Trachoma

Morbidity management for hard to reach populations in insecure areas in Burkina Faso: analysis of barriers and determination of the resilience of the health system

The study aims to identify the most effective approaches for case management and delivery of surgical services for IDPs and migrants suffering from LF and/or trachoma in security compromised areas. Barriers to reaching morbidity patients will be assessed, in addition to determinants of the institutionalizatoin of NTD morbidity management within the national health system. Research aims will be addressed through the following key activities: document review and direct inspection protocols to determine health facilities' ability to provide MMDP services; active case finding including creation of WhatsApp groups and SMS messaging to help keep track of patients and refer them to care; key informant interviews with health workers and community leaders to assess behavior change communication strategies for raising awareness among affected individuals; one-on-one interviews and focus group discussions with patients to understand barriers to care; and stakeholder engagement to increase buy-in and identify ways to operationalize MMDP services within national program.

Countries: Burkina Faso

Improving disease control and elimination decision making with geospatial algorithms

Can geospatial algorithms be used by disease programs to help identify hotspots at community and Implementation Unit level?

Countries:

Improving Neglected Tropical Disease (NTD) services and integrating into primary health care in Southern Nations, Nationalities, and Peoples' Region (SNNPR), Ethiopia

This study outlines an important first step to understanding NTD program integration in Ethiopia and builds on previous work in SNNPR. The study team plans to carry out significant formative research to better understand what gaps currently exist in the Ethiopian primary health care system that prevent integration of NTD services. They aim to answer the following questions:

  1. What are the current gaps in the Ethiopian primary health care system for implementing integrated NTD services and how can they be addressed?
  2. What is the community’s perception and awareness of selected NTDs and how can it be improved?

Following the gap analysis, the study team, along with the ministry of health and NTD taskforce of Ethiopia, will develop interventions to address these gaps. Outputs of the intervention stage are expected to include the following: a detailed description of the intervention, including case definitions, roles and responsibilities at the different levels of the health system, data recording and reporting mechanisms, referral systems; training manuals for the different primary healthcare system levels, job aids, guidance for supportive supervision. The team has made extensive plans to address issues of sustainability and scalability of the project including a cost analysis of the interventions, developing close partnerships with health facilities’ procurement departments, and close engagement during budget planning exercises of district health offices.

Countries: Ethiopia

Integrating NTD programme monitoring into routine health systems data: evaluating a DHIS2 platform for real-time mass administration of medicines (MAM) reporting

This study includes an assessment of the Sightsavers rollout of a DHIS2 based tool for data collection in the NTD program in 2 states in Nigeria. In particular, the research project seeks to evaluate the health system strengthening effects of the tool for planning, monitoring and reporting of MDA. They plan to examine:

  1. the functionality of the tool at scale
  2. ease of integration across different NTD interventions
  3. data accessibility, accuracy, timeliness, and usefulness.

The team also aims to understand whether the implementation of this tool would enhance government ownership of the data and the NTD programme in general. This research will aid in identifying barriers and opportunities for potential scale up of the tool throughout Nigeria. The team also plans to focus on understanding how the data will be used at different levels of the health system.

Countries: Nigeria

The Zambia Neglected Tropical Disease Control Programme’s role in the attainment of Universal Health Coverage in Zambia: an implementation research study.

This study aims to conduct a landscape analysis to better understand the implementation context for the NTD control programme in Zambia. The activities include:

  1. an assessment of institutional structures, service delivery systems, existing resources/capacity
  2. mapping gaps, facilitators, and barriers to program implementation
  3. identifying potential opportunities to introduce innovative approaches for program integration and improvement.

Key informant interviews and focus group discussions with policy makers and NTD program officers will complement an extensive document review. The results of this assessment will be fed into the next National Health Strategic Plan, which expires in 2021.

Countries: Zambia

Trachomatous Trichiasis and Mental Health: a comparative impact study

This study aims to understand the relationship between trachomatous trichiasis (TT) and mental health disorders over an 18-month study period, by answering the following questions:

  1. What is the impact of the blinding stage of trachoma (Trachomatous Trichiasis) on common mental disorders such as depression, anxiety and suicidality?
  2. Will the validation of the 5-Question Stigma Indicators (5-QSI) generic stigma tool help to measure and monitor stigma in trachomatous trichiasis patients in Ethiopia
  3. What are the drivers for mental disorders in TT patients
  4. Is there a difference in depression, anxiety and suicidality prevalence between TT cases accepting vs declining TT surgery; and un-operated vs postoperative TT cases? The research team will be trained on good clinical practice through the WHO Mental Health Gap Action Programme (mhGAP). Following interviews, any patient with TT will be referred for surgery and patients found with a mental health disorder will be referred for care. If a negative impact of blinding trachoma on mental health is noted, the researchers plan to use the results of the study to advocate for additional funding for the trachoma program and highlight the need to address mental health in Ethiopia.
Countries: Ethiopia
Diseases: Trachoma

Does infection data add evidence to the understanding of trachoma prevalence in low endemic areas?

  1. To evaluate strategies for the elimination of trachoma by evaluating potential makers that show interruption of transmission of C. trachomatis
  2. To determine the prevalence of ocular chlamydial infection among children aged 1 – 9 years old in Mpwapwa and Kalambo District, Tanzania
  3. To determine the associated risk factors of ocular Chlamydia infection among children aged 1 – 9 years old in Mpwapwa and Kalambo District, Tanzania
  4. To determine the usability of antibody test to detect Chlamydia antigen pgp3 using lateral flow assay
  5. To examine the longevity of the antibody response to trachoma antigens in a high and low-prevalence setting
Countries: Tanzania
Diseases: Trachoma

Trachomatous Trichiasis Management in Tanzania: Investigation of the productivity of case finding and referral of patients to trichiasis surgery services

One of important pillar of Trachoma elimination as a public health problem is to manage through epilation and surgery trachomatous trichiasis (TT) to reach in endemic district less than 0.1% of TT prevalence or less than 0.2% prevalence in adults of 15 years and older. However, surveys in 3 districts of Tanzania where numbers of TT surgeries were performed showed an unexpected higher prevalence despite intervention. This mixed methods study will help to address the main question as to why trachoma impact surveys demonstrating unexpectedly high TT prevalence in communities where TT surgical intervention is ongoing and how could this intervention/burden gap be addressed? The aim is to look at the case finding techniques effectiveness in all the communities and factors that affect TT referral and quality surgical services.

Countries: Tanzania
Diseases: Trachoma

Post-validation survey for the elimination of blinding trachoma to evaluate the effectiveness of a serological surveillance strategy in two provinces of Morocco

Conduct district-wide field trials of the Pgp3 lateral flow assay to measure the seroprevalence of antibodies against the Chlamydia trachomatis antigen Pgp3 in low-prevalence settings.

Countries: Morocco
Diseases: Trachoma

Investigation of communities at increased risk of trachoma recrudescence & a model post-elimination surveillance strategy

Primary research question

Is there evidence of on-going or recent ocular Ct transmission in communities of northern Ghana felt to be at increased risk of recrudescence, at least two years since they were identified with Ct infection and or high anti-Pgp3 seroprevalence during pre-validation trachoma surveillance surveys?

Secondary research questions

What is the geographical extent of the boundaries of any persistent Ct infection and on-going transmission in the post-elimination setting?

What is the community-level (anti-Pgp3) prevalence of seropositivity for the multiplex bead array (MBA) (and possibly ELISA) as compared to the lateral flow assay (LFA)?

Countries: Ghana
Diseases: Trachoma

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