effective and sustainable strategy to deliver the drug, diethylcarbamazine (DEC), to communities. In this study, a new drug delivery strategy - community-directed treatment (comDT) - was developed and implemented and its effectiveness compared with that of the traditional health services-organized drug delivery, in rural areas of Tamil Nadu, India. Qualitative and quantitative data showed that the communities and health services were able to distribute the drug in almost all villages. The drug distribution rate and treatment compliance rate of comDT and health services treatment were statistically compared after adjusting them for clustering. Under the comDT 68% (n=20 villages; range: 0-97%) of the population received DEC, compared with 74% (n=20 villages; range: 48-95%) with the health services treatment strategy (P > 0.05). However, only about 53% (range: 0-91%) of comDT recipients and 59% (range: 32-79%) of those who received DEC from the health services consumed the drug (P > 0.05). Although statistically not significant, the distribution and compliance rates were lower under the comDT strategy. Also, the strategy's operationalization appears to be difficult because of some social factors, and the tradition of communities' dependence on health services for treatment, whereas health services-organized distribution was much less cumbersome and found to be more acceptable to people. However, the distribution (74%) and compliance rates (59%) achieved by health services were also only moderate and may not be adequate to eliminate LF in a reasonable time frame. Health services manpower alone may not be sufficient to distribute the drug. We conclude that drug distribution by health services is the best option for India and participation of the community volunteers and village level government staffs in the programme is necessary to effectively distribute the drug and attain the desirable levels of treatment compliance to eliminate LF.
PubMed: 11737843
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Kumar</name></author><author><name sortKey="Chandrakala, A V" sort="Chandrakala, A V" uniqKey="Chandrakala A" first="A V" last="Chandrakala">A V Chandrakala</name></author><author><name sortKey="Augustin, D J" sort="Augustin, D J" uniqKey="Augustin D" first="D J" last="Augustin">D J Augustin</name></author><author><name sortKey="Appavoo, N C" sort="Appavoo, N C" uniqKey="Appavoo N" first="N C" last="Appavoo">N C Appavoo</name></author><author><name sortKey="Das, P K" sort="Das, P K" uniqKey="Das P" first="P K" last="Das">P K Das</name></author></analytic><series><title level="j">Tropical medicine & international health : TM & IH</title><idno type="ISSN">1360-2276</idno><imprint><date when="2001" type="published">2001</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Community Health 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médicamenteux)</term><term>Humains</term><term>Inde</term><term>Mâle</term><term>Nourrisson</term><term>Personnel de santé</term><term>Prestations des soins de santé</term><term>Services de santé communautaires</term><term>Services de santé ruraux</term><term>Sujet âgé</term><term>Évaluation de programme</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Diethylcarbamazine</term><term>Filaricides</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>India</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Diéthylcarbamazine</term><term>Filaricides</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Elephantiasis, Filarial</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Elephantiasis, Filarial</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Filariose lymphatique</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Community Health Services</term><term>Community Health Workers</term><term>Delivery of Health Care</term><term>Female</term><term>Health Personnel</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Program Evaluation</term><term>Rural Health Services</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Agents de santé communautaire</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Filariose lymphatique</term><term>Humains</term><term>Inde</term><term>Mâle</term><term>Nourrisson</term><term>Personnel de santé</term><term>Prestations des soins de santé</term><term>Services de santé communautaires</term><term>Services de santé 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Repeated annual single-dose mass treatment with antifilarials has been recommended as the principal strategy to achieve LF elimination. This requires an effective and sustainable strategy to deliver the drug, diethylcarbamazine (DEC), to communities. In this study, a new drug delivery strategy - community-directed treatment (comDT) - was developed and implemented and its effectiveness compared with that of the traditional health services-organized drug delivery, in rural areas of Tamil Nadu, India. Qualitative and quantitative data showed that the communities and health services were able to distribute the drug in almost all villages. The drug distribution rate and treatment compliance rate of comDT and health services treatment were statistically compared after adjusting them for clustering. Under the comDT 68% (n=20 villages; range: 0-97%) of the population received DEC, compared with 74% (n=20 villages; range: 48-95%) with the health services treatment strategy (P > 0.05). However, only about 53% (range: 0-91%) of comDT recipients and 59% (range: 32-79%) of those who received DEC from the health services consumed the drug (P > 0.05). Although statistically not significant, the distribution and compliance rates were lower under the comDT strategy. Also, the strategy's operationalization appears to be difficult because of some social factors, and the tradition of communities' dependence on health services for treatment, whereas health services-organized distribution was much less cumbersome and found to be more acceptable to people. However, the distribution (74%) and compliance rates (59%) achieved by health services were also only moderate and may not be adequate to eliminate LF in a reasonable time frame. Health services manpower alone may not be sufficient to distribute the drug. We conclude that drug distribution by health services is the best option for India and participation of the community volunteers and village level government staffs in the programme is necessary to effectively distribute the drug and attain the desirable levels of treatment compliance to eliminate LF.