Background Gender equity in global health is a target of the Sustainable Development Goals and a requirement of just societies. Substantial progress has been made towards control and elimination of neglected tropical diseases (NTDs) via mass drug administration (MDA). However, little is known about whether MDA coverage is equitable. This study assesses the availability of gender-disaggregated data and whether systematic gender differences in MDA coverage exist. Methods Coverage data were analyzed for 4784 district-years in 16 countries from 2012 through 2016. The percentage of districts reporting gender-disaggregated data was calculated and male–female coverage compared. Results Reporting of gender-disaggregated coverage data improved from 32% of districts in 2012 to 90% in 2016. In 2016, median female coverage was 85.5% compared with 79.3% for males. Female coverage was higher than male coverage for all diseases. However, within-country differences exist, with 64 (3.3%) districts reporting male coverage >10 percentage points higher than female coverage. Conclusions Reporting of gender-disaggregated data is feasible. And NTD programs consistently achieve at least equal levels of coverage for women. Understanding gendered barriers to MDA for men and women remains a priority.
BackgroundThe Global Programme to Eliminate Lymphatic Filariasis recommends the transmission assessment survey (TAS) as the preferred methodology for determining whether mass drug administration can be stopped in an endemic area. Because of the limited experience available globally with the use of Brugia Rapid™ tests in conducting TAS in Brugia spp. areas, we explored the relationship between the antibody test results and Brugia spp. infection as detected by microfilaremia in different epidemiological settings.MethodsThe study analyzes the Brugia Rapid™ antibody responses and microfilaremia in all ages at three study sites in: i) a district which was classified as non-endemic, ii) a district which passed TAS, and iii) a district which failed TAS. Convenience sampling was done in each site, in one to three purposefully selected villages with a goal of 500 samples in each district.ResultsA total of 1543 samples were collected from residents in all three study sites. In the site which was classified as non-endemic and where MDA had not been conducted, 5 % of study participants were antibody positive, none was positive for microfilaremia, and age-specific antibody prevalence peaked at almost 8 % in the 25–34 year-old age range, with no antibody-positive results found in children under eight years of age. In the site that had passed TAS, 1 % of participants were antibody positive and none was positive for microfilaremia. In the site which failed TAS, 15 % of participants were antibody positive, 0.2 % were microfilaremic, and age-specific antibody prevalence was highest in 6–7 year olds (30 %), but above 8 % in all age levels above 8 years old.ConclusionsThese results from districts which followed the current WHO guidance for mapping, MDA, and implementing TAS, while providing antibody profiles of treated and untreated populations under programmatic settings, support the choice of antibody prevalence in the 6- and 7-year-old age group in TAS for making stopping MDA decisions. Since only one study participant was microfilaremic, no conclusions could be drawn about the relationship between antibodies and microfilaremia and further longitudinal studies are required to understand this relationship.
The One Health (OH) approach is widely accepted as the preferred method to address disease threats at the human-animal-environment interface and to help address emerging and endemic zoonotic diseases.A monitoring and evaluation tool for OH implementation is required to compile and present strong evidence on the effectiveness of the OH approach for disease prevention, early warning, enhanced detection and response to public health threats. This tool would be useful for policymakers and donors to act strategically and target budget and other resources to increase the effectiveness and operational aspects of OH disease prevention and control on the ground. The monitoring and evaluation methods include focus group discussions with key stakeholders, key informant interviews with multi-sectoral field officers, questionnaires, field observation, and data collection on detected and reported disease events. The OH monitoring tool (OHMT) consists of three sets of criteria: 1) communication, coordination, collaboration; 2) multi-sectoral disease response; and 3) sustainability. These criteria are scored at five capacity levels (no capacity; limited capacity; developed capacity; demonstrated capacity; and sustainable capacity). In January 2016, four districts in Indonesia were selected as One Health pilot areas based on their high-risk for zoonotic diseases. One Health capacity building activities were implemented in the pilot districts involving three technical sectors, namely animal health, public health, and wildlife health, to improve field officers' capacities to prevent, detect and respond to zoonotic disease events. There is limited literature on the methods and monitoring tools available to evaluate implementation of the OH approach at the field level. Therefore, in 2018, the Directorate General of Livestock and Animal Health Services (DGLAHS), Ministry of Agriculture and FAO developed the OHMT to track and evaluate the implementation of OH-focused field activities, understand the challenges experienced by field officers, and propose solutions for the prevention and control of zoonoses and EID.
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