Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item 'Barely keeping the wheels on the trolley': A qualitative study of the New Zealand COVID Tracer App(Elsevier Ltd., 2024-09-01) Elers P; Derrett S; Emery T; Chambers TDigital contact tracing apps were developed to help control the spread of COVID-19 but research exploring these apps has underrepresented both 'at-risk' communities and contact tracers. Our study examines perspectives of the New Zealand COVID Tracer app among 53 participants, comprising policy advisors, contact tracers, and Māori, Pacific, and disability stakeholders, underpinned by the theory of social construction of which positions technology within the social context in which it evolves, operates, and is negotiated. Although community stakeholders believed the app helped safeguard communities from COVID-19, the health officials' views on the app's usefulness in contact tracing varied. Participants who oversaw the app's technical development generally perceived it as being more useful, particularly regarding Bluetooth proximity detection, in contrast with contact tracers' perceptions. The findings highlight a disconnection between public sentiment and operational reality in the use of the app and the need for improved collaboration and consultation in future contact tracing responses.Item Evaluating active leprosy case identification methods in six districts of Nepal.(BioMed Central Ltd., 2023-12-06) Mahato RK; Ghimire U; Lamsal M; Bajracharya B; Poudel M; Napit P; Lama K; Dahal G; Hayman DTS; Karna AK; Pandey BD; Das CL; Paudel KPBACKGROUND: Nepal has achieved and sustained the elimination of leprosy as a public health problem since 2009, but 17 districts and 3 provinces with 41% (10,907,128) of Nepal's population have yet to eliminate the disease. Pediatric cases and grade-2 disabilities (G2D) indicate recent transmission and late diagnosis, respectively, which necessitate active and early case detection. This operational research was performed to identify approaches best suited for early case detection, determine community-based leprosy epidemiology, and identify hidden leprosy cases early and respond with prompt treatment. METHODS: Active case detection was undertaken in two Nepali provinces with the greatest burden of leprosy, Madhesh Province (40% national cases) and Lumbini Province (18%) and at-risk prison populations in Madhesh, Lumbini and Bagmati provinces. Case detection was performed by (1) house-to-house visits among vulnerable populations (n = 26,469); (2) contact examination and tracing (n = 7608); in Madhesh and Lumbini Provinces and, (3) screening prison populations (n = 4428) in Madhesh, Lumbini and Bagmati Provinces of Nepal. Per case direct medical and non-medical costs for each approach were calculated. RESULTS: New case detection rates were highest for contact tracing (250), followed by house-to-house visits (102) and prison screening (45) per 100,000 population screened. However, the cost per case identified was cheapest for house-to-house visits [Nepalese rupee (NPR) 76,500/case], followed by contact tracing (NPR 90,286/case) and prison screening (NPR 298,300/case). House-to-house and contact tracing case paucibacillary/multibacillary (PB:MB) ratios were 59:41 and 68:32; female/male ratios 63:37 and 57:43; pediatric cases 11% in both approaches; and grade-2 disabilities (G2D) 11% and 5%, respectively. Developing leprosy was not significantly different among household and neighbor contacts [odds ratios (OR) = 1.4, 95% confidence interval (CI): 0.24-5.85] and for contacts of MB versus PB cases (OR = 0.7, 95% CI 0.26-2.0). Attack rates were not significantly different among household contacts of MB cases (0.32%, 95% CI 0.07-0.94%) and PB cases (0.13%, 95% CI 0.03-0.73) (χ2 = 0.07, df = 1, P = 0.9) and neighbor contacts of MB cases (0.23%, 0.1-0.46) and PB cases (0.48%, 0.19-0.98) (χ2 = 0.8, df = 1, P = 0.7). BCG vaccination with scar presence had a significant protective effect against leprosy (OR = 0.42, 0.22-0.81). CONCLUSIONS: The most effective case identification approach here is contact tracing, followed by house-to-house visits in vulnerable populations and screening in prisons, although house-to-house visits are cheaper. The findings suggest that hidden cases, recent transmission, and late diagnosis in the community exist and highlight the importance of early case detection.Item Barriers to adopting digital contact tracing for COVID-19: Experiences in New Zealand(John Wiley and Sons, Inc., 2024-04-01) Elers P; Emery T; Derrett S; Chambers TBackground Digital contact tracing (DCT) was a central component of the global response to containing COVID-19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences of diverse communities at greater risk from COVID-19 are typically underrepresented. Methods The present study aimed to understand the perceived barriers to the adoption of the app amongst Māori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Māori, Pasifika, and disability sector stakeholders and community participants. Results Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID-19 interventions. Conclusions The findings highlight how addressing communication inequality can assist in the development of contact-tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources. Patient or Public Contribution Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Māori and disability sectors.