Background

Developing Health Promotion and Disease Prevention Strategies to Reduce Neglected Infectious Diseases

Reducing Prevalence of Trachoma, STH, and Ectoparasitosis in the Indigenous Communities of River Cubiyú, Vaupés, Colombia

Background

Fabio González Ramírez, Captain of the indigenous La Sabana Community
La Sabana Community is about 8 hours from the capital of Vaupés via the river

Socio-economic and environmental risk factors for NIDs such as trachoma and STH are high in Vaupés among indigenous communities. These include faraway water sources, lack of facial cleanliness and handwashing, soil floors, animal/insect vectors in homes, and low use of footwear. Only 58% of children between 5 and 14 years old in the study group had received deworming in the last six months, which increases the risk of STH infections. Trachoma prevalence was 21.7% in 2013, and facial cleanliness and environmental  strategies have not proven successful in the region (Miller et al., 2020).

The Vaupés health department’s proposed inter-sectoral approach includes mass antibiotic and deworming mass drug administration (MDA) campaigns, environmental interventions, and behavior change strategies to promote hygiene. These strategies need to be contextualized to the social, political, and health situation of the indigenous communities to be successful.

This study aimed to co-design a series of integrated strategies with key stakeholders and the indigenous community. When planned collaboratively, these strategies will improve the quality of health interventions and services provided to indigenous communities in Vaupés and align with the priorities of government, participating organizations, and communities.

Miller, H. A., De Mesa, C. B. L., Talero, S. L., Cárdenas, M. M., Ramírez, S. P., Moreno-Montoya, J., Porras, A., & Trujillo-Trujillo, J. (2020). Prevalence of trachoma and associated factors in the rural area of the department of Vaupés, Colombia. In PLoS ONE (Vol. 15, Issue 5).

Context

Problems and Opportunities

Challenges

  • Highly dispersed and remote nature of the communities living along the river (with no vehicle access)
  • Lack of socio-demographic and population health data
  • Multiple languages spoken among the indigenous communities
  • Cultural beliefs about NIDs affecting the acceptance of medical interventions

Opportunities

  • Conduct a situation analysis to uncover health problems and potential solutions
  • Integrate campaigns to enable cost savings and greater health impact 
  • Leverage positive attitudes toward campaign integration in indigenous communities for advocacy efforts
  • Leverage trusting relationships based on prior activities among the indigenous communities, University team, and Department of Health 
  • Engage communities in planning to facilitate communication and build local capacity

Research Objectives

The primary objective of this study was to identify which health promotion and disease prevention strategies can be integrated to reduce the prevalence of trachoma and STH infections in the indigenous communities of the Cubiyú River area. A focus on reducing the prevalence of ectoparasite infections emerged during the study.

Secondary objectives:

  • Identify the actors involved in decision-making for health promotion and disease prevention in the department of Vaupés.
  • Understand the perspectives of the community and stakeholders on the prevention and health promotion strategies that have been applied for trachoma, STH, and ectoparasitosis.
  • Co-develop integrated strategies with the community and stakeholders to address conditions and behaviors contributing to the current prevalence of trachoma, STH, and ectoparasitosis infections, using the theory of change framework.

“We have a knowledge born in the Global South and that answers back to the needs of the South, and also has a strength that seeks sustainable solutions in the long term for the communities.”
- Jovana A. Ocampo Cañas, Associate Professor, Faculty of Medicine, University of the Andres