7 research outputs found

    Safeguarding community-centred global health research during crises

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    Global health researchers encounter challenges in conducting research during crises, including pandemics, natural disasters and humanitarian conflicts.1 2 External crises often arise without prior notice and disrupt well-planned research. It is difficult to continue research activities under these circumstances, particularly when researchers and communities are at risk.3 Furthermore, community engagement and involvement (CEI), a crucial element in decolonised global health research,4 can become particularly difficult, as the community members’ primary focus may be on survival and acquiring basic needs, which must be a priority above commitment and participation in research. Conducting research in a context of crisis imposes concerns about ethical, credible and equitable research.5 6 The COVID-19 pandemic had a significant impact on global health research, particularly in low-income and middle-income countries (LMICs). Both funding acquisition and scholarly output in LMICs were affected.2 Collaborative research relied on virtual communication platforms, and alternative data collection mechanisms, such as online questionnaires and telephone interviews. However, the validity, reliability and generalisability of such datasets are still subject to extensive discussion.7 Populations without reliable internet access and electronic devices were often excluded from participation, which further exacerbated social inequity, particularly in disadvantaged rural communities.8 9 Here, we share the experience of the Sri Lankan team of the multicountry global health research programme ECLIPSE. We highlight three aspects that will inform the global scientific community in safeguarding research during crises: (1) positioning the research within the crisis context; (2) using CEI for ongoing research and (3) innovating methods and moving beyond the virtual mode

    Community-based interventions for the prevention and control of Cutaneous Leishmaniasis: A systematic review

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    We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD: 1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore, we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access

    'We do not rush to the hospital for ordinary wounds (suḷu tuvāla)': A qualitative study on the early clinical manifestations of cutaneous leishmaniasis and associated health behaviours in rural Sri Lanka.

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    Knowledge of early clinical manifestations, people's perceptions and behaviours is crucial in preventing and controlling neglected tropical diseases (NTDs). Cutaneous leishmaniasis is an NTD that causes skin lesions and affects millions worldwide. Delayed healthcare-seeking behaviour leading to prolonged treatment periods and complications is rife among people with cutaneous leishmaniasis. This study examined the patient-reported early clinical manifestations of cutaneous leishmaniasis, local interpretations and associated health behaviours within the socio-cultural context of rural Sri Lanka. We conducted a qualitative study among people with cutaneous leishmaniasis in three rural communities in the Anuradhapura district, Sri Lanka. Participants' experiences were explored through a study-bespoke participant experience reflection journal and in-depth interviews. We analysed the data using a narrative-thematic approach. The study included 30 people with cutaneous leishmaniasis (12 females and 18 males) aged between 18 and 75 years. We identified four major themes during the analysis: 1) patient-reported early clinical manifestations of cutaneous leishmaniasis, 2) local interpretations of the early skin lesion(s), 3) associated actions and behaviours, and 4) the time gap between the initial notice of symptoms and seeking healthcare for cutaneous leishmaniasis. Early clinical manifestations differed among the participants, while the majority misinterpreted them as a mosquito/ant bite, pimple, wart, eczema, macule, or worm infestation. Participants undertook different context-specific self-management actions to cure cutaneous leishmaniasis. We identified an average time gap between the notice of symptoms and the first visit to the healthcare facility ranging from three to twelve months. Diverse early clinical manifestations, local interpretations, and associated behaviours of people with cutaneous leishmaniasis have led to a substantial delay in healthcare-seeking. The study sheds light on the importance of understanding the manifestations of NTDs within the social context. Our findings will inform designing context-specific health interventions to improve awareness and healthcare-seeking in cutaneous leishmaniasis in rural settings. [Abstract copyright: Copyright: © 2023 Gunasekara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    Safeguarding community-centred global health research during crises

