Background Schistosomiasis is endemic in the uMkhanyakude district of KwaZulu-Natal, South Africa. The South Africa Department of Health (DoH) has decided to implement a schistosomiasis preventive mass drug administration program in all affected parts of the country. Quality management is part of the strategic objectives of the treatment program. We conducted a risk assessment and developed guidelines for the quality management of a schistosomiasis preventive treatment program for children aged five years and below in the uMkhanyakude District of KwaZulu-Natal. Methods We conducted a scenario planning exercise by interviewing 10 child health experts from the uMKhanyakude Health District to establish potential risks associated with a planned schistosomiasis preventive control treatment program for children aged five years old and below. The risks were analyzed using a modified Failure Mode and Effect Analysis (FMEA). An FMEA table was produced to guide the quality management of the planned schistosomiasis preventive control treatment program for children aged five years and below in the uMkhanyakude Health District. Results We identified potential risks, failure modes and possible failure corrective/preventive measures in the following activities that would be part of the mass treatment of children aged five years and below infected with schistosomiasis in the uMkhanyakude District. These included enrolment of children into the treatment program; general health checks; weight and height measurements; administration of drugs; reporting of side effects and monitoring and evaluation. Conclusion We were able to use FMEA guide quality management and identify potential risks associated with the planned schistosomiasis preventive treatment program for children aged five years old and below in the uMkhanyakude District of KwaZulu-Natal. The FMEA for this program will be useful to the quality management of schistosomiasis preventive treatment programs for this age group in other similar settings.
Background: The early childhood development of millions of children in some low and medium income countries may be compromised by schistosomiasis infections contracted at the age of 5 years or below. Currently there are no standard guidelines for treating schistosomiasis in children that are five years and younger using praziquantel (PZQ), the only drug that the WHO recommends to treat schistosomiasis. This review is on processes and resources involved in the treatment of schistosomiasis in children aged five years and below.Methods: An electronic search for peer-reviewed articles published in the period from 2008 to 2018 (August) was done in the Academic Search Complete, CINAHL with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE databases via EBSCOHost and Google Scholar databases. The search targeted journals that described the treatment of schistosomiasis in children five years and below using praziquantel. Results: Twelve studies met the inclusion criteria. The process of treating schistosomiasis in the children aged five years old and below included the following activities: enrolment of the children into the treatment program; clinical examination; diagnosis; taking anthropometric measurements; feeding the children, making the PZQ palatable to the children; administration of PZQ and monitoring of side effects. There was also a variation in the resources used to treat children aged five- and below for schistosomiasis. Conclusions: A PZQ mass drug administration program for children aged five years old and below in endemic areas should exclude diagnosis of schistosomiasis before treatment. The resources required in the treatment process should be affordable, should not require skills and maintenance resources that are beyond those that are available at primary healthcare level.
BackgroundSchistosomiasis negatively impacts early childhood development. Inclusion of children aged five years and below in mass drug administration (MDA) programs for controlling schistosomiasis could improve early childhood development in communities where the disease is endemic. We estimated the projected cost of implementing a schistosomiasis control MDA program for children aged five years and below in the uMkhanyakude district of South Africa.MethodWe calculated the cost of implementing a schistosomiasis MDA program targeting children aged five years and below using an economies of scaled based cost function. We further compared different labor composition simulations to determine the most affordable and available human resources to implement the program. We also explored programs to which the MDA program could be integrated; and estimated what the costs for would be. Moreover, we simulated cost-effectiveness and determined the cost drivers for each simulation considered.ResultsA ward-based outreach team (WBOT) for implementing a schistosomiasis MDA program targeting children 5 years old and below was the best labor composition option. The simulations conducted indicated that treating children in batches of 2500 using the WBOT team approach could reduce the cost of treatment by 53% compared to treating the children on batches of 500. Integrating a schistosomiasis MDA targeting children aged 5 years and below with the immunization program was estimated to cost 3% less than integration with the deworming and Vitamin A supplementation program indicating that the former option is more cost-effective. Praziquantel, the drug that is used to treat schistosomiasis contributed 59% of the total cost for such a program.Conclusion.We estimated that US$4.3 million would be needed to implement a cost effective MDA program targeting children 5 years old and blow over 3 years in uMkhanyakude district.
BackgroundSchistosomiasis negatively impacts early childhood development. Inclusion of children aged five years and below in mass drug administration (MDA) programs for controlling schistosomiasis could improve early childhood development in communities where the disease is endemic. We estimated the projected cost of implementing a schistosomiasis control MDA program for children aged five years and below in the uMkhanyakude district of South Africa.MethodWe calculated the cost of implementing a schistosomiasis MDA program targeting children aged five years and below using an economies of scaled based cost function. We further compared different labor composition simulations to determine the most affordable and available human resources to implement the program. We also explored programs to which the MDA program could be integrated; and estimated what the costs for would be. Moreover, we simulated cost-effectiveness and determined the cost drivers for each simulation considered.ResultsA ward-based outreach team (WBOT) for implementing a schistosomiasis MDA program targeting children 5 years old and below was the best labor composition option. The simulations conducted indicated that treating children in batches of 2500 using the WBOT team approach could reduce the cost of treatment by 53% compared to treating the children on batches of 500. Integrating a schistosomiasis MDA targeting children aged 5 years and below with the immunization program was estimated to cost 3% less than integration with the deworming and Vitamin A supplementation program indicating that the former option is more cost-effective. Praziquantel, the drug that is used to treat schistosomiasis contributed 59% of the total cost for such a program.Conclusion.We estimated that US$4.3 million would be needed to implement a cost effective MDA program targeting children 5 years old and blow over 3 years in uMkhanyakude district.
