A. Hossain

A. Sultana

B. Abidta

N. Ratnalingam

Y.M. Qui

Annals of Global Health

Directory of Open Access Journals

New and emerging priorities for global health A n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6M a yeJ u n e 2 0 1 6 : 3 9 7 – 4 3 6424USA, 2Centre for Population Health, Burnet Institute, Australia,3School of Public Health and Preventive Medicine, Monash University,AustraliaBackground: Displacement due to conflict and persecution isoccurring at levels not seen since World War Two. Exposure toconflict and displacement are risk factors for mental health disordersand substance use. We aimed to systematically review the literatureabout alcohol and illicit use among refugees, internally displacedpeople (IDPs) and asylum seekers, and identify priority areas forintervention and future research.Methods: Structured searches of seven medical, allied health andsocial science databases were conducted in accordance withPRISMA guidelines, identifying 54 relevant original peer-reviewedarticles. We present here findings from 41 quantitative studies,drawing preferentially on studies using validated measures to assessprevalence and risk factors for substance use.Findings: Over two thirds of studies focused on resettled refugeepopulations in high-income countries, predominantly in the UnitedStates and Central Europe. Seven studies were conducted in campsettings. Most studies used cross-sectional methods (80%); onlytwo cohort studies and one brief intervention study were identified.The highest-quality prevalence estimates of hazardous/harmfulalcohol use ranged from 17%-36% in camp settings and 4%-7%in community settings. Best estimates of alcohol dependence were4%-42% and 1%-25% in camp and community settings, respec-tively. Prevalence of drug dependence was below 5% in the fivestudies conducted in community settings, and 20% in the one studyconducted in a camp setting. Male sex, trauma exposure and mentalhealth symptoms were commonly identified as independent riskfactors for susbstance use.Interpretations: Our understanding of substance use among thesepopulations remains limited, particularly in low and middle-incomecountries, where over 80% of the global refugee population resides.Nonetheless, best estimates suggest that as many as one in three dis-placed persons in camp settings may be using alcohol in harmful orhazardous ways. Less is known about illicit drug use. Findingssuggest a need to integrate substance use prevention and treatmentinto services offered to refugees, IDPs and asylum seekers. Longitu-dinal research is required to examine changes in substance use acrossthe migration trajectory. There is also a need to develop and evaluateinteventions to reduce substance use and related harms amongforced migrant populations.Funding: Danielle Horyniak is supported by an Early CareerFellowship from the Australian National Health & MedicalResearch Council.Abstract #: 1.064_NEPThree year review of anti-jiggers education and treatmentintervention programming in Sabatia District, WesternProvince, KenyaA. Hossain1,2, A. Sultana1,2, B. Abidta2,3, N. Ratnalingam2,4,Y.M. Qui2,5; 1University of Toronto Dalla Lana School of PublicHealth, Toronto, ON, Canada, 2Students for International Develop-ment, Toronto, ON, Canada, 3Karolinska Institute, Stockholm, Sweden,4University of Toronto, Toronto, ON, Canada, 5John HopkinsBloomberg School of Public Health, Baltimore, MD, USAProject Purpose: Jiggers (Tunga penetrans) is a vector-borne disease.An estimated 2 million Kenyans are affected. Limited resources fromthe Ministry of Health (MOH) due to competing public health prior-ities and no standard practice of care have made addressing thisneglected disease a challenge. In partnership with the MOH andcommunity health workers (CHWs), Students for InternationalDevelopment (SID) implemented three anti-jigger campaigns in2012-2014 during May-August in Sabatia District, Western Kenya.Structure: Consultation with dispensary staff and health districtofficers informed the site of intervention each year in Wunundi,Wodanga and Munungi regions, respectively. CHWs identifiedmost severe households cases for treatment - 30 cases (2012), 120cases (2013), 50 cases (2014). In the 2012 pilot year, treatmenttook place at a public health camp. Individuals soaked the infectedarea in potassium permanganate (PP) for 20 minutes. Projectmanagers and CHWs did home follow-ups with: 1) home fumiga-tion using a non-toxic insecticide 2) dispelled common myths 3)introduced accessible alternative of tobacco and petroleum jelly.2013 year was scaled up with: 1) home cleaning with cow dung 2)fumigation 3) 10 consecutive PP treatment days 4) shoes uponcompletion. 2014 year held home visits (cleaning/fumigation) for10 treatment days, and had an education emphasis.Outcome/Evaluation: Campaigns led to a 90% case reductionrate. Consistent treatment (7-10 days) is most effective. This buildsrapport between CHWs and patients, reduces stigma, and increasespersonal hygiene practices. Home interventions eliminate financialbarriers. A pre/post count of individual’s jiggers and a survey ofjiggers health education (beliefs, interventions, causes) were admin-istered by CHWs pre-, mid-, and post-intervention. Overall, therewas a positive shift in health-behaviour knowledge, though a limita-tion of interviewer bias exists.Going Forward: An unmet goal is quarterly follow-ups by CHWswhen SID is absent. Sparse evidence for best practices of care hasbeen challenging in guiding treatment of “severe” cases. We hopeto standardize treatment guidelines with Kenya MOH and supporttheir efforts in making this a key public health priority, throughmonitoring and evaluation.Funding: Supplies from Ahadi Kenya and private donations.Abstract #: 1.065_NEPTrends in between-country health equity in Sub-Saharan Africafrom 1990 to 2011: improvement, convergence and reversalJ. Jin1, L. Shi2, J. Huang1; 1Key Laboratory of Health TechnologyAssessment, Ministry of Health (Fudan University), Shanghai, China,2Department of Public Health Sciences, Clemson UniversityBackground: With substantial amounts of foreign aid invested insub-Saharan Africa, it remains unclear whether health inequity inthis region decreased over time.Method: We use the World Health Organization’s data about of46 nations in sub-Saharan Africa to run a convergence model totrack the variation of health indicators (under-5 mortality, U5MR

Three year review of anti-jiggers education and treatment intervention programming in Sabatia District, Western Province, Kenya

http://www.annalsofglobalhealth.org/articles/10.1016/j.aogh.2016.04.180/galley/1021/download/

Three year review of anti-jiggers education and treatment intervention programming in Sabatia District, Western Province, Kenya

Abstract

Similar works

Full text

Available Versions

Directory of Open Access Journals