UNDERSTANDING LOW UPTAKE OF MASS TREATMENT FOR INTESTINAL SCHISTOSOMIASIS AMONG SCHOOL CHILDREN: A QUALITATIVE STUDY IN JINJA DISTRICT, UGANDA
UNDERSTANDING LOW UPTAKE OF MASS TREATMENT FOR INTESTINAL SCHISTOSOMIASIS AMONG SCHOOL CHILDREN: A QUALITATIVE STUDY IN JINJA DISTRICT, UGANDA
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DOI：
10.1017/s002193201400011x
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发表时间：
2015-07-01
影响因子：
1.5
通讯作者：
Katahoire, Anne
中科院分区：
文献类型：
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作者：
Muhumuza, Simon;Olsen, Annette;Katahoire, Anne
尽管乌干达试图通过学校教师使用吡喹酮进行以学校为基础的大规模药物管理(MDA)来控制肠道血吸虫病，但在某些地区，只有不到30%的学童接受这种治疗。这项研究的目的是了解为什么学龄儿童对吡喹酮的摄取率较低，并提出提高摄取率的策略。这是一项横断面定性研究，在MDA后2个月进行了24次焦点小组讨论和15次关键信息者访谈。与12所小学的学童进行了焦点小组讨论，并与学校教师、县以下各级卫生助理和区病媒控制干事进行了关键信息提供人的访谈。研究表明，学龄儿童对吡喹酮的低摄取率是个人、人际、机构、社区和公共政策因素之间复杂相互作用的结果。吸毒率低的个人和人际因素包括对血吸虫病预防的信息不足，社区对血吸虫病治疗的信念和态度，以及儿童和教师对吡喹酮副作用的共同关注，特别是在空腹服用该药物的情况下。体制、政策和社区因素包括教师准备不足和提供便利，以及学校供餐政策，该政策要求父母负责在学校为孩子提供食物，但由于该地区普遍贫困，许多父母无法支付每日一餐的费用。结论是，促进学龄儿童接受吡喹酮的战略需要多管齐下，不仅要解决教师的准备和动机以及对儿童的健康教育，而且还要解决药物分配的经济和政治方面，包括学校供餐政策。
Despite attempts to control intestinal schistosomiasis through school-based mass drug administration (MDA) with praziquantel using school teachers in Uganda, less than 30% of the school children take the treatment in some areas. The aim of the study was to understand why the uptake of praziquantel among school children is low and to suggest strategies for improved uptake. This was a cross-sectional qualitative study in which 24 focus group discussions and 15 key informant interviews were conducted 2 months after MDA. The focus group discussions were held with school children in twelve primary schools and the key informant interviews were held with school teachers, sub-county health assistants and the District Vector Control Officer. The study shows that the low uptake of praziquantel among school children is a result of a complex interplay between individual, interpersonal, institutional, community and public policy factors. The individual and interpersonal factors underpinning the low uptake include inadequate information about schistosomiasis prevention, beliefs and attitudes in the community about treatment of schistosomiasis and shared concerns among children and teachers about the side-effects of praziquantel, especially when the drug is taken on an empty stomach. The institutional, policy and community factors include inadequate preparation and facilitation of teachers and the school feeding policy, which requires parents to take responsibility for providing their children with food while at school, yet many parents cannot meet the cost of a daily meal due to the prevailing poverty in the area. It is concluded that strategies to improve uptake of praziquantel among school children need to be multi-pronged addressing not only the preparation and motivation of teachers and health education for children, but also the economic and political aspects of drug distribution, including the school feeding policy.