Abstract
BackgroundSustainable and equitable health programmes require a grounded understanding of the context in which they are being implemented. This socio-cultural understanding is pivotal for effective delivery of elimination programmes. Standardised valid methods are needed for gathering authentic socio-cultural insights. The currently recommended protocol for collecting Lymphatic Filariasis (LF) related socio-cultural data, while moving in the right direction, is inadequate. To collect data which provides an understanding of local health beliefs and practices, and communities' understanding of LF, techniques must be developed that are both valid and time efficient. An approach developed in the Pacific provides a basic snapshot of socio-cultural insights which are crucial to the development of relevant and sustainable health education and elimination programmes.SummaryThe increasing interest in socio-cultural LF research presents a unique opportunity for coupling socio-cultural and bio-medical understandings of LF. To address the backlog in the socio-cultural sphere will require investment of time and effort to integrate valid qualitative approaches into current data collection methodologies.
Highlights
Sustainable and equitable health programmes require a grounded understanding of the context in which they are being implemented
One third of people infected with lymphatic filariasis (LF) live in India, a third live in Africa and the remainder live in Papua New Guinea, Southeast Asia, the Pacific Islands and the Americas
The protocol assumes a shared "western" understanding of health and of LF, and attempts to confirm whether or not communities are compliant with bio-medically oriented local elimination programmes
Summary
Lymphatic filariasis (LF) exacts an enormous infectious toll, affecting approximately 80 tropical and sub-tropical countries. Papua New Guinea (PNG) is the country with the greatest remaining burden of lymphatic filariasis (LF) in the Western Pacific Region [4]. A survey conducted on the Island in 1997 found a prevalence rate of 56% using immunochromatographic card tests [7]. Over a five year period the Misima Island LF control programme combined ongoing awareness campaigns with annual single-dose administration of diethylcarbamazine (DEC) and albendazole for all community members. This approach dramatically reduced infection rates to below two percent [7]. Surveys using immunochromatographic card tests conducted in 1999/ 2000 and 2001 indicated that Chuuk Lagoon Islands and Yap State had incidences of 0.2% and 0.5%, respectively. In response an MDA was conducted in 2003 and a second is planned for the end of 2004
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