Controlling onchocerciasis by community-directed, ivermectin-treatment programmes in Uganda: why do some communities succeed and others fail?
Controlling onchocerciasis by community-directed, ivermectin-treatment programmes in Uganda: why do some communities succeed and others fail?
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DOI：
10.1080/00034980050034590
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发表时间：
2000-06-01
影响因子：
--
通讯作者：
Richards, FO
中科院分区：
文献类型：
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作者：
Katabarwa, NM;Mutabazi, D;Richards, FO
在乌干达，人类盘尾丝虫病通过每年在流行率大于或等于30%的所有流行社区开展大规模社区导向的伊维菌素治疗方案得到控制。这是一个实际、长期和具有成本效益的战略。在一些社区，这一系统成功地提供了所需覆盖水平的治疗（即年度治疗目标的90%，这本身相当于所有有资格服用伊维菌素的人）。然而，其他社区未能达到这一目标。本研究的目的是确定与实现这一目标的成功或失败显著相关的因素。分析的数据是对一份问卷的回答，问卷由从64个随机选择的地方病社区中的每一个社区中随机选择的10名户主填写在卡巴莱、莫约、内比和鲁昆吉里四个地区，有36个成功，28个没有达到覆盖目标。在统计学显著性水平上（P小于或等于0.05），社区成员参与：（1）关于方案执行的决定;（2）参加健康教育会议;（3）选择社区分销商;（4）对CBD进行实物奖励。一般来说，社区成员参与CDITP的规划和执行（以及由此产生的社区所有权的自豪感）比外部卫生工作者甚至社区领导人或地方议会更有可能产生成功的结果。
In Uganda, human onchocerciasis is controlled by annual, mass, community-directed, ivermectin-treatment programmes (CDITP) in all endemic communities where the prevalence of the disease is greater than or equal to 30%. This is a practical, long-term and cost-effective strategy. In some communities, this system succeeds in providing treatment at the desired level of coverage (i.e. 90% of the annual treatment objective, which is itself equivalent to all those individuals eligible to take ivermectin). Other communities, however, fail to reach this target. The aim of the present study was to determine the factors that were significantly associated with success or failure in achieving this target. The data analysed were answers to a questionnaire completed by 10 household heads randomly selected from each of 64 randomly selected endemic communities (of which 36 succeeded and 28 failed to reach their coverage target) in the four districts of Kabale, Moyo, Nebbi and Rukungiri.Among the programme-related Factors investigated, success was associated, at a statistical level of significance (P less than or equal to 0.05), with involvement of community members in: (1) decisions about the execution of the programme; (2) attendance at health-education sessions; (3) selection of the community-based distributors (CDB); and (4) rewarding CBD in kind. In general, the involvement of community members in the planning and execution of a CDITP (and the resultant sense of pride in community ownership) was more likely to produce successful results than when external health workers or even community leaders or local councils Look responsibility.