The Effectiveness of a Multifocal Training to Improve the Treatment of Chromoblastomycosis in Rural Madagascar.

Madagascar has the highest number of cases of chromoblastomycosis in the world, but the areas of highest incidence have limited affordable access and knowledge of first line medications to treat this long-term fungal infection of the skin and subcutaneous tissue. The impact of a multifocal training targeting medical doctors who live in the area of the country with the highest prevalence of this disease has not been clearly reported. The purpose of this project was to determine the effect of a multifocal training on chromoblastomycosis for Malagasy medical doctors in the SAVA (Sambava, Andapa, Vohemar, and Antalaha) province of Madagascar (in the country's northeast) about diagnosis, staging, patient education poster, and treatment options of chromoblastomycosis versus common treatment practices to increase participant's knowledge and utilization of current treatment recommendations for chromoblastomycosis. Medical doctors in the SAVA province of Madagascar enrolled in the multifocal trainings.

Educating African pastors on mother-to-child transmission of HIV/AIDS.

PURPOSE: To educate pastors of the Assemblies of God in Burkina Faso concerning HIV/AIDS and mother-to-child transmission (MTCT). DESIGN: A pretest-posttest design was used with a convenience sample of 102 pastors attending the educational program on HIV/AIDS and MTCT in January, February, and March of 2005. The educational program was implemented in local Bible colleges in Ouagadougou, Burkina Faso. METHODS: Participants attended an 18-hour program on HIV/AIDS and MTCT. A picture booklet was designed and used to help explain the prevention of MTCT of HIV The pretest-posttest examination and follow-up evaluation were designed for this project. FINDINGS: Results of the pretest showed minimal knowledge of pastors regarding HIV/AIDS. The median composite scores on the knowledge questions increased from 16% on the pretest to 92% on the posttest. Within the 3-month follow-up period, 34 follow-up evaluations were received. Although all the responding pastors had recommended testing for expectant mothers, only 13 had discussed MTCT in their churches or communities. CONCLUSIONS: The educational program was effective in increasing the pastors' knowledge of HIV/AIDS and MTCT. Further research is needed to identify barriers to full utilization of that knowledge.