Assessing factors influencing communities’ acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana

Background Guyana is one of four countries in the Latin American Region where lymphatic filariasis (LF) remains endemic. In preparation for the introduction of a new triple drug therapy regimen (ivermectin, diethylcarbamazine, and albendazole (IDA)) in 2019, an acceptability study was embedded within sentinel site mapping in four regions to assess mass drug administration (MDA) coverage and compliance, acceptability, and perceptions about treatment and disease. The results from this survey would inform the rollout of IDA in Guyana in 2019. Methods Data collection for the study occurred in August 2019, using a validated questionnaire administered by trained enumerators. Across all regions, a total of 1,248 participants were sampled by the Filarial Mapping team. Four-hundred and fifty-one participants aged over 18 years were randomly selected for participation in an expanded acceptability questionnaire. All data were captured in Secure Data Kit (SDK). Results Acceptability was measured using a mean acceptability score. Unadjusted mean scores ranged from 24.6 to 29.3, with 22.5 as the threshold of acceptability. Regional variation occurred across many indicators of interest: self-rated understanding about LF, mechanisms of LF transmission, LF drug safety and history of treatment during MDA. Region IV (Georgetown) recorded higher knowledge about LF, but lower compliance and acceptability. Number of pills was not perceived as a concern. Conclusion Acceptability of MDA was good across all four regions under study. Results from this study set a baseline level for key indicators and acceptability, from which the acceptability of IDA can be measured. Regional variations across indicators suggest that localized approaches should be considered for social mobilization and MDA delivery to capture these contextual differences.

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Socioeconomic factors associated with compliance with mass drug administration for lymphatic filariasis elimination in Kenya: Descriptive study results

Annals of Tropical Medicine and Public Health ◽

10.4103/1755-6783.95962 ◽

2012 ◽

Vol 5 (2) ◽

pp. 103 ◽

Cited By ~ 12

Author(s):

DorisW Njomo ◽

DunstanA Mukoko ◽

SammyM Njenga ◽

M Amuyunzu-Nyamongo ◽

JaphethK Magambo

Keyword(s):

Socioeconomic Factors ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Descriptive Study ◽

Factors Associated ◽

Study Results

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Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666190206210808 ◽

2020 ◽

Vol 20 (2) ◽

pp. 167-174

Author(s):

Ilo Dicko ◽

Yaya Ibrahim Coulibaly ◽

Modibo Sangaré ◽

Bismark Sarfo ◽

Priscillia Awo Nortey

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Health Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Improve Compliance ◽

Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

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Evaluating context-specific evidence-based quality improvement intervention on lymphatic filariasis mass drug administration in Northern Ghana using the RE-AIM framework

Tropical Medicine and Health ◽

10.1186/s41182-021-00305-3 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Alfred Kwesi Manyeh ◽

Tobias Chirwa ◽

Rohit Ramaswamy ◽

Frank Baiden ◽

Latifat Ibisomi

Keyword(s):

Quality Improvement ◽

Needs Assessment ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Northern Ghana ◽