Background The early childhood development of millions of children in some low and medium income countries may be compromised by schistosomiasis infections contracted at the age of 5 years or below. Currently there are no standard guidelines for treating schistosomiasis in children that are five years and younger using praziquantel (PZQ), the only drug that the WHO recommends to treat schistosomiasis. This review is on processes and resources involved in the treatment of schistosomiasis in children aged five years and below. Methods An electronic search for peer-reviewed articles published in the period from 2008 to 2018 (August) was done in the Academic Search Complete, CINAHL with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE databases via EBSCOHost and Google Scholar databases. The search targeted journals that described the treatment of schistosomiasis in children five years and below using praziquantel. Results Twelve studies met the inclusion criteria. The process of treating schistosomiasis in the children aged five years old and below included the following activities: enrolment of the children into the treatment program; clinical examination; diagnosis; taking anthropometric measurements; feeding the children, making the PZQ palatable to the children; administration of PZQ and monitoring of side effects. There was also a variation in the resources used to treat children aged five- and below for schistosomiasis. Conclusions A PZQ mass drug administration program for children aged five years old and below in endemic areas should exclude diagnosis of schistosomiasis before treatment. The resources required in the treatment process should be affordable, should not require skills and maintenance resources that are beyond those that are available at primary healthcare level.
Background: Children aged five years and below in schistosomiasis endemic areas spend several years living with the schistosome infections before they can be treated as they are excluded from school based mass drug administration programs. The WHO has recommended that these children be included in schistosomiasis preventive chemotherapy in endemic areas. Including these children in schistosomiasis control mass drug administration programs is a complicated task involving translating clinical studies into clinical practice processes, contextualizing clinical practice processes to the resources that are available in the community and economic evaluations. Methodology: We conducted a scoping search on google scholar and the concepts we searched for included implementation strategies, contextualization strategies, resource planning and economic evaluations in health care, risk and quality assessments. We then developed a conceptual framework and explained how the conceptual framework could be used to develop an implementation strategy for a mass drug administration for children aged five year and belowResults: The most common methods/frameworks that were identified in our search for health care implementation strategy development include the following: Donabedian framework, scoping review, FMEA, scenario planning, resource planning and economic evaluation of healthcare interventions and cost-effectiveness analysis.Conclusion: We concluded that the Donabedian framework can be modified and used in conjunction with scoping reviews, FMEA, scenario planning and economic evaluations to develop an implementation strategy for a schistosomiasis control MDA program for children aged five years old and below.
Background The early childhood development of millions of children in some low- and medium-income countries may be compromised by schistosomiasis infections contracted at the age of 5 years and below. Currently, there are no standard guidelines for treating schistosomiasis in children that are 5 years and younger using praziquantel (PZQ), the only drug that the World Health Organization (WHO) recommends for treating schistosomiasis. The review is on processes and resources involved in the treatment of schistosomiasis in children aged 5 years and below. Methods An electronic search for peer-reviewed articles published in the period from January 2011 to August 2021 was done in the Academic Search Complete, CINAHL with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE databases via EBSCOHost and Google Scholar databases. The search targeted journals that described the treatment of schistosomiasis in children 5 years and below using praziquantel. Results Thirteen studies met the inclusion criteria. The patient journey for treating schistosomiasis in children aged 5 years old and below using PZQ included the following activities: enrolment of the children into the treatment program; clinical examination; diagnosis; taking anthropometric measurements; feeding the children, making the PZQ palatable to the children; administration of PZQ; and monitoring of side effects. There was also a variation in the resources used to treat children aged 5 and below for schistosomiasis. Conclusions A PZQ mass drug administration program for children aged 5 years old and below in endemic areas should exclude the diagnosis of schistosomiasis before treatment. The resources required in the treatment process should be affordable, and should not require skills and maintenance resources that are beyond those that are available at the primary healthcare level.
Background Schistosomiasis is endemic in the uMkhanyakude district of KwaZulu-Natal, South Africa. The South Africa Department of Health (DoH) has decided to implement a schistosomiasis preventive mass drug administration program in all affected parts of the country. Quality management is part of the strategic objectives of the treatment program. We conducted a risk assessment and developed guidelines for the quality management of a schistosomiasis preventive treatment program for children aged five years and below in the uMkhanyakude District of KwaZulu-Natal. Methods We conducted a scenario planning exercise by interviewing 10 child health experts from the uMKhanyakude Health District to establish potential risks associated with a planned schistosomiasis preventive control treatment program for children aged five years old and below. The risks were analyzed using a modified Failure Mode and Effect Analysis (FMEA). An FMEA table was produced to guide the quality management of the planned schistosomiasis preventive control treatment program for children aged five years and below in the uMkhanyakude Health District. Results We identified potential risks, failure modes and possible failure corrective/preventive measures in the following activities that would be part of the mass treatment of children aged five years and below infected with schistosomiasis in the uMkhanyakude District. These included enrolment of children into the treatment program; general health checks; weight and height measurements; administration of drugs; reporting of side effects and monitoring and evaluation. Conclusion We were able to use FMEA guide quality management and identify potential risks associated with the planned schistosomiasis preventive treatment program for children aged five years old and below in the uMkhanyakude District of KwaZulu-Natal. The FMEA for this program will be useful to the quality management of schistosomiasis preventive treatment programs for this age group in other similar settings.
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