scholarly journals Risk factors for lymphatic filariasis and mass drug administration non-participation in Mandalay Region, Myanmar

2020 ◽  
Author(s):  
Benjamin Felix Rothschild Dickson ◽  
Patricia M Graves ◽  
Ni Ni Aye ◽  
Thet Wai Nwe ◽  
Tint Wai ◽  
...  

Abstract Background: Myanmar commenced a lymphatic filariasis (LF) elimination program in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere, however, there remains little information on the factors that contribute in Myanmar. Methods: We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for never-taking MDA. Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results: After adjustment for covariates and survey design, being CFA positive was significantly associated with age (odds ratio (OR) 1.03, 95% CI 1.01 – 1.06), per year), male gender (OR 3.11, 1.23 – 7.87), elevation (OR 0.97, 0.94 – 1.00, per metre) and the density of people per household room (OR 1.56, 1.26 – 1.93). LF-related hydrocoele was associated with age (OR 1.06, 1.02 – 1.09, per year) and residing in Amarapura Township (OR 8.56, 1.33 – 55.22). Never-taking MDA was associated with age (less than 15 years: OR 2.89, 1.11 – 7.51; greater than 60 years: OR 4.00, 1.53 – 10.48), male gender (OR 1.85, 1.05 – 3.25), residing in Amarapura township (OR 2.99, 1.39 – 6.43), moving to one’s current village from another (OR 2.84, 1.15 – 7.02) and ever having declined medication (OR 13.76, 4.79 – 39.58). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.18, 0.04 – 0.96)).Conclusions: These results contribute to the understanding of LF and MDA participation related risk factors, and will assist Myanmar improve its elimination and morbidity management programs.

2020 ◽  
Author(s):  
Benjamin Felix Rothschild Dickson ◽  
Patricia M. Graves ◽  
Ni Ni Aye ◽  
Thet Wai Nwe ◽  
Tint Wai ◽  
...  

Abstract Background: Myanmar commenced a lymphatic filariasis (LF) elimination program in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere, however, there remains little information on the factors that contribute in Myanmar. Methods: We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for never-taking MDA. Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results: After adjustment for covariates and survey design, being CFA positive was significantly associated with age (odds ratio (OR) 1.03, 95% CI 1.01 – 1.06), per year), male gender (OR 3.11, 1.23 – 7.87), elevation (OR 0.97, 0.94 – 1.00, per metre) and the density of people per household room (OR 1.56, 1.26 – 1.93). LF-related hydrocoele was associated with age (OR 1.06, 1.02 – 1.09, per year) and residing in Amarapura Township (OR 8.56, 1.33 – 55.22). Never-taking MDA was associated with age (less than 15 years: OR 2.89, 1.11 – 7.51; greater than 60 years: OR 4.00, 1.53 – 10.48), male gender (OR 1.85, 1.05 – 3.25), residing in Amarapura township (OR 2.99, 1.39 – 6.43), moving to one’s current village from another (OR 2.84, 1.15 – 7.02) and ever having declined medication (OR 13.76, 4.79 – 39.58). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.18, 0.04 – 0.96)). Conclusions: These results contribute to the understanding of LF and MDA participation related risk factors, and will assist Myanmar improve its elimination and morbidity management programs.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Benjamin F. R. Dickson ◽  
Patricia M. Graves ◽  
Ni Ni Aye ◽  
Thet Wai Nwe ◽  
Tint Wai ◽  
...  

Abstract Background Myanmar commenced a lymphatic filariasis (LF) elimination programme in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere; however, there remains little information on the factors that contribute in Myanmar. Methods We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and, if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and, if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for non-participation (never taking MDA). Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results After adjustment for covariates and survey design, being CFA positive was significantly associated with age [odds ratio (OR) 1.03, 95% CI 1.01–1.06), per year], male gender (OR 3.14, 1.27–7.76), elevation (OR 0.96, 0.94–0.99, per metre) and the density of people per household room (OR 1.59, 1.31–1.92). LF-related hydrocoele was associated with age (OR 1.06, 1.03–1.09, per year) and residing in Amarapura Township (OR 8.93, 1.37–58.32). Never taking MDA was associated with male gender [OR 6.89 (2.13–22.28)] and age, particularly in females, with a significant interaction term. Overall, compared to those aged 30–44 years, the proportion never taking MDA was higher in all age groups (OR highest in those < 5 years and > 60 years, ranging from 3.37 to 12.82). Never taking MDA was also associated with residing in Amarapura township (OR 2.48, 1.15–5.31), moving to one’s current village from another (OR 2.62, 1.12–6.11) and ever having declined medication (OR 11.82, 4.25–32.91). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.16, 0.03–0.74) and the number visits by the MDA programme (OR 0.69, 0.48–1.00). Conclusions These results contribute to the understanding of LF and MDA participation-related risk factors and will assist Myanmar to improve its elimination and morbidity management programmes.


