Re-assessing community-directed treatment: evidence from Mazabuka District, Zambia.
Cross-sectional surveys with carers, health workers, community drug distributors (CDDs) and neighbourhood health committees were conducted to identify factors associated with utilization of community-directed treatment (ComDT) of soil-transmitted helminths in children aged 12-59 months in Mazabuka district, Zambia. The surveys took place in December 2006 and December 2007. In addition child treatment records were reviewed. The factors that were found to be significantly associated (p < 0.05) with treatment of children by the CDDs were: (1) the perception of soil-transmitted helminth infections as having significant health importance, (2) the community-based decision to launch and subsequently implement ComDT, (3) the use of the door-to-door method of drug distribution, (4) CDDs being visited by a supervisor, (5) CDDs receiving assistance in mobilizing community members for treatment, (6) CDDs having access to a bicycle and (7) CDDs having received assistance in collecting drugs from the health centre. Despite the effectiveness of ComDT in raising treatment coverage there are factors in the implementation process that will still affect whether children and their carers utilize the ComDT approach. Identification and understanding of these factors is paramount to achieving the desired levels of utilization of such interventions.
*Department of Public Health, School of Medicine,University of Zambia,Lusaka,Zambia.
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Halwindi
†DBL-Centre for Health Research and Development,University of Copenhagen,Frederiksberg,Denmark.
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Magnussen
‡Department of Clinical Sciences, School of Medicine,Copperbelt University,Ndola,Zambia.
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Siziya
§Section of Health Services Research, Department of Public Health, Faculty of Health and Medical Sciences,University of Copenhagen,Copenhagen,Denmark.
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Meyrowitsch
†DBL-Centre for Health Research and Development,University of Copenhagen,Frederiksberg,Denmark.
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Olsen
D000871:Anthelmintics / Q000627:therapeutic use; D002675:Child, Preschool; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006373:Helminthiasis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008509:Medication Systems; D012423:Rural Health; D012987:Soil / Q000469:parasitology*; D015024:Zambia
D000871:Anthelmintics; D012987:Soil