Papers by Charlotte Gryseels
European journal of public health, Oct 1, 2014
Background Sex workers (SW) are a socially vulnerable group. Due to stigma and exceptional workin... more Background Sex workers (SW) are a socially vulnerable group. Due to stigma and exceptional working conditions, SW often cannot access the regular health care system. Not only do SW have a higher risk of medical problems such as sexually transmitted infections, psychosocial problems such as violence and drug use are also more common in this group. In Flanders, Belgium, non-profit organisations Ghapro and Pasop provide free of charge and anonymous preventive medical and social assistance to SW. This study aimed at evaluating the effect of the organisations on the (psychosocial) health seeking behaviour of sex workers. The public health relevance of this study should be stressed, as it shows the importance of prevention programs focusing on the broader scope of social problems caused by the complex circumstances of SW' lives. Methods A face-to-face structured questionnaire was conducted anonymously with an intervention group (IG) and a control group (CG). The IG existed of SW who had been in contact with Ghapro or Pasop twice a year for at least two years. The CG were SW that never had any contact with any such organisation. Respondents were recruited in all sex work sectors in Flanders. Results 273 SW completed the questionnaire (152 IG, 121 CG). Following perceived risks are associated with sexwork: relationship problems (41.2%), emotional problems (40.8%) and violence (37.5%). 31.8% indicates that their work influences their mental health. Of all respondents, 25.7% needed social assistance in the last year, mostly for financial problems (29.4%), needing somebody to talk to (27.9%) and housing problems (19.1%). In the IG, 10.3% did not find any help for their problems; in the CG, this was 26.9%. Conclusions Many SW have to cope with the impact of their profession on their mental health. SW who can rely on organisations that provide free of charge and anonymous social assistance specifically for SW, more often find their way to psychosocial health care when they need it. After the study was completed, the Flemish government subsidised the expansion of Ghapro and Pasop to other provinces in Flanders. The expansion did not only take into account the medical offer, but also their psychosocial assistance. Key messages Many sex workers have to cope with the impact of their profession on their mental health. Through organisations targeting sex workers specifically, access to psychosocial health care is improved.
European journal of public health, Oct 1, 2013
Vaccine
Background: Polarized debates about Covid-19 vaccination and vaccine mandates for healthcare work... more Background: Polarized debates about Covid-19 vaccination and vaccine mandates for healthcare workers (HCWs) challenge Belgian HCWs ability to discuss Covid-19 vaccine sentiments with peers and patients. Although studies have identified drivers of HCWs vaccine hesitancy, they do not include effects of workplace interactions and have not addressed consequences beyond vaccine coverage. Methods: Interviews and focus group discussions with 74 HCWs practicing in Belgium addressed Covid-19 vaccine sentiments and experiences of discussing vaccination with peers and patients. Results: Most participating HCWs reported difficulties discussing Covid-19 vaccination with peers and patients. Unvaccinated HCWs often feared that expressing their vaccine sentiments might upset patients or peers and that they would be suspended. Consequently, they used social cues to evaluate others' openness to vaccine-skeptical discourses and avoided discussing vaccines. Surprisingly, some vaccineconfident HCWs hid their vaccine sentiments to avoid peer and patient conflicts. Both vaccinated and unvaccinated HCWs observed that unvaccinated patients occasionally received suboptimal care. Suboptimal care was central in unvaccinated HCW unwillingness to express their vaccine sentiments to peers. Both vaccinated and unvaccinated HCWs described loss of trust and ruptured social relations with peers and patients holding divergent vaccine sentiments. Discussion: Belgian HCW perceived Covid-19 vaccines as a risky discussion topic and engaged in ''strategic silences" around vaccination to maintain functional work relationships and employment in health institutions. Loss of trust between HCW and peers or patients, along with suboptimal patient care based on vaccination status, threaten to weaken Belgium's, and by implication, other health systems, and to catalyze preventable disease outbreaks.