Quality Improvement Intervention ◽

Evidence Based ◽

Context Specific ◽

Improvement Intervention

Abstract Background Over a decade of implementing a global strategy to eliminate lymphatic filariasis in Ghana through mass drug administration, the disease is still being transmitted in 11 districts out of an initial 98 endemic districts identified in 2000. A context-specific evidence-based quality improvement intervention was implemented in the Bole District of Northern Ghana after an initial needs assessment to improve the lymphatic filariasis mass drug administration towards eliminating the disease. Therefore, this study aimed to evaluate the process and impact of the lymphatic filariasis context-specific evidence-based quality improvement intervention in the Bole District of Northern Ghana. Method A cross-sectional mixed methods study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the context-specific evidence-based quality improvement intervention was employed. Quantitative secondary data was extracted from the neglected tropical diseases database. A community survey was conducted with 446 randomly selected participants. Qualitative data were collected from 42 purposively selected health workers, chiefs/opinion leaders and community drug distributors in the study area. Results The evaluation findings showed an improvement in social mobilisation and sensitisation, knowledge about lymphatic filariasis and mass drug administration process, willingness to ingest the medication and adherence to the direct observation treatment strategy. We observed an increase in coverage ranging from 0.1 to 12.3% after implementing the intervention at the sub-district level and reducing self-reported adverse drug reaction. The level of reach, effectiveness and adoption at the district, sub-district and individual participants’ level suggest that the context-specific evidence-based quality improvement intervention is feasible to implement in lymphatic filariasis hotspot districts based on initial context-specific needs assessment. Conclusion The study provided the groundwork for future application of the RE-AIM framework to evaluate the implementation of context-specific evidence-based quality improvement intervention to improve lymphatic filariasis mass drug administration towards eliminating the disease as a public health problem.

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Clinical case estimates of lymphatic filariasis in an endemic district of Bangladesh after a decade of mass drug administration

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trv084 ◽

2015 ◽

Vol 109 (11) ◽

pp. 700-709 ◽

Cited By ~ 7

Author(s):

Israt Hafiz ◽

Patricia Graves ◽

Rouseli Haq ◽

Meerjady Sabrina Flora ◽

Louise A. Kelly-Hope

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Clinical Case ◽

Endemic District

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Lymphatic filariasis, infection status in Culex quinquefasciatus and Anopheles species after six rounds of mass drug administration in Masasi District, Tanzania

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00808-5 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Eliza Lupenza ◽

Dinah B. Gasarasi ◽

Omary M. Minzi

Keyword(s):

Vector Control ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Wuchereria Bancrofti ◽

Elimination Phase ◽

Anopheles Species ◽

The Status ◽

Household Environment ◽

Indoor And Outdoor

Abstract Background Lymphatic filariasis (LF) elimination program in Tanzania started in 2000 in response to the Global program for the elimination of LF by 2020. Evidence shows a persistent LF transmission despite more than a decade of mass drug administration (MDA). It is advocated that, regular monitoring should be conducted in endemic areas to evaluate the progress towards elimination and detect resurgence of the disease timely. This study was therefore designed to assess the status of Wuchereria bancrofti infection in Culex quinqefasciatus and Anopheles species after six rounds of MDA in Masasi District, South Eastern Tanzania. Methods Mosquitoes were collected between June and July 2019 using Center for Diseases Control (CDC) light traps and gravid traps for indoor and outdoor respectively. The collected mosquitoes were morphologically identified into respective species. Dissections and PCR were carried out to detect W. bancrofti infection. Questionnaire survey and checklist were used to assess vector control interventions and household environment respectively. A Poisson regression model was run to determine the effects of household environment on filarial vector density. Results Overall, 12 452 mosquitoes were collected of which 10 545 (84.7%) were filarial vectors. Of these, Anopheles gambiae complex, An. funestus group and Cx. quinquefasciatus accounted for 0.1%, 0.7% and 99.2% respectively. A total of 365 pools of Cx. quinquefasciatus (each with 20 mosquitoes) and 46 individual samples of Anopheles species were analyzed by PCR. For Cx. quinquefasciatus pools, 33 were positive for W. bancrofti, giving an infection rate of 0.5%, while the 46 samples of Anopheles species were all negative. All 1859 dissected mosquitoes analyzed by microscopy were also negative. Households with modern latrines had less mosquitoes than those with pit latrines [odds ratio (OR) = 0.407, P < 0.05]. Houses with unscreened windows had more mosquitoes as compared to those with screened windows (OR = 2.125, P < 0.05). More than 80% of the participants own bednets while 16.5% had no protection. Conclusions LF low transmission is still ongoing in Masasi District after six rounds of MDA and vector control interventions. The findings also suggest that molecular tools may be essential for xenomonitoring LF transmission during elimination phase.

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