Community-directed treatment of onchocerciasis with ivermectin in Takum, Nigeria.

摘要: A study to identify factors within the community that can ensure sustainable community-directed treatment (ComDT) with ivermectin compared effectiveness of programme-designed (PD) and community-designed (CD) strategies in 37 villages Takum area Nigeria. In a subset PD villages, designated PD1, communities were asked use village heads as distributors (CDD), other (PD2) select female distributors, both instructed house-to-house method distribution. Community-designed communities, on hand, design their own approach. All received health education, guidelines, training enabling them determine appropriate dosage. total 1744 people interviewed about experiences after two cycles. Communities preferred honest, reliable members CDDs, but few women selected. The results show striking similarity between CD many respects. PD1 where programme head CDD, mode distribution was changed from central point, took place compound head. PD2 specified should be women, who selected replaced by male children. These changes original consistent local cultural norms made arrangement for more acceptable people. Programme-designed used performed better than those coverage former group compares well villages. Only five achieved > 60%, dosage correct most cases (87.4%). Drug shortage frequent reason non-treatment. devised means ensuring equity fairness sharing limited supply freely altered designs fit values. success this strategy tested parts Long-term ComDT, however, requires drug inputs professionals system minimal supervision. core issues sustainability ComDT appear not so much structure, process which they are introduced. will only sustain implementation fits free alter procedures inconsistent customs.