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Title: Community-directed treatment: The way forward to eliminating lymphatic filariasis as a public-health problem in Ghana
Authors: Gyapong, M.
Gyapong, J.O.
Owusu-Banahene, G.
Keywords: EMTREE drug terms: ivermectin
EMTREE medical terms: article; community care; drug storage; filariasis; Ghana; health care access; health care availability; health care delivery; health care facility; health care personnel; health care system; human; patient compliance; public health service
MeSH: Adolescent; Adult; Aged; Child; Child, Preschool; Community Health Services; Elephantiasis, Filarial; Endemic Diseases; Female; Filaricides; Ghana; Humans; Ivermectin; Male; Medication Systems; Middle Aged; Outcome and Process Assessment (Health Care); Patient Compliance; Patient Participation
Issue Date: 2001
Citation: Gyapong, M., Gyapong, J. O., & Owusu-Banahene, G. (2001). Community-directed treatment: The way forward to eliminating lymphatic filariasis as a public-health problem in ghana. Annals of Tropical Medicine and Parasitology, 95(1), 77-86.
Abstract: The elimination of lymphatic filariasis as a public-health problem is currently dependent on the delivery of annual drug treatments to at least 80% of the eligible members of endemic populations for at least 5 years. However, for various reasons, this goal may not be achievable by the health systems of most endemic countries in sub-Saharan Africa, particularly if treatment is not community-directed. In Ghana, community-directed ivermectin treatment involving the regular public-health services at the implementation level (ComDT/HS) has recently been compared with mass-treatment in which only the health services participated (HST). Health staff and the target communities appreciated the ComDT/HS approach more than the HST approach and were more willing to participate in the community-directed scheme. The treatment coverage achieved by ComDT/HS (74.5%) was not only much higher than that of HST (43.5%) but also probably adequate for filariasis elimination. HST coverage was particularly poor in villages located > 5 km from a health facility, but distance from such a facility had no significant effect on treatment coverage in the ComDT/HS arm. As virtually all the subjects who received drugs swallowed them, compliance with treatment was not a problem. The ComDT/HS approach is therefore recommended, especially for areas where access to health facilities is poor and the health workers are over-stretched. The implications of these findings for the global programme for filariasis elimination are discussed.
ISSN: 00034983
Appears in Collections:School of Public Health 9

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