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">11737843</PMID><DateCreated><Year>2001</Year><Month>12</Month><Day>13</Day></DateCreated><DateCompleted><Year>2002</Year><Month>01</Month><Day>10</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1360-2276</ISSN><JournalIssue CitedMedium="Print"><Volume>6</Volume><Issue>12</Issue><PubDate><Year>2001</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Tropical medicine & international health : TM & IH</Title><ISOAbbreviation>Trop. Med. Int. Health</ISOAbbreviation></Journal><ArticleTitle>Effectiveness of community and health services-organized drug delivery strategies for elimination of lymphatic filariasis in rural areas of Tamil Nadu, India.</ArticleTitle><Pagination><MedlinePgn>1062-9</MedlinePgn></Pagination><Abstract><AbstractText>Lymphatic filariasis (LF) is targeted for global elimination. Repeated annual single-dose mass treatment with antifilarials has been recommended as the principal strategy to achieve LF elimination. This requires an effective and sustainable strategy to deliver the drug, diethylcarbamazine (DEC), to communities. In this study, a new drug delivery strategy - community-directed treatment (comDT) - was developed and implemented and its effectiveness compared with that of the traditional health services-organized drug delivery, in rural areas of Tamil Nadu, India. Qualitative and quantitative data showed that the communities and health services were able to distribute the drug in almost all villages. The drug distribution rate and treatment compliance rate of comDT and health services treatment were statistically compared after adjusting them for clustering. Under the comDT 68% (n=20 villages; range: 0-97%) of the population received DEC, compared with 74% (n=20 villages; range: 48-95%) with the health services treatment strategy (P > 0.05). However, only about 53% (range: 0-91%) of comDT recipients and 59% (range: 32-79%) of those who received DEC from the health services consumed the drug (P > 0.05). Although statistically not significant, the distribution and compliance rates were lower under the comDT strategy. Also, the strategy's operationalization appears to be difficult because of some social factors, and the tradition of communities' dependence on health services for treatment, whereas health services-organized distribution was much less cumbersome and found to be more acceptable to people. However, the distribution (74%) and compliance rates (59%) achieved by health services were also only moderate and may not be adequate to eliminate LF in a reasonable time frame. Health services manpower alone may not be sufficient to distribute the drug. We conclude that drug distribution by health services is the best option for India and participation of the community volunteers and village level government staffs in the programme is necessary to effectively distribute the drug and attain the desirable levels of treatment compliance to eliminate LF.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ramaiah</LastName><ForeName>K D</ForeName><Initials>KD</Initials><AffiliationInfo><Affiliation>Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India. mosquito@sancharnet.in</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vijay Kumar</LastName><ForeName>K N</ForeName><Initials>KN</Initials></Author><Author ValidYN="Y"><LastName>Chandrakala</LastName><ForeName>A V</ForeName><Initials>AV</Initials></Author><Author ValidYN="Y"><LastName>Augustin</LastName><ForeName>D J</ForeName><Initials>DJ</Initials></Author><Author ValidYN="Y"><LastName>Appavoo</LastName><ForeName>N C</ForeName><Initials>NC</Initials></Author><Author ValidYN="Y"><LastName>Das</LastName><ForeName>P K</ForeName><Initials>PK</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Trop Med Int Health</MedlineTA><NlmUniqueID>9610576</NlmUniqueID><ISSNLinking>1360-2276</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005369">Filaricides</NameOfSubstance></Chemical><Chemical><RegistryNumber>V867Q8X3ZD</RegistryNumber><NameOfSubstance UI="D004049">Diethylcarbamazine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003153" MajorTopicYN="Y">Community Health Services</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003150" MajorTopicYN="N">Community Health Workers</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003695" MajorTopicYN="Y">Delivery of Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004049" MajorTopicYN="N">Diethylcarbamazine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004605" MajorTopicYN="N">Elephantiasis, Filarial</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005369" MajorTopicYN="N">Filaricides</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007194" MajorTopicYN="N" Type="Geographic">India</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015397" MajorTopicYN="Y">Program Evaluation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019035" MajorTopicYN="Y">Rural Health Services</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2001</Year><Month>12</Month><Day>12</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2002</Year><Month>1</Month><Day>11</Day><Hour>10</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2001</Year><Month>12</Month><Day>12</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">11737843</ArticleId><ArticleId IdType="pii">813</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Inde</li></country></list><tree><noCountry><name sortKey="Appavoo, N C" sort="Appavoo, N C" uniqKey="Appavoo N" first="N C" last="Appavoo">N C Appavoo</name><name sortKey="Augustin, D J" sort="Augustin, D J" uniqKey="Augustin D" first="D J" last="Augustin">D J Augustin</name><name sortKey="Chandrakala, A V" sort="Chandrakala, A V" uniqKey="Chandrakala A" first="A V" last="Chandrakala">A V Chandrakala</name><name sortKey="Das, P K" sort="Das, P K" uniqKey="Das P" first="P K" last="Das">P K Das</name><name sortKey="Vijay Kumar, K N" sort="Vijay Kumar, K N" uniqKey="Vijay Kumar K" first="K N" last="Vijay Kumar">K N Vijay Kumar</name></noCountry><country name="Inde"><noRegion><name sortKey="Ramaiah, K D" sort="Ramaiah, K D" uniqKey="Ramaiah K" first="K D" last="Ramaiah">K D Ramaiah</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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