Are census data accurate for estimating coverage of a lymphatic filariasis MDA campaign? Results of a survey in Sierra Leone

Kamara, Wogba; Zoerhoff, Kathryn L.; Toubali, Emily; Hodges, Mary H.; Bisanzio, Donal; Chowdhury, Dhuly; Sonnie, Mustapha; Magbity, Edward; Samai, Mohamed; Conteh, Abdulai; Macarthy, Florence; Baker, Margaret; Koroma, Joseph B.

doi:10.1371/journal.pone.0224422

Cited by 6 publications

(7 citation statements)

References 24 publications

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“…Absenteeism could be attributed to migration due to occupation where people move to other localities for farming activities, casual labor or to urban areas for employment. Migration of persons negatively affects MDA uptake and the findings are consistent with those of a study conducted in Sierra Leone [25]. Other reasons contributing to absenteeism could be lack of awareness of distribution mode and schedules for MDA due to inadequate community sensitization activities that lack repeated messaging and reminders.…”

Section: Discussionsupporting

confidence: 82%

“…The study by Krentel et al, (2017), explains how health systems' challenges such as when supplies are inadequate for the program activities affect implementation of the program by becoming challenges of the CDDs [28]. Kamara et al, (2019) recommend pre-MDA registrations in areas where populations are highly mobile which are implemented correctly to avoid missing pockets of population as a way of ensuring that CDDs receive adequate supply of drugs for distributions [25]. The Kenyan NTD program is encouraged to collaborate with all relevant stakeholders to ensure that no households miss out on registration and subsequent drug distribution for successful LF campaigns.…”

Section: Discussionmentioning

confidence: 99%

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Implementation challenges and opportunities for improved mass treatment uptake for lymphatic filariasis elimination: Perceptions and experiences of community drug distributors of coastal Kenya

et al. 2020

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Community drug distributors (CDDs) who are volunteers have the responsibility of awareness creation, household census, drug distribution and record-keeping and are thus key stakeholders in the campaign for Lymphatic Filariasis (LF) elimination. Taking into account their experiences and perceptions is important for a successful elimination campaign. We conducted a qualitative study in 2018 to identify implementation challenges and opportunities for improved mass drug administration (MDA) uptake based on the CDDs perceptions and experiences. Within a larger study that used mixed methods quasi-experimental design, we collected qualitative data from two wards in Kaloleni Sub-County of Kilifi County which was purposively selected owing to its low, 56% and 50.5% treatment coverage in 2015 and 2016 respectively. Focus group discussions (FGDs) (n = 8) and in-depth interviews (IDIs) (n = 8) with CDDs, IDIs (n = 22) with opinion leaders and IDIs (n = 8) with health workers were conducted and the data analyzed by QSR NVIVO version 10 according to thematic areas. The results showed that based on the perceptions and experiences of the CDDs, several challenges: communities’ refusal to take the drugs; absenteeism during MDA; non-adherence to CDDs selection criteria; inadequacy in number of CDDs engaged during the campaign and training provided; insufficiency of drugs issued to CDDs; lack of CDDs supervision and low motivation negatively impact on MDA uptake. Opportunities to address the challenges included: awareness creation on MDA, health education on LF and observation of hygiene during drug administration, increased duration of awareness creation and drug administration, adherence to CDDs selection criteria and putting into consideration the vastness of an area and population density while deploying CDDs. Other opportunities include: improved CDDs training and scheduling; issuing of enough drugs to CDDs to meet the communities’ demand and improved supervision and motivation of CDDs. Addressing the challenges highlighted is an important step of maximizing MDA uptake. The opportunities presented need to be considered by the NTD program personnel, the county health personnel and the community while planning the implementation of MDA campaigns.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Implementation challenges and opportunities for improved mass treatment uptake for lymphatic filariasis elimination: Perceptions and experiences of community drug distributors of coastal Kenya

et al. 2020

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“…13 For example, in Sierra Leone, a study found populations in two districts to be higher than projected from census data following post-conflict population growth due to reopening of mines resulting in post-war employment opportunities. 39 If there are concerns about denominator accuracy, the population data can be triangulated using other data sources, such as health facility catchment area populations, community drug distributor pre-MDA registration, and remote sensing data using nightlights and land use. 21 39 Furthermore, the quality of reported data can be reviewed during supportive supervision visits and data quality assessments to determine which aspects of the reporting system are not functioning well, and to identify actions to strengthen the system such as improved training on data collection, increased supervision or revising data collection tools.…”

