Browsing by Autor "Gregory S. Noland"

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Building Trust through Lymphatic Filariasis Elimination: A Platform to Address Social Exclusion and Human Rights in the Dominican Republic.
(National Institutes of Health, 2018) Hunter Keys; Manuel Gonzales; Madsen Beau de Rochars; Stephen Blount; Gregory S. Noland
Hispaniola, the Caribbean island that includes the countries of Haiti and the Dominican Republic (DR), accounts for 90% of lymphatic filariasis (LF) in the Americas. Both countries have committed to LF elimination by 2020. In the DR, LF occurs mainly in bateyes, or company towns that historically hosted migrant laborers from Haiti. A legacy of anti-Haitian discrimination as well as the 2013 Sentencia, which stripped generations of Haitian-descended Dominicans of their citizenship, ensure that this population remains legally, economically, and socially marginalized. Despite this context, the country's LF elimination program (PELF) has worked in bateyes to eliminate LF through health education and annual drug treatment to interrupt parasite transmission. Based on interviews with batey residents and observations of PELF activities from February-April 2016, this study describes local understandings of social exclusion alongside the PELF community-based approach. The Sentencia reinforced a common perception shared by batey residents: that their lives were unimportant, even unrecognized, in Dominican society. At the same time, the government-run PELF has generated trust in government health activities and partially counteracts some of the effects of social exclusion. These findings suggest that neglected tropical disease (NTD) programs can not only improve the health of marginalized populations, but also create a platform for improving human rights.
Post-Mass Drug Administration Transmission Assessment Survey for Elimination of Lymphatic Filariasis in La Ciénaga, Dominican Republic
(American Society of Tropical Medicine and Hygiene, 2015) Gregory S. Noland; Stephen Blount; M Lastre González
The Dominican Republic is one of four remaining countries in the Americas with lymphatic filariasis (LF). Annual mass drug administration (MDA) with albendazole and diethylcarbamazine was conducted in La Ciénaga, an impoverished urban barrio in Santo Domingo, from 2004 to 2006. Eight years after the last MDA, a transmission assessment survey (TAS) was conducted in November-December 2014 to determine if LF transmission remains absent. Of 815 first and second grade primary school students (mean age: 6.51 years; range 5-9) tested by immunochromatographic test (ICT), zero (0.0%) were positive. This is below the TAS critical cutoff of nine, indicating that the area "passed" TAS and that transmission remains interrupted in La Ciénaga. Importantly, this also provides evidence that three rounds of effective (> 65% coverage) MDA, likely aided by environmental improvements and periodic school-based albendazole monotherapy MDA, achieved interruption of LF transmission from a relatively low-transmission setting.