An impact evaluation of two rounds of mass drug administration on the prevalence of active trachoma: A clustered cross sectional survey

Introduction We investigated the impact of two round of mass drug administration on trachoma prevalence in Plateau and Nasarawa States of Nigeria. The mass drug administration was conducted as a component of the SAFE Strategy, a combination of interventions recommended for the global elimination of blinding trachoma. Methods The study consisted of a two-stage cross-sectional clustered sample survey in which 3990 people from 793 households were screened for clinical signs of trachoma. Results Of the total 3990 people examined, 1530 were children, of which 808 (53%) were boys and 704 (47%) were girls. The impact of intervention as measured by the changes in overall prevalence of follicular trachoma were as follows: At baseline the overall prevalence of follicular trachoma among children 1–9 years of age was 6.4%, 95% CI [5.8, 7.0]; the overall prevalence of trachomatous trichiasis in the total population was 0.20%, 95% CI [0.16, 0.25]. At follow up, the overall prevalence of follicular trachoma among children 1–9 years of age was 3.4%, 95% CI [1.9, 4.9]; the overall prevalence of trachomatous trichiasis in the total population was 0.20%, 95% CI [0.00, 0.05]. The highest statistically significant reduction (96%) in follicular trachoma prevalence was observed in Doma Local Government Area of Nasarawa State from baseline prevalence of 13.6%, 95% CI [9.7, 17.5] to follow-up prevalence of 0.5%, 95% CI [0.0, 1.5] and the lowest reduction (58%) in follicular trachoma prevalence was observed in Langtang North Local Government Area of Plateau State from baseline prevalence of 15.8%, 95% CI [9.3, 22.3] to 6.6%, 95% CI [1.6, 11.6], (p\u3c0.05). Conclusion A significant reduction in the overall prevalence of follicular trachoma was achieved after two rounds of mass drug administration. In the absence of significant activities pertaining to facial cleanliness and environmental sanitation components of the SAFE strategy in the intervention areas, the observed deep reductions in prevalence could mainly be attributed to mass drug administration. Therefore, two rounds of mass azithromycin administration may be as effective as guideline-recommended three or more rounds in reducing active trachoma prevalence but findings should be replicated in more robustly designed studies

Emerging themes in coping with lifetime stress and implication for stress management education

Background: Adults with adverse childhood experiences and exposure to adverse life events experience a diverse array of physical, mental, and social health problems across their lifespan. Adult exposure to emotional trauma, physical injury, or other adverse life events may result in the development of post-traumatic stress and post-traumatic stress disorder. Understanding individuals’ response to stress and their coping strategies is as important as the stimulus or the causes of the stress for effective stress management interventions. Methods: This is a mixed quantitative and qualitative online survey study which explores the coping strategies to stress in adults with adverse childhood experiences and exposure to adverse life events through analysis of emerging themes from survey questionnaire responses of study participants. Results: Participants who respond to stress through adaptive coping focused either on problem-solving, 17.6% (32 out of 188), or on emotion-focused coping, 45.2% (85 out of 188). Participants engaged in problem-solving mainly through therapy such as counseling and other professional stress management, whereas those who chose emotion-focused coping used diverse strategies including practicing mindfulness, meditation, and yoga; using humor and jokes; seeking higher power or religious pursuits; engaging in physical or breathing exercises; and seeking social support. Participants who practiced maladaptive coping styles constituted 37.2% (70 out of 188) of respondents and resorted to avoidance of the stressful condition, withdrawal from a stressful environment, disengagement from stressful relationships, and use and abuse of drugs and/or alcohol. Conclusion: An understanding of emerging themes in coping strategies calls for collaborative and multidisciplinary approaches in the design, implementation, and execution of health education and promotion programs tailored to meet the diverse needs of priority populations. Stress management educators need to take into account the vulnerabilities of individuals who resort to maladaptive coping and institute evidence-based behavioral and social service intervention strategies, including life skills training, to prevent the consequences of maladaptive coping and to enhance the self-efficacy of individuals to cope more effectively with stress and stressful life events

Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration.

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely "Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene." Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors

Emerging themes in coping with lifetime stress and implication for stress management education

