Assessing Lymphatic Filariasis Data Quality in Endemic Communities in Ghana, Using the Neglected Tropical Diseases Data Quality Assessment Tool for Preventive Chemotherapy

Abstract

BackgroundThe activities of the Global Programme for the Elimination of Lymphatic Filariasis have been in operation since the year 2000, with Mass Drug Administration (MDA) undertaken yearly in disease endemic communities. Information collected during MDA–such as population demographics, age, sex, drugs used and remaining, and therapeutic and geographic coverage–can be used to assess the quality of the data reported. To assist country programmes in evaluating the information reported, the WHO, in collaboration with NTD partners, including ENVISION/RTI, developed an NTD Data Quality Assessment (DQA) tool, for use by programmes. This study was undertaken to evaluate the tool and assess the quality of data reported in some endemic communities in Ghana.MethodsA cross sectional study, involving review of data registers and interview of drug distributors, disease control officers, and health information officers using the NTD DQA tool, was carried out in selected communities in three LF endemic Districts in Ghana. Data registers for service delivery points were obtained from District health office for assessment. The assessment verified reported results in comparison with recounted values for five indicators: number of tablets received, number of tablets used, number of tablets remaining, MDA coverage, and population treated. Furthermore, drug distributors, disease control officers, and health information officers (at the first data aggregation level), were interviewed, using the DQA tool, to determine the performance of the functional areas of the data management system.FindingsThe results showed that over 60% of the data reported were inaccurate, and exposed the challenges and limitations of the data management system. The DQA tool is a very useful monitoring and evaluation (M&E) tool that can be used to elucidate and address data quality issues in various NTD control programmes.

Persistent ‘hotspots’ of lymphatic filariasis microfilaraemia despite 14 years of mass drug administration in Ghana

“…Previous studies in Ghana have pointed out that data reported on epidemiological coverage may not be accurate (60%), however, this situation is not different between hotspots and stopped-MDA districts. 20 Poor compliance (44%) has been reported in a hotspot district in Ghana. 13 Secondly, although LLINs were reportedly distributed equally among the hotspot and stopped-MDA districts, there was no documentation of their actual use.…”

Progress towards lymphatic filariasis elimination in Ghana from 2000-2016: analysis of microfilaria prevalence data from 430 communities

“…We acknowledge the fact that these reported coverage may not be very reliable [33] since some areas reported coverage more than 100% (Figure S2). Our data showed a relatively high and constant coverage over time.…”

Fifteen years of programme implementation for the elimination of Lymphatic Filariasis in Ghana: Impact of MDA on immunoparasitological indicators

“…The number of years required to interrupt transmission appears to depend on the MF prevalence at the inception. It is important to note that several factors, in particular therapeutic coverage and adherence rates, geographical coverage [7,8], mosquito vector characteristics [9], and drug regimens [10], may all influence the rate of decline of parasitological parameters, which measure the success of the programme, will need to be considered in the process of monitoring and evaluation of MDA programmes.…”

“…Furthermore, a recent study using the WHO data quality assessment (DQA) tool revealed inaccuracies of coverage results reported at the service delivery points [8], pointing to challenges in the data management and reporting tools of the programme. Therapeutic coverage and adherence to MDA are two important indices used to assess the success of MDA campaigns [19,20].…”

“…However, these surveys have also highlighted the need to review the five to six years of recommended MDA required to interrupt transmission, as persistent transmission has been observed in some communities. The DQA in initial districts [8] revealed some inaccuracies in reported coverage, and the program is working towards improving the data reported in the remaining districts through training on the effective use of the data reporting tools and processes. While the challenges of persistent transmission are yet to be resolved, the distribution of insecticide-treated bed nets could accelerate the elimination of LF in these areas as high coverage of bed nets should reduce the transmission of the disease [17,18].…”