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    Global health researchers face multiple challenges in proceeding with research programmes during crises, including ethical and safety questions, equitable participation of community members and the collection of robust data. ⇒ In Sri Lanka, the multi country global health programme ECLIPSE adopted innovative research methods in a context dictated by pandemic conditions, and strengthened by community engagement and involvement (CEI), to achieve its goals, provides a model for global health researchers working in crisis settings. ⇒ Following the government regulations in combination with scientific guidelines, closely monitoring the pandemic and timely prediction, adopting a robust CEI approach at the early stages of research and using innovative methods that moves beyond virtual mode can help navigation of research without disruption. ⇒ Incorporated crisis preparedness and alternative plans focusing on encouraging the use of CEI in grant proposal development by researchers and a the demand of global health research funders on these key aspects would enhance the ability of research programmes to sustain during crises

    Community based interventions for the prevention and control of Cutaneous Leishmaniasis : a systematic review

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    We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD: 1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore, we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).peer-reviewe

    Engineering Performance of Concrete Incorporated with Recycled High-Density Polyethylene (HDPE)—A Systematic Review

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    Incorporating recycled plastic waste in concrete manufacturing is one of the most ecologically and economically sustainable solutions for the rapid trends of annual plastic disposal and natural resource depletion worldwide. This paper comprehensively reviews the literature on engineering performance of recycled high-density polyethylene (HDPE) incorporated in concrete in the forms of aggregates or fiber or cementitious material. Optimum 28-days’ compressive and flexural strength of HDPE fine aggregate concrete is observed at HDPE-10 and splitting tensile strength at HDPE-5 whereas for HDPE coarse aggregate concrete, within the range of 10% to 15% of HDPE incorporation and at HDPE-15, respectively. Similarly, 28-days’ flexural and splitting tensile strength of HDPE fiber reinforced concrete is increased to an optimum of 4.9 MPa at HDPE-3 and 4.4 MPa at HDPE-3.5, respectively, and higher than the standard/plain concrete matrix (HDPE-0) in all HDPE inclusion levels. Hydrophobicity, smooth surface texture and non-reactivity of HDPE has resulted in weaker bonds between concrete matrix and HDPE and thereby reducing both mechanical and durability performances of HDPE concrete with the increase of HDPE. Overall, this is the first ever review to present and analyze the current state of the mechanical and durability performance of recycled HDPE as a sustainable construction material, hence, advancing the research into better performance and successful applications of HDPE concrete

    'We do not rush to the hospital for ordinary wounds (suḷu tuvāla)': A qualitative study on the early clinical manifestations of cutaneous leishmaniasis and associated health behaviours in rural Sri Lanka.

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    BackgroundKnowledge of early clinical manifestations, people's perceptions and behaviours is crucial in preventing and controlling neglected tropical diseases (NTDs). Cutaneous leishmaniasis is an NTD that causes skin lesions and affects millions worldwide. Delayed healthcare-seeking behaviour leading to prolonged treatment periods and complications is rife among people with cutaneous leishmaniasis. This study examined the patient-reported early clinical manifestations of cutaneous leishmaniasis, local interpretations and associated health behaviours within the socio-cultural context of rural Sri Lanka.Methodology/principal findingsWe conducted a qualitative study among people with cutaneous leishmaniasis in three rural communities in the Anuradhapura district, Sri Lanka. Participants' experiences were explored through a study-bespoke participant experience reflection journal and in-depth interviews. We analysed the data using a narrative-thematic approach. The study included 30 people with cutaneous leishmaniasis (12 females and 18 males) aged between 18 and 75 years. We identified four major themes during the analysis: 1) patient-reported early clinical manifestations of cutaneous leishmaniasis, 2) local interpretations of the early skin lesion(s), 3) associated actions and behaviours, and 4) the time gap between the initial notice of symptoms and seeking healthcare for cutaneous leishmaniasis. Early clinical manifestations differed among the participants, while the majority misinterpreted them as a mosquito/ant bite, pimple, wart, eczema, macule, or worm infestation. Participants undertook different context-specific self-management actions to cure cutaneous leishmaniasis. We identified an average time gap between the notice of symptoms and the first visit to the healthcare facility ranging from three to twelve months.Conclusions/significanceDiverse early clinical manifestations, local interpretations, and associated behaviours of people with cutaneous leishmaniasis have led to a substantial delay in healthcare-seeking. The study sheds light on the importance of understanding the manifestations of NTDs within the social context. Our findings will inform designing context-specific health interventions to improve awareness and healthcare-seeking in cutaneous leishmaniasis in rural settings
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