High coverage of vitamin A supplementation and measles vaccination during an integrated Maternal and Child Health Week in Sierra Leone

Sesay, Fatmata; Hodges, Mary H.; Kamara, Habib I.; Turay, Mohamed; Wolfe, Adam C.; Samba, Thomas; Koroma, Aminata Shamit; Kamara, Wogba; Fall, Amadou; Mitula, Pamela; Conteh, Ishata; Maksha, Nuhu; Jambai, Amara

doi:10.1093/inthealth/ihu073

Cited by 11 publications

(25 citation statements)

References 8 publications

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“…Nationwide biannual MDA for PSC commenced in 2006 with mebendazole (2006–2009), and then continued with albendazole. The program consistently reported over 85% treatment coverage which was validated by post-event coverage surveys [30]. In 2007, distribution of albendazole for LF treatment was integrated with CDTI in eight districts and by 2010 had reached all 14 districts including the Western Area Rural and Urban as shown in Fig.…”

Section: Introductionmentioning

confidence: 81%

“…As LF MDA phases out, alternative strategies for adolescent girls and non-pregnant women of reproductive age will be required [50]. However, alternative school- and/or community-based MDA platforms for SAC may also be needed to maintain control [51] in the Western Area rural and urban where there is no onchocerciasis [30]. Antenatal deworming coverage should be increased (target coverage of 80%) as a priority for both reproductive health and anaemia prevention [52, 53].…”

Section: Discussionmentioning

confidence: 99%

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Soil-transmitted helminth infection in school age children in Sierra Leone after a decade of preventive chemotherapy interventions

Bah

Paye

et al. 2019

Infect Dis Poverty

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Background Baseline mapping of soil-transmitted helminth (STH) infections among school age children (SAC) in 2008–2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone. Following these surveys, mass drug administration (MDA) of mebendazole/albendazole was conducted biannually at national level targeting pre-school children (PSC) aged 12–59 months and intermittently at sub-national level targeting SAC. In addition, MDA with ivermectin and albendazole for eliminating lymphatic filariasis (LF) has been conducted nationwide since 2010 targeting individuals over 5 years of age. Each MDA achieved high coverage, except in 2014 when all but one round of MDA for PSC was cancelled due to the Ebola emergency. The objective of the current study was to determine the prevalence and intensity of STH infections among SAC after a decade of these deworming campaigns. Methods Seventy-three schools in 14 districts were purposefully selected, including 39 schools from the baseline surveys, with approximately two sites from each of low, moderate and high prevalence categories at baseline per district. Fresh stool samples were collected from 3632 children aged 9–14 years (male 51%, female 49%) and examined using the Kato Katz technique. Results The prevalence of STH infections in Sierra Leone decreased in 2016 compared to 2008: Ascaris lumbricoides 4.4% (95% confidence interval [ CI ]: 3.7–5.1%) versus 6.6% (95% CI : 0–25%), Trichuris trichiura 0.7% (95% CI : 0.5–1.1%) versus 1.8% (95% CI : 0–30.2%), hookworm 14.9% (95% CI : 13.8–16.1) versus 38.5% (95% CI : 5.4–95.1%), and any STH 18.3% (95% CI :17.0–19.5%) versus 48.3% ( CI : 5.4–96.3%), respectively. In 2016, no district had high hookworm prevalence and four districts had moderate prevalence, compared with eight and four districts respectively in 2008. In 2016, the arithmetic mean hookworm egg count in all children examined was light: 45.5 eggs per gram (EPG) of faeces, (95% CI :\ 35.96–55.07 EPG); three (0.08%) children had heavy infections and nine (0.25%) children had moderate infections. Conclusions Sierra Leone has made considerable progress toward controlling STH as a public health problem among SAC. As LF MDA phases out (between 2017 and 2021), transition of deworming to other platforms and water and sanitation strategies need to be strengthened to maintain STH control and ultimately interrupt transmission. Electronic supplementary material The online version of this article (10.1186/s40249-019-0553-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Soil-transmitted helminth infection in school age children in Sierra Leone after a decade of preventive chemotherapy interventions

Bah

Paye

et al. 2019

Infect Dis Poverty

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“…For example, Sierra Leone and Bangladesh had a two-dose coverage of 8% and 0% in 2014, but a coverage of >90% in previous years [105]. This illustrates that implementation irregularities in VAS programs continue to exist, despite being a well-established, scaled-up intervention in many countries.…”

Section: Discussionmentioning

confidence: 99%

Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency

Wirth¹,

Petry²,

et al. 2017

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Vitamin A supplementation (VAS) programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA) reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but amidst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD) data. We found that two-thirds of the countries explored either have no VAD data or data that were >10 years old (i.e., measured before 2006), which included twenty countries with VAS coverage ≥70%. Fifty-one VAS programs were implemented in parallel with at least one other VA intervention, and of these, 27 countries either had no VAD data or data collected in 2005 or earlier. To fill these gaps in VAD data, countries implementing VAS and other VA interventions should measure VA status in children at least every 10 years. At the same time, the coverage of VA interventions can also be measured. We identified three countries that have scaled down VAS, but given the lack of VA deficiency data, this would be a premature undertaking in most countries without appropriate status assessment. While the global debate about VAS is important, more attention should be directed towards individual countries where programmatic decisions are made.

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“…Finally, though not commonly, projects have engaged communities by sharing surveillance and evaluation results. Noteworthy examples of projects with strong community engagement strategies include mobilization of churches in Mozambique [12] and Nigeria [18] and national mobilization of communities and short–term community workers for national health weeks in Sierra Leone [19]. …”

Section: Methodsmentioning

confidence: 99%

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects

Perry¹,

Sacks²,

Schleiff³

et al. 2017

Journal of Global Health

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BackgroundAs part of our review of the evidence of the effectiveness of community–based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used.MethodsWe screened 12 166 published reports in PubMed of community–based approaches to improving maternal, neonatal and child health in high–mortality, resource–constrained settings from 1950–2015. A total of 700 assessments, including 148 reports from other publicly available sources (mostly unpublished evaluation reports and books) met the criteria for inclusion and were reviewed using a data extraction form. Here we identify and categorize key strategies used in project implementation.ResultsSix categories of strategies for program implementation were identified, all of which required working in partnership with communities and health systems: (a) program design and evaluation, (b) community collaboration, (c) education for community–level staff, volunteers, beneficiaries and community members, (d) health systems strengthening, (e) use of community–level workers, and (f) intervention delivery. Four specific strategies for intervention delivery were identified: (a) recognition, referral, and (when possible) treatment of serious childhood illness by mothers and/or trained community agents, (b) routine systematic visitation of all homes, (c) facilitator–led participatory women’s groups, and (d) health service provision at outreach sites by mobile health teams.ConclusionsThe strategies identified here provide useful starting points for program design in strengthening the effectiveness of CBPHC for improving MNCH.

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High coverage of vitamin A supplementation and measles vaccination during an integrated Maternal and Child Health Week in Sierra Leone

Cited by 11 publications

References 8 publications

Soil-transmitted helminth infection in school age children in Sierra Leone after a decade of preventive chemotherapy interventions

Soil-transmitted helminth infection in school age children in Sierra Leone after a decade of preventive chemotherapy interventions

Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects

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