Factors Associated With Coverage in Community-directed Treatment With Ivermectin for Onchocerciasis Control in Savanah and Forest Areas in Central African Republic: A Cross-sectional Study
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: The aim of this study was to identify factors associated with coverage in community-directed treatment with ivermectin for onchocerciasis control in savannah and forest areas in the Central African Republic.Methods: A cross-sectional study was conducted in 2 districts where onchocerciasis is endemic. We employed a pretested and validated questionnaire that included questions about the socio-demographic characteristics of the respondents and variables relevant to coverage assessment. Multivariate logistic regression analyses were performed to identify the associations between surveyed mass drug administration (MDA) coverage and the variables considered, while accounting for potential confounding factors. A <i>p</i>-value <0.05 was considered statistically significant.Results: At the district level, the MDA program achieved a reach of 87.29% (95% confidence interval [CI], 86.03 to 88.55) in Bossangoa and 61.74% (95% CI, 59.56 to 63.92) in Kémo, compared to the reported rates of 90.02% and 91.70%, respectively. Women in both Bossangoa and Kémo were 1.28 times more likely to have taken ivermectin than men (95% CI, 1.12 to 1.47; <i>p</i>=0.008; 95% CI, 1.09 to 2.00; <i>p</i>=0.041, respectively). The age groups of 5-14, 15-24, and 25-34 were statistically associated with better distribution coverage in both districts. Individuals with knowledge of onchocerciasis were more likely to receive ivermectin compared to those without knowledge, with adjusted odds ratios of 1.41 (95% CI, 1.11 to 2.01; <i>p</i>=0.030) and 3.19 (95% CI, 2.91 to 4.08; <i>p</i>=0.001), respectively.Conclusions: The authors recommend implementing measures to improve MDA coverage in future campaigns. These measures should include allocating sufficient time for MDA activities, providing health education, and mobilising the entire population.
Abstract
Objectives: The aim of this study was to identify factors associated with coverage in community-directed treatment with ivermectin for onchocerciasis control in savannah and forest areas in the Central African Republic.Methods: A cross-sectional study was conducted in 2 districts where onchocerciasis is endemic. We employed a pretested and validated questionnaire that included questions about the socio-demographic characteristics of the respondents and variables relevant to coverage assessment. Multivariate logistic regression analyses were performed to identify the associations between surveyed mass drug administration (MDA) coverage and the variables considered, while accounting for potential confounding factors. A <i>p</i>-value <0.05 was considered statistically significant.Results: At the district level, the MDA program achieved a reach of 87.29% (95% confidence interval [CI], 86.03 to 88.55) in Bossangoa and 61.74% (95% CI, 59.56 to 63.92) in Kémo, compared to the reported rates of 90.02% and 91.70%, respectively. Women in both Bossangoa and Kémo were 1.28 times more likely to have taken ivermectin than men (95% CI, 1.12 to 1.47; <i>p</i>=0.008; 95% CI, 1.09 to 2.00; <i>p</i>=0.041, respectively). The age groups of 5-14, 15-24, and 25-34 were statistically associated with better distribution coverage in both districts. Individuals with knowledge of onchocerciasis were more likely to receive ivermectin compared to those without knowledge, with adjusted odds ratios of 1.41 (95% CI, 1.11 to 2.01; <i>p</i>=0.030) and 3.19 (95% CI, 2.91 to 4.08; <i>p</i>=0.001), respectively.Conclusions: The authors recommend implementing measures to improve MDA coverage in future campaigns. These measures should include allocating sufficient time for MDA activities, providing health education, and mobilising the entire population.
참고문헌 (39)
- Mackenzie CD, "Elimination of onchocerciasis from Africa : possible?", Trends Parasitol, 28(1), pp.16~22 (2012)[DOI]
- Tada I, "3)Onchocerciasis", Trop Med Health, 43(Suppl), pp.57~60 (2015)[DOI]
- "Onchocerciasis (river blindness)"[URL]
- Benton B, "Economic impact of onchocerciasis control through the African Programme for Onchocerciasis Control : an overview", Ann Trop Med Parasitol, 92(Suppl 1), pp.S33~S39 (1998)[DOI]
- Molyneux DH, "Onchocerciasis control and elimination : coming of age in resource-constrained health systems", Trends Parasitol, 21(11), pp.525~529 (2005)[DOI]
- Babalola OE, "Ocular onchocerciasis : current management and future prospects", Clin Ophthalmol, 5, pp.1479~1491 (2011)[DOI]
- Tekle AH, "Progress towards onchocerciasis elimination in the participating countries of the African Programme for Onchocerciasis Control : epidemiological evaluation results", Infect Dis Poverty, 5(1), pp.66~ (2016)[DOI]
- Diawara L, "Feasibility of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa : first evidence from studies in Mali and Senegal", PLoS Negl Trop Dis, 3(7), pp.e497~ (2009)[DOI]
- Katabarwa MN, "Comparison of reported and survey-based coverage in onchocerciasis programs over a period of 8 years in Cameroon and Uganda", Am J Trop Med Hyg, 100(5), pp.1208~1215 (2019)[DOI]
