Distribution and Utilisation of Ivermectin ( Mectizan ) : A Chemotherapeutic Approach to the Control of Onchocerciasis in Old Ohaozara LGA , Ebonyi State , Eastern Nigeria

OKPARA, ELOM; Mnaemeka, Alo Moses; Iyioku, Ugah Uchenna; Udoh, Usanga Victor

doi:10.12816/0017934

Cited by 1 publication

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“…[33][34][35][36][37] This could be because of incomplete enumeration of targets and communities, inaccurate and outdated census information, inefficient drug distribution, or pressure to meet the program's goals resulting in deliberate inflation. 35,[38][39][40][41] Political pressure both to achieve targets and to increase the population size can also distort reported coverage.…”

Section: Discussionmentioning

confidence: 99%

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

Griswold

Eigege

Ityonzughul

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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The western region of Edo state in southern Nigeria is highly endemic for onchocerciasis. Despite years of mass drug administration (MDA) with ivermectin (IVM), reports suggest persistently high prevalence of onchocerciasis, presumably because of poor coverage. In 2016, twice-per-year treatment with IVM (combined with albendazole for lymphatic filariasis in the first round where needed) began in five local government areas (LGAs) of Edo state. We undertook a multistage cluster survey within 3 months after each round of MDA to assess coverage. First-round coverage was poor: among 4,942 people of all ages interviewed from 145 clusters, coverage was 31.1% (95% confidence intervals [CI]: 24.1-38.0%). Most respondents were not offered medicines. To improve coverage in the second round, three LGAs were randomized to receive MDA through a "modified campaign" approach focused on improved supervision and monitoring. The other two LGAs continued with standard MDA as before. A similar survey was conducted after the second round, interviewing 3,362 people in 87 clusters across the five LGAs. Coverage was not statistically different from the first round (40.0% [95% CI: 31.0-49.0%]) and there was no significant difference between the groups ( = 0.7), although the standard MDA group showed improvement over round 1 ( < 0.01). The additional cost per treatment in the modified MDA was 1.6 times that of standard MDA. Compliance was excellent among those offered treatment. We concluded that poor mobilization, medicine distribution, and program penetration led to low coverage. These must be addressed to improve treatment coverage in Edo state.

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