Background: Adults with adverse childhood experiences and exposure to adverse life events experience a diverse array of physical, mental, and social health problems across their lifespan. Adult exposure to emotional trauma, physical injury, or other adverse life events may result in the development of post-traumatic stress and post-traumatic stress disorder. Understanding individuals’ response to stress and their coping strategies is as important as the stimulus or the causes of the stress for effective stress management interventions. Methods: This is a mixed quantitative and qualitative online survey study which explores the coping strategies to stress in adults with adverse childhood experiences and exposure to adverse life events through analysis of emerging themes from survey questionnaire responses of study participants. Results: Participants who respond to stress through adaptive coping focused either on problem-solving, 17.6% (32 out of 188), or on emotion-focused coping, 45.2% (85 out of 188). Participants engaged in problem-solving mainly through therapy such as counseling and other professional stress management, whereas those who chose emotion-focused coping used diverse strategies including practicing mindfulness, meditation, and yoga; using humor and jokes; seeking higher power or religious pursuits; engaging in physical or breathing exercises; and seeking social support. Participants who practiced maladaptive coping styles constituted 37.2% (70 out of 188) of respondents and resorted to avoidance of the stressful condition, withdrawal from a stressful environment, disengagement from stressful relationships, and use and abuse of drugs and/or alcohol. Conclusion: An understanding of emerging themes in coping strategies calls for collaborative and multidisciplinary approaches in the design, implementation, and execution of health education and promotion programs tailored to meet the diverse needs of priority populations. Stress management educators need to take into account the vulnerabilities of individuals who resort to maladaptive coping and institute evidence-based behavioral and social service intervention strategies, including life skills training, to prevent the consequences of maladaptive coping and to enhance the self-efficacy of individuals to cope more effectively with stress and stressful life events

Supplementary_material_4-20_18 – Supplemental material for Emerging themes in coping with lifetime stress and implication for stress management education

<p>Supplemental material, Supplementary_material_4-20_18 for Emerging themes in coping with lifetime stress and implication for stress management education by Asrat G Amnie in SAGE Open Medicine</p

Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration.

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely "Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene." Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors

Opportunities and next steps in capacity building and training.

<p>Opportunities and next steps in capacity building and training.</p

Opportunities and next steps in advocacy for WASH and NTD sectors.

<p>Opportunities and next steps in advocacy for WASH and NTD sectors.</p

Joint advocacy and harmonized messaging between WASH and NTD sectors as “constructive interference.” Figure adapted from http://www.physicsnet.co.uk[37].

<p>Joint advocacy and harmonized messaging between WASH and NTD sectors as “constructive interference.” Figure adapted from <a href="http://www.physicsnet.co.uk" target="_blank">http://www.physicsnet.co.uk</a><a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002439#pntd.0002439-PhysicsNetcouk1" target="_blank">[37]</a>.</p

WASH-related NTDs and transmission mechanisms.

<p>Table adapted from „WASH: the silent weapon against NTDs” <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002439#pntd.0002439-WaterAid1" target="_blank">[36]</a>. Table represents the strength of connection between, and potential impact of, WASH and disease, starting at the top, where WASH impact on disease is likely to be strongest and moving to the bottom of the table, where impact may be weakest.</p>a<p>World Health Organization, “Prevention of blindness and visual impairment” 2012. <a href="http://www.who.int/blindness/causes/priority/en/index2.html" target="_blank">http://www.who.int/blindness/causes/priority/en/index2.html</a> (accessed: 5 August 2012).</p>b<p>World Health Organization, “Intestinal worms” 2012. <a href="http://www.who.int/intestinal_worms/en/" target="_blank">http://www.who.int/intestinal_worms/en/</a> (accessed 5 August 2012); World Health Organization, “Neglected tropical diseases” 2012. <a href="http://www.who.int/neglected_diseases/diseases/strongyloidiasis/en/" target="_blank">http://www.who.int/neglected_diseases/diseases/strongyloidiasis/en/</a> (accessed: 5 August 2012).</p>c<p>World Health Organization, “Schistosomiasis: fact sheet no. 115” 2012. <a href="http://www.who.int/mediacentre/factsheets/fs115/en/index.html" target="_blank">http://www.who.int/mediacentre/factsheets/fs115/en/index.html</a> (accessed: 5 August 2012).</p>d<p>World Health Organization, “Drancunculiasis: fact sheet no. 359” 2012. <a href="http://www.who.int/mediacentre/factsheets/fs359/en/index.html" target="_blank">http://www.who.int/mediacentre/factsheets/fs359/en/index.html</a> (accessed: 5 August 2012).</p>e<p>World Health Organization, “Lymphatic filariasis: fact sheet no. 102” 2012. <a href="http://www.who.int/mediacentre/factsheets/fs102/en/index.html" target="_blank">http://www.who.int/mediacentre/factsheets/fs102/en/index.html</a> (accessed: 5 August 2012).</p>f<p>World Health Organization, “Dengue and severe fever: fact sheet no. 117” 2012. <a href="http://www.who.int/mediacentre/factsheets/fs117/en/index.html" target="_blank">http://www.who.int/mediacentre/factsheets/fs117/en/index.html</a> (accessed: 5 August 2012).</p>g<p>World Health Organization, “Priority eye diseases” 2012. <a href="http://www.who.int/blindness/causes/priority/en/index3.html(accessed:5" target="_blank">http://www.who.int/blindness/causes/priority/en/index3.html(accessed: 5</a> August 2012).</p