Dada, S

Lees, S

Mateus, A L P

McKay, G

English

RVC Research Online

Abstracts / International Journal of Infectious Diseases 79(S1) (2019) 1–150 131lic health decisions, by providing thought-provoking analysis of theimplications for future health communication policy and practiceResults: In order to create a credible scientific discourse, certainpatterns that are still ingrained in the health organizations mustbe overcome: (1) homogeneous executive committees; (2) publichealth experts versus “people with agendas”; (3) from certaintyto uncertainty; (4) the preference for consensus; (5) conflicts ofinterest; (6) facts/rationality v. emotions/myths; and (7) the med-icalization of public health.Conclusion: In the digital age, organizations can deconstructwhat Foucault called the field of knowledge/power by using thedifferent narratives of diverse publics to create a more balanceddemocratic system that also has creative flexibility. For that to hap-pen, the establishment must change its mode of thinking in itsscientific discourse, while at the same time building digital andcommunication systems that use crowdsourcing to solve scientificproblems, and involving and including the public in the discoursein the public sphere. These steps can contribute to a differentrisk management approach for epidemic crises, bringing organiza-tions closer to theirmetaphorical potential of embracing the publicsphere.https://doi.org/10.1016/j.ijid.2018.11.31921.119The four R’s: a community engagementframework for disease preparedness research inSierra LeoneS. Dada1,∗, S. Lees2, A. Mateus3, G. McKay21 London School of Hygiene and Tropical Medicine &the Royal Veterinary College, Marietta, GA/US2 London School of Hygiene and Tropical Medicine,London/UK3 Royal Veterinary College, London/UKPurpose: Building trust and engaging the communitywere corecomponents of the 2015 EBOVAC and 2018 PREVAC Ebola vaccinetrials in Sierra Leone. Thus, it recruited a community liaison team(CLT) toengagewith thecommunity throughpublicmeetings, radiochat shows and other activities, and a social science team (SST) toassess community members’ and participants’ perceptions of thetrial. Both teamsprovided regularupdates the clinical teamtoadaptprocedures.This study sought to understandbarriers and facilitators to com-munity engagement around biomedical research. Specifically, itaimed to determine the viability of rolling out the EBOVAC andPREVAC trials’ model in other disease preparedness programmes.Methods & Materials: A field study was conducted to assessthe model’s implementation in these trials during following theEbola outbreak. EBOVAC and PREVAC team members attended 15in-depth interviews, communitymembers and local leaders attend3 focus group discussions (FGDs) to discuss the Ebola epidemic, thecurrent trials and community engagement activities.Results: Based on initial findings, four main principles char-acterized the community engagement model used in the Ebolavaccine trials: reciprocal, relatable, relational and respectful.The trial incorporated two separate teams to ensure recipro-cal communication between the trial and the community. The CLTdelivered key messages from the trial, whilst the SST completedethnographic research in the field to uncover trial rumours andperceptions in the community. These findings were brought backto the CLT and incorporated into targeted messaging. Trial work-ers approached the communities as equals by dressing modestly,speaking local dialects, and using relatable examples. Appreciationand understanding of the importance of interpersonal relation-ships and respect for the people, their customs and traditions alsoplayed a large role in the success of the community engagementprogramme.Conclusion: These findings could provide a community engage-ment framework for other programmes occurring in “peace time”(disease preparedness) or during a disease outbreak. The frame-work should be tested in other settings where such interventionsare ongoing, to ascertain whether these principles remain consis-tent across settings and diseases. If this is the case, this frameworkcould be incorporated into international guidelines on communityengagement.https://doi.org/10.1016/j.ijid.2018.11.32021.120Socioeconomic factors predict the increase ofincidence rates of visceral leishmaniasis in higlyendemic areas in BrazilG.L. Werneck1,∗, E. Braga21 Federal University of Rio de Janeiro & StateUniversity of Rio de Janeiro, IESC & IMS, Rio deJaneiro/BR2 State University of Rio de Janeiro, Epidemiology,Rio de Janeiro/BRPurpose: To evaluate the association between socioeconomicfactors and the changes in the incidence of visceral leishmaniasis(VL) in highly endemic areas in Brazil.Methods & Materials: Among the 2,136 Brazilian municipal-ities with at least one VL case from 2001 to 2013, we selectedthose 480 with an average of ≥1 VL case/year. VL cases for eachmunicipality were obtained from the Brazilian System for Noti-fiable Diseases. Socioeconomic and demographic variables wereobtained from the Brazilian Census (2010) and included incomeinequality (Gini index), % population living in rural areas, % popu-lation <5 years of age, % households with access to water supply,sewerage system, electric light, and garbage collection. Informa-tion on the annual coverage of the implementation of euthanasiaof VL infected dogswas obtained from the Brazilian VL Control Pro-gramme (2005–2012). The outcome is the VL incidence rates from2006 to 2013. Associations between variableswere evaluated usinga multivariate multilevel Poisson regression. Associations wereexpressed as incidence rate ratios and 95% confidence intervals.Results: A total of 23,638 VL cases were registered in the 480municipalities from 2006 to 2013. Results indicated an annualdecrease in the incidence rates by 3% (p<0.001), with significantvariations in trends among themunicipalities. For every increase in0.1 points in theGini index, the annual VL incidence rates decreasedby 48% (p<0.001). For every increase in 1% in the householdswith access to water supply plus sewerage system and electriclight, the VL rates decreased by 2% (p=0.044 and p=0.034, respec-tively). For every increase in 1% of the rural population and of thepopulation <5 years of age, the VL rates increased by 0.8% and17%, respectively (p =0.005 and p=<0.001). The implementationof euthanasia of infected dogs in a particular year was associatedwith an increase in 9% in the VL incidence in the following year,reflecting the widely accepted knowledge that control measuresare usually implemented after VL cases identification.Conclusion: Efforts for decreasing income inequality and pro-viding essential urban services might be effective strategies forcontrolling the spread of VL in urban areas.https://doi.org/10.1016/j.ijid.2018.11.321

The four R's: a community engagement framework for disease preparedness research in Sierra Leone

https://researchonline.rvc.ac.uk/id/eprint/12008/1/12008.pdf

The four R's: a community engagement framework for disease preparedness research in Sierra Leone

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