Descripción: |
Current global health interventions tend to focus on the “big 3” diseases:
malaria, AIDS, and tuberculosis. This focus has led to a dearth of funding for and
research into diseases that are also endemic in areas where the big 3 tend to
strike. Due to their relative lack of priority, these underfunded and underresearched
diseases have been termed, “Neglected Tropical Diseases” (NTDs).
This neglect is alarming as NTDs, which “blind, debilitate, deform, or maim” (ICL
2013), affect more than 1 billion people worldwide (Hotez et al 2008). Of the 17
NTDs, those caused by worms (helminthiases and schistosomiasis) affect over
one billion people worldwide (Hotez et al. 2008). For reasons that are not
completely clear, these diseases tend to strike children from ages 5 to 15 (Hotez et
al 2008). Thus, due to the low cost of worm drugs and the high incidence of
worm infection in children, the World Health Organization (WHO) currently
recommends repeated, school-based, mass-drug administration (MDA) as a
worm management strategy (WHO 2006). WHO’s MDA recommendation has led
to concerns in the global health community. For one, MDA places worms under
selective pressure to develop resistance to chemotherapy (Geerts and Gryseels
2000) & (Albonico et al. 2004). Second, MDA occurs in schools in which
absenteeism may be very common (Standley 2013), which often leaves those who
bear the largest burden of disease untreated.
Methods:
In this paper, we research the efficacy of coupling MDA with an easy-toimplement,
game-based educational interventional. By designing it to be easy-to-replicate outside of schools, we hope to demonstrate that our intervention, unlike
MDA, will not be limited by absenteeism. We also hope to demonstrate that an
educational intervention decreases worm infection rate to a greater extent than
MDA alone. Such a result would suggest that coupling MDA with an intervention
similar to our will decrease the need for repeated MDA and thus allay fears about
the evolution of drug resistant parasites.
Our results demonstrate that a low-cost, game based intervention does
lead to intake and retention of health knowledge (p < 0.5 | Fisher’s Exact Test).
Additionally, our results demonstrate that coupling MDA with educational
intervention decreases infection rate to a greater extent than an MDA-only
intervention (p < 0.5 | Fisher’s Exact Test), suggesting that health workers and
NGOs might be able to achieve more significant gains in worm burden reduction
were they to couple current interventions with a culturally-appropriate, behaviorfocused
intervention. Thus we recommend that similar, low-cost, and culturallyappropriate,
behavior-focused, educational interventions be integrated into to the
healthcare worker arsenal as a means to achieve more significant reductions in
worm burden. |