Exploring gender dimensions of treatment programmes for neglected tropical diseases in Uganda

July 12, 2013
This is a U of T researcher with female study participants in Buyende District, Uganda. Credit: Heather Rilkoff, MPH, Dalla Lana School of Public Health

Males and females face different challenges in accessing treatment for neglected tropical diseases (NTDs), according to a new study from researchers at the University of Toronto Dalla Lana School of Public Health, Uganda Ministry of Health and Imperial College London. The study, published by PLOS Neglected Tropical Diseases on July 11, explores the role of gender in access to treatment in the Uganda National Neglected Tropical Disease Control Program.

NTDs are a group of parasitic, viral and bacterial diseases that affect at least a billion people worldwide. Predominantly seen in rural and underserved communities in Africa, the Middle East and Southeast Asia, NTDs can pose significant health risks for both male and female populations. International donors have been funding mass-drug distribution programs to treat for over a decade.

"For females, NTDs, such as schistosomiasis and soil transmitted helminths (worms), can cause ," says lead author Heather Rilkoff. "On the other hand, NTDs are thought to be somewhat more prevalent in males because men are more likely to have occupational roles, such as farming and fishing, which increase their exposure to the diseases."

The study suggested that men tend to have more difficulty accessing treatment, which is typically distributed annually house-to-house, as they may spend little or no time at home during the day due to occupational roles such as farming, trading or truck driving, which take place away from the household. Females, on the other hand, tend to be home more often and are more likely to receive treatment.

However, the study also found that women who were pregnant or breastfeeding at the time of the annual distribution, and the community who distributed the medicines, were often unaware of which medicines were safe to take, when it was safe to take them, and where women could find access to the medicines once they were no longer pregnant or lactating. WHO guidelines advise not providing two of the four medicines used in the program to pregnant or breastfeeding women until several months after delivery. In some communities, pregnant women were not given any treatments at all, even though they could still potentially receive treatments for and helminth infections. This might lead to a large proportion of women who consistently miss treatment every year.

"This could have implications both for the individual women and the long term impact of the program. In these communities, a woman might spend 50% of her reproductive years pregnant or breastfeeding. Unless women are aware of when they're allowed to take the medicines, and where to access treatment once the annual mass treatment is over, large proportions of women will go untreated year after year," says Rilkoff.

Mass-treatment programs, which train community members to distribute medicines within their communities, have been identified as an effective strategy to treat affected populations. However, limited evidence is available to discuss challenges to treatment access, adherence, delivery and monitoring at the community level.

"While there were often similarities across communities involved in the study in terms of gender-based challenges to accessing treatment, there were differences as well. Ensuring that there is health education and effective training of community health workers in each community will definitely help, but the nuances we see between communities also suggests that each community should be supported to create their own solutions to these issues."

The study suggests a more comprehensive understanding of the nuances and challenges of community-based programmes is needed to address gender-related challenges and ensure future success of the programmes.

"The international community have put in significant efforts to establish these programs. But because the programs are community-based, there really needs to be more resources devoted to supporting the volunteer health workers who administer the medicines to address the gender-related challenges that they face, and to ensure that they are able to carry out their duties without taking time away from their own livelihoods," says Rilkoff.

Explore further: Integrated neglected tropical disease control and elimination programs: A global health 'best buy'

Related Stories

Integrated neglected tropical disease control and elimination programs: A global health 'best buy'

January 17, 2013
A recently released report, entitled "Social and Economic Impact Review on Neglected Tropical Diseases," highlights links between neglected tropical diseases (NTDs) and socio-economic prosperity. Published by Hudson Institute's ...

Africa hopes to speed up medicine approval systems

June 8, 2013
Bringing a new medicine to market in Africa requires 54 separate applications to each country on the continent, a time-intensive process that could be costing lives. African leaders are now trying to move toward a regional ...

Three neglected-disease treatments newly added to WHO Essential Medicines List for paediatric use

July 11, 2013
This week the World Health Organization (WHO) released its newly updated 4th WHO Model List of Essential Medicines for Children (EMLc), in which three treatments developed by the Drugs for Neglected Diseases initiative (DNDi) ...

Deworming important for children's health, has limited impact on infection in wider communities

February 28, 2013
Although they have an important impact on children's health and education, school-based deworming programmes have a limited impact on the level of infection in the wider community, according to a mathematical modeling study ...

Pregnancy adds challenge for teens treated for drug abuse, report says

May 9, 2013
(HealthDay)—Half of pregnant teens in substance-abuse treatment programs used alcohol or drugs in the month before they entered treatment. And nearly 20 percent used drugs or alcohol on a daily basis during that month, ...

FDA warns pregnant women about migraine drugs

May 6, 2013
(HealthDay)—Pregnant women who struggle with migraine headaches should never use medicines containing the ingredient valproate because they can lower the IQ scores of their children, the U.S. Food and Drug Administration ...

Recommended for you

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Research examines lung cell turnover as risk factor and target for treatment of influenza pneumonia

July 24, 2017
Influenza is a recurring global health threat that, according to the World Health Organization, is responsible for as many as 500,000 deaths every year, most due to influenza pneumonia, or viral pneumonia. Infection with ...

Scientists propose novel therapy to lessen risk of obesity-linked disease

July 24, 2017
With obesity related illnesses a global pandemic, researchers propose in the Journal of Clinical Investigation using a blood thinner to target molecular drivers of chronic metabolic inflammation in people eating high-fat ...

Raccoon roundworm—a hidden human parasite?

July 24, 2017
The raccoon that topples your trashcan and pillages your garden may leave more than just a mess. More likely than not, it also contaminates your yard with parasites—most notably, raccoon roundworms (Baylisascaris procyonis).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.