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Effectiveness of community and health services-organized drug delivery strategies for elimination of lymphatic filariasis in rural areas of Tamil Nadu, India
- Source :
- Tropical medicineinternational health : TMIH. 6(12)
- Publication Year :
- 2001
-
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 strategys 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. The authors 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 program is necessary to effectively distribute the drug and attain the desirable levels of treatment compliance to eliminate LF. (authors)
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Health Personnel
Population
Developing country
India
Diethylcarbamazine
Elephantiasis, Filarial
Environmental protection
Environmental health
medicine
Humans
Community Health Services
education
Child
Lymphatic filariasis
Aged
Community Health Workers
education.field_of_study
business.industry
Public health
Public Health, Environmental and Occupational Health
Infant
Middle Aged
medicine.disease
language.human_language
Infectious Diseases
Filaricides
Tamil
Child, Preschool
Drug delivery
language
Parasitology
Female
Rural Health Services
Rural area
business
Delivery of Health Care
medicine.drug
Program Evaluation
Subjects
Details
- ISSN :
- 13602276
- Volume :
- 6
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Tropical medicineinternational health : TMIH
- Accession number :
- edsair.doi.dedup.....63c108d3f1cfed4dc1794b4b812c125a