Section: Discussionmentioning

confidence: 99%

How well do coverage surveys and programmatically reported mass drug administration coverage match? Results from 214 mass drug administration campaigns in 15 countries, 2008–2017

et al. 2023

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IntroductionDelivering preventive chemotherapy through mass drug administration (MDA) is a central approach in controlling or eliminating several neglected tropical diseases (NTDs). Treatment coverage, a primary indicator of MDA performance, can be measured through routinely reported programmatic data or population-based coverage evaluation surveys. Reported coverage is often the easiest and least expensive way to estimate coverage; however, it is prone to inaccuracies due to errors in data compilation and imprecise denominators, and in some cases measures treatments offered as opposed to treatments swallowed.ObjectiveAnalyses presented here aimed to understand (1) how often coverage calculated using routinely reported data and survey data would lead programme managers to make the same programmatic decisions; (2) the magnitude and direction of the difference between these two estimates, and (3) whether there is meaningful variation by region, age group or country.MethodsWe analysed and compared reported and surveyed treatment coverage data from 214 MDAs implemented between 2008 and 2017 in 15 countries in Africa, Asia and the Caribbean. Routinely reported treatment coverage was compiled using data reported by national NTD programmes to donors, either directly or via NTD implementing partners, following the implementation of a district-level MDA campaign; coverage was calculated by dividing the number of individuals treated by a population value, which is typically based on national census projections and occasionally community registers. Surveyed treatment coverage came from post-MDA community-based coverage evaluation surveys, which were conducted as per standardised WHO recommended methodology.ResultsCoverage estimates using routine reporting and surveys gave the same result in terms of whether the minimum coverage threshold was reached in 72% of the MDAs surveyed in the Africa region and in 52% in the Asia region. The reported coverage value was within ±10 percentage points of the surveyed coverage value in 58/124 of the surveyed MDAs in the Africa region and 19/77 in the Asia region. Concordance between routinely reported and surveyed coverage estimates was 64% for the total population and 72% for school-age children. The study data showed variation across countries in the number of surveys conducted as well as the frequency with which there was concordance between the two coverage estimates.ConclusionsProgramme managers must grapple with making decisions based on imperfect information, balancing needs for accuracy with cost and available capacity. The study shows that for many of the MDAs surveyed, based on the concordance with respect to reaching the minimum coverage thresholds, the routinely reported data were accurate enough to make programmatic decisions. Where coverage surveys do show a need to improve accuracy of routinely reported results, NTD programme managers should use various tools and approaches to strengthen data quality in order to use data for decision-making to achieve NTD control and elimination goals.

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“…In Ghana, and elsewhere, lymphatic filariasis MDA activities are already burdened with barriers to attaining optimal treatment coverage [ 26 – 29 ], facilitated by inaccurate reported data [ 30 – 32 ] and socio-cultural and health system challenges [ 33 ]. As such, more effort will be required to address the MDA challenges during the COVID-19 era.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 related perception among some community members and frontline healthcare providers for NTD control in Ghana

et al. 2022

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Introduction The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a major breakdown of health service provision in the fight against neglected tropical diseases (NTDs). COVID-19 may impact NTDs service delivery in varied ways. As the Ghana NTD programme planned to resume MDA activities, we examined the COVID-19 related perceptions and practices among some community members and frontline health workers for NTD control activities in the country. Methods The study was conducted in seven communities in the Ahanta West district of Ghana. This was a qualitative study using in-depth interviews (IDI) and focus group discussions (FGDs) for data collection. Participants were purposively selected from varied backgrounds to represent both beneficiaries and service providers directly involved in NTD programme implementation. Trained and experienced qualitative data collectors conducted the FGD and IDI sessions in the local Twi language, while health worker sessions were conducted in English. Discussions were audio-recorded and transcribed directly into English. Data was analysed using an iterative process. The transcripts were pre-coded using the broad themes, entered into a computer using Microsoft Word, and then imported into the MAXQDA software for thematic content analysis to select relevant representative narratives for presentation. Results Participants were aware of the COVID-19 pandemic and referred to it appropriately as ‘coronavirus’, COVID-19, and often as ‘the new disease’. Though many respondents could not describe the route of transmission, most of them reported that it is transmitted through touch or sharing of common items. They reported some signs/symptoms like fever, headache and difficulty breathing, and prevention methods like the use of hand sanitiser, washing of hands and sneezing appropriately. Respondents have reported that COVID-19 has negatively affected their daily lives by limiting their movements and therefore work. It also came to light that COVID-19 has also negatively affected the NTD programme implementation, especially mass drug administration (MDA) activities, leading to the postponement of the yearly MDA. The COVID-19 pandemic has negatively affected clinic attendance; people are afraid that they may be tested for COVID-19 at the clinic. Conclusion COVID-19 has negatively affected the NTD programme. Education and the provision of personal protective equipment will be required to build the confidence of frontline care providers including community drug distributors and community members in order to enhance quality service and participation in future MDA activities.

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Are census data accurate for estimating coverage of a lymphatic filariasis MDA campaign? Results of a survey in Sierra Leone

Cited by 6 publications

References 24 publications

Implementation challenges and opportunities for improved mass treatment uptake for lymphatic filariasis elimination: Perceptions and experiences of community drug distributors of coastal Kenya

Implementation challenges and opportunities for improved mass treatment uptake for lymphatic filariasis elimination: Perceptions and experiences of community drug distributors of coastal Kenya

How well do coverage surveys and programmatically reported mass drug administration coverage match? Results from 214 mass drug administration campaigns in 15 countries, 2008–2017

COVID-19 related perception among some community members and frontline healthcare providers for NTD control in Ghana

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