- Traore MO, "Proof-of-principle of onchocerciasis elimination with ivermectin treatment in endemic foci in Africa : final results of a study in Mali and Senegal", PLoS Negl Trop Dis, 6(9), pp.e1825~ (2012)[DOI]
- "Accelerating work to overcome the global impact of neglected tropical diseases - a roadmap for implementation" (2012)[URL]
- "Sustaining the drive to overcome the global impact of neglected tropical diseases: second WHO report on neglected diseases" (2013)[URL]
- Kuesel AC, "Research for new drugs for elimination of onchocerciasis in Africa", Int J Parasitol Drugs Drug Resist, 6(3), pp.272~286 (2016)[DOI]
- Gebrezgabiher G, "Evaluation of mass treatment with ivermectin program reach and survey coverage for onchocerciasis elimination in selected endemic areas of Ethiopia", PLoS One, 17(7), pp.e0271518~ (2022)[DOI]
- Stolk WA, "Required duration of mass ivermectin treatment for onchocerciasis elimination in Africa : a comparative modelling analysis", Parasit Vectors, 8, pp.552~ (2015)[DOI]
- Budge PJ, "Accuracy of coverage survey recall following an integrated mass drug administration for lymphatic filariasis, schistosomiasis, and soil-transmitted helminthiasis", PLoS Negl Trop Dis, 10(1), pp.e0004358~ (2016)[DOI]
- Griswold E, "Evaluation of treatment coverage and enhanced mass drug administration for onchocerciasis and lymphatic filariasis in five local government areas treating twice per year in Edo State, Nigeria", Am J Trop Med Hyg, 99(2), pp.396~403 (2018)[DOI]
- Higazi TB, "Chemotherapy in the treatment, control, and elimination of human onchocerciasis", Res Rep Trop Med, 5, pp.77~93 (2014)[DOI]
- Baker MC, "Measuring treatment coverage for neglected tropical disease control programs : analysis of a survey design", Am J Epidemiol, 178(2), pp.268~275 (2013)[DOI]
- Woodhall DM, "Exploring innovative ways to conduct coverage surveys for neglected tropical diseases in Malawi, Mali, and Uganda", Acta Trop, 132, pp.119~124 (2014)[DOI]
- Worrell C, "Drug coverage surveys for neglected tropical diseases : 10 years of field experience", Am J Trop Med Hyg, 87(2), pp.216~222 (2012)[DOI]
- Zouré HG, "The geographic distribution of onchocerciasis in the 20 participating countries of the African Programme for Onchocerciasis Control : (2)pre-control endemicity levels and estimated number infected", Parasit Vectors, 7, pp.326~ (2014)[DOI]
- "Uniting to combat neglected tropical diseases (NTDs)"[URL]
- "Preventive chemotherapy: tools for improving the quality of reported data and information: a field manual for implementation" (2019)[URL]
- "Independent participatory monitoring of CDTI projects: guidelines and instruments" (2002)[URL]
- "Elimination of human onchocerciasis: progress report, 2022-2023" (2023)[URL]
- Semiyaga NB, "Refusal to take ivermectin : the associated ‘risk’ factors in Hoima district, Uganda", Ann Trop Med Parasitol, 99(2), pp.165~172 (2005)[DOI]
- Gebrezgabiher G, "Evaluation of mass treatment with ivermectin program reach and survey coverage for onchocerciasis elimination in selected endemic areas of Ethiopia", PLoS One, 17(7), pp.e0271518~ (2022)[DOI]
- Serme M, "Evaluation of therapeutic coverage of mass treatment campaign against lymphatic filariasis in two health districts in Burkina Faso", Med Trop Sante Int, 2(4) (2022)[DOI]
- Gass K, "A multicountry comparison of three coverage evaluation survey sampling methodologies for neglected tropical diseases", Am J Trop Med Hyg, 103(4), pp.1700~1710 (2020)[DOI]
- Brieger WR, "Compliance with eight years of annual ivermectin treatment of onchocerciasis in Cameroon and Nigeria", Parasit Vectors, 4, pp.152~ (2011)[DOI]
- Onowhakpor AO, "Assessment of the performance of community-directed treatment with ivermectin strategy for the control and elimination of onchocerciasis in Edo State, Nigeria", Indian J Public Health, 61(4), pp.267~273 (2017)[DOI]
- Lakwo TL, "Non-adherence to community directed treatment with ivermectin for onchocerciasis control in Rungwe district, southwest Tanzania", East Afr Med J, 83(6), pp.326~332 (2006)[DOI]
- Griswold E, "Evaluation of treatment coverage and enhanced mass drug administration for onchocerciasis and lymphatic filariasis in five local government areas treating twice per year in Edo State, Nigeria", Am J Trop Med Hyg, 99(2), pp.396~403 (2018)[DOI]
- Astale T, "Population-based coverage survey results following the mass drug administration of azithromycin for the treatment of trachoma in Amhara, Ethiopia", PLoS Negl Trop Dis, 12(2), pp.e0006270~ (2018)[DOI]
- Churko C, "Ivermectin treatment coverage validation in two onchocerciasis endemic districts in Ethiopia : a community-based cross-sectional study, 2019", J Multidiscip Healthc, 14, pp.137~144 (2021)[DOI]
- Afonne C, "A coverage evaluation survey for mass drug administration of ivermectin in Ukwa East local government area, Abia State, Nigeria", Int J Infect Dis, 101(Suppl 1), pp.213~ (2020)[DOI]
- Yirga D, "Factors associated with compliance with community directed treatment with ivermectin for onchocerciasis control in Southwestern Ethiopia", Parasit Vectors, 3, pp.48~ (2010)[DOI]
- Amazigo UV, "Monitoring community-directed treatment programmes for sustainability: lessons from the African Programme for Onchocerciasis Control (APOC)", Ann Trop Med Parasitol, 96(Suppl 1), pp.S75~S92 (2002)[DOI]