Background. Reducing the risk of recurrent P. vivax malaria is critical for malaria control and e... more Background. Reducing the risk of recurrent P. vivax malaria is critical for malaria control and elimination. Primaquine (PQ) is the only widely available drug against P. vivax dormant liver stages, but is recommended as a 14-day regimen, which can undermine adherence to a complete course of treatment. Methods. This is a mixed-methods study to assess socio-cultural factors influencing adherence to a 14-day PQ regimen in a 3-arm, treatment effectiveness trial in Papua, Indonesia. The qualitative strand, consisting of interviews and participant observation was triangulated with a quantitative strand in which trial participants were surveyed using a questionnaire. Results. Trial participants differentiated between two types of malaria: tersiana and tropika, equivalent to P. vivax and P. falciparum infection, respectively. The perceived severity of both types was similar with 44.0% (267/607) perceiving tersiana vs. 45.1% (274/607) perceiving tropika as more severe. There was no perceived...
American Journal of Tropical Medicine and Hygiene, 2018
Frontiers in Public Health, 2021
Despite the scale-up of vector control, diagnosis and treatment, and health information campaigns... more Despite the scale-up of vector control, diagnosis and treatment, and health information campaigns, malaria persists in the forested areas of South-Central Vietnam, home to ethnic minority populations. A mixed-methods study using an exploratory sequential design was conducted in 10 Ra-glai villages in Bac Ai district of Ninh Thuan province to examine which social factors limited the effectiveness of the national malaria elimination strategy in the local setting. Territorial arrangements and mobility were found to directly limit the effectiveness of indoor residual spraying and long-lasting insectidical treated nets (LLINs). Households (n=410) were resettled in the “new villages” by the government, where they received brick houses (87.1%) and sufficient LLINs (97.3%). However, 97.6% of households went back to their “old villages” to continue slash-and-burn agriculture. In the old village, 48.5% of households lived in open-structured plot huts and only 5.7% of them had sufficient LLIN ...
Malaria Journal
Background Reducing the risk of recurrent Plasmodium vivax malaria is critical for malaria contro... more Background Reducing the risk of recurrent Plasmodium vivax malaria is critical for malaria control and elimination. Primaquine (PQ) is the only widely available drug against P. vivax dormant liver stages, but is recommended as a 14-day regimen, which can undermine adherence to a complete course of treatment. Methods This is a mixed-methods study to assess socio-cultural factors influencing adherence to a 14-day PQ regimen in a 3-arm, treatment effectiveness trial in Papua, Indonesia. The qualitative strand, consisting of interviews and participant observation was triangulated with a quantitative strand in which trial participants were surveyed using a questionnaire. Results Trial participants differentiated between two types of malaria: tersiana and tropika, equivalent to P. vivax and Plasmodium falciparum infection, respectively. The perceived severity of both types was similar with 44.0% (267/607) perceiving tersiana vs. 45.1% (274/607) perceiving tropika as more severe. There was...
American Journal of Tropical Medicine and Hygiene, 2018
Frontiers in Public Health
Dialogue with people who are vaccine hesitant has been recommended as a method to increase vaccin... more Dialogue with people who are vaccine hesitant has been recommended as a method to increase vaccination uptake. The process of cultivating dialogue is shaped by the context in which it occurs, yet the development of interventions addressing vaccine hesitancy with dialogue often overlooks the role of context and favors relatively fixed solutions. This reflexive paper shares three key lessons related to context for dialogue-based interventions. These lessons emerged during a participatory research project to develop a pilot intervention to create open dialogue among healthcare workers in Belgium about COVID-19 vaccination concerns. Through a mixed methods study consisting of in-depth interviews, focus group discussions, and surveys, we engaged healthcare workers in the design, testing, and evaluation of a digital platform featuring text-based and video-based (face-to-face) interactions. The lessons are: (1) what dialogue means, entails, and requires can vary for a population and contex...
