Developing an appropriate model of care for lymphatic filariasis and leprosy patients who need MMDP services in Bihar State, India
What is the comparative effect of enhancing the existing MMDP services with or without community-based components in significantly reducing the burden of Acute Attacks (AA), Hydrocele, and Mental Health (MH) issues among people affected by LF?
The influence of stigma on social participation and mental well-being amongst men and women affected/disabled by lymphatic filariasis and leprosy in the districts of Jaunpur and Patna in India
To what extent does stigma affect social participation and mental wellbeing among men and women affected/disabled by lymphatic filariasis or leprosy in Jaunpur in Uttar Pradesh and Patna in Bihar?
Improving outcome of future transmission assessment surveys and community compliance for MDA in 14 LF endemic districts of Uttar Pradesh.
The success of MDA programs requires effective planning, community engagement, and delivery by community drug distributors. This proposal seeks to assess barriers and facilitators of effective coverage. Using in depth interviews, focus group discussions, and surveys, they will investigate factors related to acceptance, availability, and accessibility of MDA from the perspectives of drug distributors, healthcare workers, community leaders, the NTD program, and community members. Using the findings from the formative phase, an intervention package will be developed and implemented during MDA, followed by an evaluation of the impact of the intervention on coverage.
This project is part of a larger series of four studies that use a mixed methods approach to understand why particular districts that have undergone 5+ years of MDA are failing or are likely to fail transmission assessment surveys (TAS). Other studies include 169.1D Ghana, 169.2U Burkina Faso, and 177U Nepal. This study in Uttar Pradesh also provides a second opportunity to deploy the rapid ethnographic approach that will be first tested in Nepal. Team members from HERD Nepal will be traveling to India to train their team on the technique and assist with roll out.
Operational research to develop an M&E study to guide a triple drug stopping decision for lymphatic filariasis in India
What is the indicator(s) and accompanying M&E strategy that enables country programs to determine when the risk of ongoing transmission of LF has been reduced so that IDA can be stopped with little risk of resurgence of transmission?
Improving Mass Drug Administration After Pre-Transmission Assessment Survey (Pre-TAS) Failure: A Mixed Methods Study in Nepal
This study builds on the methods developed for the operational studies ongoing in Ghana and Burkina Faso. The first two research questions are the same as those earlier studies with two new questions added here- question 3 on triple drug therapy (ivermectin, DEC, albendazole – IDA) and 4 on the use of a new rapid ethnography approach.
- What factors are associated with effective (and lower) MDA coverage as defined as availability, accessibility, and acceptability in settings that have repeatedly failed Pre-TAS?
- What is the impact of an adapted and tailored intervention package on achieving effective coverage?
- What messages and community engagement approaches are needed to ensure the acceptability of IDA triple drug therapy in Nepal?
- How does the rapid ethnography approach compare to more traditional qualitative analysis methods in terms of cost, timeliness, and ability to provide required information for programmatic decisions? Can local capacity for use of this approach be built rapidly?
Is there still LF transmission after successful TAS 3?
Developing a surveillance framework for the post-elimination phase of the lymphatic filariasis programme in Bangladesh
- Can the micro-stratification of lymphatic filariasis (LF) transmission assessment surveys positive case and clinical case data be used to identify, map and monitor transmission hotspots as part of an enhanced endgame surveillance strategy?
- Can targeted molecular xenomonitoring detect ongoing transmission [to the same extent as human surveillance] in defined LF transmission hotspots?
This study aims to determine if the addition of lymphatic stimulating activities to community-based home-care for lymphoedema can improve outcomes for people affecetd by moderate to late stage disease.
Development of Tools to Re-Orient Social Mobilization Strategies to Close the MDA Coverage-Compliance Gap
To improve compliance and reduce the coverage-compliance gap in mass drug administration through enhanced and tailored social mobilization.
Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.