Community based interventions for the prevention and control of Non-Helmintic NTD
Findings suggest that a range of CBI including drug administration, health education, cleanliness campaigns, vector control and clean water and sanitation facilities have the potential to prevent and control this set of diseases. However, this would require efforts to overcome the barriers to sustainable implementation including improved surveillance, access and coverage, high level governmental commitment and strong partnerships to mobilize resources.
Non-helminthic infections are a group of diseases which can lead to burdensome health and economic consequences. The World Health Organization (WHO) recommends widespread vector control and environmental management to prevent the spread of vector borne diseases. This review aimed at systematically analyze the effectiveness of community based interventions (CBI) for the prevention and control of non-helminthic diseases including dengue, trypanosomiasis, chagas, leishmaniasis, buruli ulcer, leprosy and trachoma. Of 3452 titles, 348 full texts were reviewed and 62 studies were included (21 RCT and 41 before after studies). Findings suggest that CBI are effective in reducing positive serostatus, house index and ovitrap index for dengue, domiciliary infestation rates and serology for chagas, incidence and cure rates of cutaneous leishmaniasis, incidence and detection of leprosy, active trachoma and chlamydia trachomatic infections. In addition, qualitative synthesis showed that combination approaches can promote wider coverage and integrated delivery is more effective. Sustainability can be assured by training a significant number of local human resources along with motivational tools, as well as community involvement, knowledge and education. Behaviour change promotion, mass media and community-wide events, favorable political and sociocultural context are also key factors. Barriers to program implementation included incomplete surveillance coverage, climatic conditions, lack of adequate and sustained community and the identification of neighborhoods at increased risk of infestation and transmission for targeted control strategies. Effective surveillance coverage of closed or vacant houses also remains to be addressed.