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Qualitative analysis of the impact of a lymphatic filariasis elimination programme using mass drug administration on Misima Island, Papua New Guinea

机译：定性分析使用大规模药物管理对巴布亚新几内亚米西玛岛的淋巴丝虫病消除计划的影响

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Background\udPapua New Guinea is the only endemic country in the Western Pacific Region that has not yet introduced a countrywide programme to eliminate lymphatic filariasis. However, on Misima Island in Milne Bay Province, government and private sectors have collaborated to implement a pilot elimination programme. Although interim evaluation indicated that the programme has been parasitologically successful, an appreciation that sustainable health gains depend on understanding and accommodating local beliefs prompted this qualitative study.\ud\udMethods\udWe investigated Misima community members knowledge and attitudes about lymphatic filariasis and the elimination programme. A combination of focus groups and key informant interviews were used to explore participants perceptions of health; knowledge of the aetiology and symptoms of filariasis, elephantiasis and hydrocele; attitudes towards the disease and mass drug distribution; and the social structure and decision-making protocols within the villages.\ud\udResults\udFocus group discussions proved inferior to key informant interviews for gathering rich data. Study participants did not consider lymphatic filariasis ("pom") a major health problem but were generally positive about mass drug administration campaigns. A variety of conditions were frequently and incorrectly attributed to filariasis. Participants expressed the belief that individuals infected with filariasis always had visible manifestations of disease.\udA common misconception was that taking drugs during campaigns provided long-term immunity against disease. The role of mosquito vectors in transmission was not generally appreciated and certain clinical presentations, particularly hydrocele, were associated with supernatural forces. Multiple adverse events were associated with mass drug administration campaigns and most study participants mentioned community members who did not participate in campaigns.\ud\udConclusion\udImportant issues requiring educational intervention and elimination activity modification in the Misima region were identified during this study. Research outcomes should assist Papua New Guinea in developing and implementing a national elimination strategy and inform discussions regarding the appropriateness of current elimination strategies.
机译：背景\巴布亚新几内亚是西太平洋地区唯一一个尚未实施全国性计划以消除淋巴丝虫病的流行国家。但是，在米尔恩湾省的米西玛岛上，政府和私营部门已经合作实施了一项试点消除计划。尽管中期评估表明该计划在寄生虫学上取得了成功，但对可持续健康收益取决于对当地信念的理解和适应的认识促使这项定性研究。\ ud \ udMethods \ ud我们调查了Misima社区成员对淋巴丝虫病的知识和态度以及消除方案。焦点小组和关键知情人访谈相结合，用于探讨参与者对健康的看法；了解丝虫病，象皮病和鞘膜积液的病因和症状；对疾病和大规模药物分配的态度； \ ud \ udResults \ udFocus小组讨论被认为不如收集丰富数据的关键线人访谈。研究参与者认为淋巴丝虫病（“ pom”）不是主要的健康问题，但总体上对大规模药物管理运动持积极态度。各种情况经常被错误地归因于丝虫病。与会者表示相信感染丝虫病的人总是有明显的疾病表现。\ ud一个普遍的误解是，在运动期间服用药物可以长期抵抗疾病。蚊媒在传播中的作用未被普遍认识，某些临床表现，特别是鞘膜积液，与超自然力量有关。大量不良事件与大规模药物管理运动有关，大多数研究参与者提到没有参加运动的社区成员。\ ud \ ud结论\ ud在本研究中发现了需要在Misima地区进行教育干预和消除活动修改的重要问题。研究成果应有助于巴布亚新几内亚制定和实施国家消除战略，并为有关当前消除战略的适当性的讨论提供信息。

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