Malaria Journal, 2022
Background Despite freely distributed insecticide-treated nets (ITNs) and health information camp... more Background Despite freely distributed insecticide-treated nets (ITNs) and health information campaigns to increase their use among populations at risk, malaria transmission persists in forested areas in Vietnam, especially among ethnic minority communities. A mixed-methods study was conducted in four villages of Ca Dong and M’nong ethnicity in Central Vietnam between 2009 and 2011 to assess factors limiting the uptake of ITNs. Methods The mixed-methods research design consisted of a qualitative study to explore the context and barriers to ITN use, and a cross-sectional household survey (n = 141) to quantify factors for limited and appropriate net use. Results The Ca Dong and M’nong’s livelihood was dependent on swidden farming in the forest. Poverty-related factors, including the lack of beds, blankets, the practice of sleeping around the kitchen fire and deteriorated ITNs due to open housing structures, were reasons for alternative and non-use of ITNs. When household members stayed...
Additional file 2. Risk of bias in studies included in systematic review. This table provides a d... more Additional file 2. Risk of bias in studies included in systematic review. This table provides a detailed bias assessment and score across the three domains of the Newcastleâ Ottawa Quality Assessment Scale.
Additional file 6. Univariate analysis of potential determinants for contact. The table shows all... more Additional file 6. Univariate analysis of potential determinants for contact. The table shows all results of univariate analysis looking for relationship between each of ten potential determinants and distributor-household contact in 2012 and 2013.
Additional file 4. Characteristics of households included in the Household Survey. The table summ... more Additional file 4. Characteristics of households included in the Household Survey. The table summarizes potential variables to be included in the principal component analysis for socio-economic status which is possible to influence on distributor-household contact and repellent consumption.
Additional file 3. Questionnaire for distributors for socio-economic status and repellents distri... more Additional file 3. Questionnaire for distributors for socio-economic status and repellents distribution survey. A Khmer version of this questionnaire was used during the distributor survey to collect information on socio-economic status of all distributors and how they distribute repellents.
Additional file 5. Differences in contact level between districts (left) and communes (right) in ... more Additional file 5. Differences in contact level between districts (left) and communes (right) in 2012. The figures detail districts and their corresponding communes which are associated with distributor-household contact in 2012. The distribution of repellents in district Lum Phat and Oyadao was less performant as compared to the others.
In order to provide our readers with timely access to new content, papers accepted by the America... more In order to provide our readers with timely access to new content, papers accepted by the American Journal of Tropical Medicine and Hygiene are posted online ahead of print publication. Papers that have been accepted for publication are peer-reviewed and copy edited but do not incorporate all corrections or constitute the final versions that will appear in the Journal. Final, corrected papers will be published online concurrent with the release of the print issue. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Pathogens, 2020
Malaria elimination in the Greater Mekong Sub-Region is challenged by a rising proportion of mala... more Malaria elimination in the Greater Mekong Sub-Region is challenged by a rising proportion of malaria attributable to P. vivax. Primaquine (PQ) is effective in eliminating the parasite’s dormant liver stages and can prevent relapsing infections, but it induces severe haemolysis in patients with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, highlighting the importance of testing enzyme activity prior to treatment. A mixed-method study was conducted in south-central Vietnam to explore the factors that affect acceptability of G6PD testing, treatment-seeking behaviors, and adherence to current regimens. The majority of respondents (75.7%) were unaware of the different parasite species and rather differentiated malaria by perceived severity. People sought a diagnosis if suspected of malaria fever but not if they perceived their fevers as mild. Most respondents agreed to take prescribed medication to treat asymptomatic infection (94.1%) and to continue medication even if they felt b...
Developing world bioethics, Jan 16, 2017
Ensuring individual free and informed decision-making for research participation is challenging. ... more Ensuring individual free and informed decision-making for research participation is challenging. It is thought that preliminarily informing communities through 'community sensitization' procedures may improve individual decision-making. This study set out to assess the relevance of community sensitization for individual decision-making in research participation in rural Gambia. This anthropological mixed-methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations ...
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Papers by Charlotte Gryseels