Author(s):  
Anwith H. Shivalingaiah ◽  
Ravikumar K. ◽  
Sunil M. Gurupadaswamy

Background: Lymphatic filariasis is a debilitating and disfiguring disease causing significant socioeconomic burden. India is endemic for filariasis which includes Kalaburagi and Yadgir districts in Karnataka. India has the target for filariasis elimination by 2020 and mass drug administration [MDA] is a strategy for elimination. The objective of the study was to evaluate the coverage and compliance of mass drug administration against lymphatic filariasis.Methods: The study was a cross sectional study conducted during the month of October 2018 in Kalaburagi and Yadgir districts. The study subjects included all the residents of cluster except subjects aged below 2 years and pregnant women. Multi stage sampling was used and three clusters from rural area and one cluster from urban area from each district. Data collection was done by household survey after informed consent using a standard questionnaire.Results: A total population of 1,963 subjects residing in 399 houses of two districts was included. Majority of the study subjects 1517 (77.27%) were in the age group of more than 15 years with predominantly males 984(50.12%). The coverage rate and compliance rate of MDA was 83.17% and 92.46% in Kalaburagi district and 86.71% and 86.98% in Yadgir district respectively. The effective coverage rate and coverage compliance gap was 76.89% and 7.53% in Kalaburagi district, 75.42% and 13.01% in Yadgir district. Incomplete dose of MDA was consumed by 17 subjects in Kalaburagi district and 21 subjects in Yadgir district.Conclusions: The effective MDA coverage in both the study districts is below 85% which is not satisfactory.


Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 94-99
Author(s):  
Huluvadi Shivalingaiah Anwith ◽  
S R Suhas ◽  
Seema K S ◽  
Karishma P S ◽  
K Ravi Kumar ◽  
...  

Introduction: Lymphatic filariasis or elephantiasis is the most debilitating and disfiguring scourge among all diseases which imposes severe social and economic burden. Currently an estimated 63crores people are at a risk of filariasis in 256 endemic districts across 16 states and 5 union territories in India. National filarial control programme is operational since 1955 in India and the current goal is achieving elimination of filariasis by 2020through Mass Drug Administration (MDA). Objective: To assess the coverage, compliance and causes for noncompliance of MDA in the study districts. Method: A cross sectional descriptive study was conducted in October 2019 and January 2020 in Koppal and Bidar districts respectively. Randomly four clusters were selected, three from rural area and one from urban area. All the residents of a cluster were included except subjects aged below 2 years and pregnant women. Data collection was done by household survey using a standard questionnaire. Results: Total populations of 2043 subjects residing in 480 houses were included. The coverage rate was95.44 &94.73% with compliance rate of 91.61% &93.12% in Koppal & Bidar districts, respectively. The effective coverage rate was 87.44 %& 88.2% in Koppal & Bidar districts respectively. Drug consumption by DOT was 95.1% in Koppal&85.8% in Bidar district. Conclusions: The coverage& compliance of MDA was found to be satisfactoryas it was >65%.Consumption of MDA by DOT to be more emphasized to reduce coverage compliance gap and increase the effective coverage rate.


2020 ◽  
Vol 20 (2) ◽  
pp. 167-174
Author(s):  
Ilo Dicko ◽  
Yaya Ibrahim Coulibaly ◽  
Modibo Sangaré ◽  
Bismark Sarfo ◽  
Priscillia Awo Nortey

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.


2020 ◽  
Vol 14 (12) ◽  
pp. e0008916
Author(s):  
Colleen L. Lau ◽  
Meru Sheel ◽  
Katherine Gass ◽  
Saipale Fuimaono ◽  
Michael C. David ◽  
...  

Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted mass drug administration (MDA) from 2000–2006. Despite passing Transmission Assessment Surveys (TAS) in 2011/2012 and 2015, American Samoa failed TAS-3 in 2016, with antigen (Ag) prevalence of 0.7% (95%CI 0.3–1.8%) in 6–7 year-olds. A 2016 community survey (Ag prevalence 6.2% (95%CI 4.4–8.5%) in age ≥8 years) confirmed resurgence. Using data from the 2016 survey, this study aims to i) investigate antibody prevalence in TAS-3 and the community survey, ii) identify risk factors associated with being seropositive for Ag and anti-filarial antibodies, and iii) compare the efficiency of different sampling strategies for identifying seropositive persons in the post-MDA setting. Antibody prevalence in TAS-3 (n = 1143) were 1.6% for Bm14 (95%CI 0.9–2.9%), 7.9% for Wb123 (95%CI 6.4–9.6%), and 20.2% for Bm33 (95%CI 16.7–24.3%); and in the community survey (n = 2507), 13.9% for Bm14 (95%CI 11.2–17.2%), 27.9% for Wb123 (95%CI 24.6–31.4%), and 47.3% for Bm33 (95%CI 42.1–52.6%). Multivariable logistic regression was used to identify risk factors for being seropositive for Ag and antibodies. Higher Ag prevalence was found in males (adjusted odds ratio [aOR] 3.01), age ≥18 years (aOR 2.18), residents of Fagali’i (aOR 15.81), and outdoor workers (aOR 2.61). Ag prevalence was 20.7% (95%CI 9.7–53.5%) in households of Ag-positive children identified in TAS-3. We used NNTestav (average number needed to test to identify one positive) to compare the efficiency of the following strategies for identifying persons who were seropositive for Ag and each antibody: i) TAS of 6–7 year-old children, ii) population representative surveys of older age groups, and iii) targeted surveillance of subpopulations at higher risk of being seropositive (older ages, householders of Ag-positive TAS children, and known hotspots). For Ag, NNTestav ranged from 142.5 for TAS, to <5 for households of index children. NNTestav was lower in older ages, and highest for Ag, followed by Bm14, Wb123 and Bm33 antibodies. We propose a multi-stage surveillance strategy, starting with population-representative sampling (e.g. TAS or population representative survey of older ages), followed by strategies that target subpopulations and/or locations with low NNTestav. This approach could potentially improve the efficiency of identifying remaining infected persons and residual hotspots. Surveillance programs should also explore the utility of antibodies as indicators of transmission.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Zerihun Zerdo ◽  
Tsegaye Yohanes ◽  
Befikadu Tariku

Mass drug administration (MDA) to the most risky population including school-age children (SAC) is the central strategy to control soil-transmitted helminth (STH) infection. The present study was aimed at estimating the prevalence of STHs reinfection three months posttreatment and associated risk factors among SAC in Chencha district. A cross-sectional study design was employed from April 20 to May 5, 2015, to enroll 408 SAC. Structured questionnaire and Kato-Katz thick smear technique were used to interview parents or guardians and quantify the number of eggs per gram of stool. Pearson chi-square and logistic regression were used to assess the association between predictor variable and STH reinfection. The prevalence of STHs within three months of mass chemotherapy among SAC was 36.8% which is 93.4% of the prevalence (39.4%) before treatment. The estimated prevalence of reinfection (95%CI) forAscaris lumbricoides,Trichuris trichiura, and hookworms was 23.8% (21.1–28.2), 16.2% (12.7–20.1), and 1.0% (0.3–2.5), respectively. Children of merchant fathers were more likely to be reinfected by STHs in Chencha district. In conclusion, there is rapid reinfection after mass chemotherapy among SAC in Chencha district. Further studies should be carried out to generate cost efficient methods that can supplement mass drug administration to accelerate the control of STHs.


2014 ◽  
Vol 40 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Ram Kumar Adhikari ◽  
Jeevan Bahadur Sherchand ◽  
Shiva Raj Mishra ◽  
Kamal Ranabhat ◽  
Rajendra Raj Wagle

2020 ◽  
Vol 14 (11) ◽  
pp. e0008854
Author(s):  
Gabriela A. Willis ◽  
Helen J. Mayfield ◽  
Therese Kearns ◽  
Take Naseri ◽  
Robert Thomsen ◽  
...  

The Global Programme to Eliminate Lymphatic Filariasis has made considerable progress but is experiencing challenges in meeting targets in some countries. Recent World Health Organization guidelines have recommended two rounds of triple-drug therapy with ivermectin, diethylcarbamazine (DEC), and albendazole (IDA), in areas where mass drug administration (MDA) results with two drugs (DEC and albendazole) have been suboptimal, as is the case in Samoa. In August 2018, Samoa was the first country in the world to implement countrywide triple-drug MDA. This paper aims to describe Samoa’s experience with program coverage and adverse events (AEs) in the first round of triple-drug MDA. We conducted a large cross-sectional community survey to assess MDA awareness, reach, compliance, coverage and AEs in September/October 2018, 7–11 weeks after the first round of triple-drug MDA. In our sample of 4420 people aged ≥2 years (2.2% of the population), age-adjusted estimates indicated that 89.0% of the eligible population were offered MDA, 83.9% of the eligible population took MDA (program coverage), and 80.2% of the total population took MDA (epidemiological coverage). Overall, 83.8% (2986/3563) reported that they did not feel unwell at all after taking MDA. Mild AEs (feeling unwell but able to do normal everyday things) were reported by 13.3% (476/3563) and moderate or severe AEs (feeling unwell and being unable to do normal everyday activities such as going to work or school) by 2.9% (103/3563) of participants. This study following the 2018 triple-drug MDA in Samoa demonstrated a high reported program awareness and reach of 90.8% and 89.0%, respectively. Age-adjusted program coverage of 83.9% of the total population showed that MDA was well accepted and well tolerated by the community.


Sign in / Sign up

Export Citation Format

Share Document