Non-adherence to community directed treatment with ivermectin for onchocerciasis control in Rungwe district, Southwest Tanzania

Lakwo, T. L.; Gasarasi, DB

doi:10.4314/eamj.v83i6.9440

Cited by 23 publications

(24 citation statements)

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“…This finding concurs with the study of Lakwo and Gasarasi [22] which associated local beliefs and poor perceptions of modern medicine with non-adherence to treatment. Mathieu et al , [23] also found that having been sick was one of the common reasons given for non-compliance.…”

Section: Discussionsupporting

confidence: 91%

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The Role of Personal Opinions and Experiences in Compliance with Mass Drug Administration for Lymphatic Filariasis Elimination in Kenya

et al. 2012

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BackgroundThe main strategy adopted for Lymphatic Filariasis (LF) elimination globally is annual mass drug administration (MDA) for 4 to 6 rounds. At least 65% of the population at risk should be treated in each round for LF elimination to occur. In Kenya, MDA using diethylcarbamazine citrate (DEC) and albendazole data shows declining compliance (proportion of eligible populations who receive and swallow the drugs) levels (85%–62.8%). The present study's aim was to determine the role of personal opinions and experiences in compliance with MDA.Methods/FindingsThis was a retrospective cross-sectional study conducted between January and September 2009 in two districts based on December 2008 MDA round. In each district, one location with high and one with low compliance was selected. Through systematic sampling, nine villages were selected and interviewer-based questionnaires administered to 965 household heads or adult representatives also systematically sampled. The qualitative data were generated from opinion leaders, LF patients with clinical signs and community drug distributors (CDDs) all purposively selected and interviewed. Sixteen focus group discussions (FGDs) were also conducted with single-sex adult and youth male and female groups. Chi square test was used to assess the statistical significance of differences in compliance with treatment based on the records reviewed.The house-to-house method of drug distribution influenced compliance. Over one-quarter (27%) in low compared to 15% in high compliance villages disliked this method. Problems related to size, number and taste of the drugs were more common in low (16.4%) than in high (14.4%) compliance villages. Reasons for failure to take the drugs were associated with compliance (p<0.001). The reasons given included: feeling that the drugs were not necessary, CDD not visiting to issue the drugs, being absent and thinking that the drugs were meant for only the patients with LF clinical signs. A dislike for modern medicine prevailed more in low (6.7%) than in high (1.2%) compliance villages. Experience of side effects influenced compliance (P<0.001). The common side effects experienced included giddiness, fever, headache and vomiting. Social support, alcohol and substance use were not associated with compliance in both types of villages (p>0.05).Conclusions/SignificanceCommunity sensitization on treatment, drugs used, their regimen and distribution method involving all leaders should be strengthened by the Programme Implementers. The communities need to be made aware of the potential side effects of the drugs and that health personnel are on standby for the management of side effects in order to build confidence and increase the compliance levels.

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Section: Discussionsupporting

confidence: 91%

“…However, in the current study this behavior was not associated with non-compliance. Lakwo and Gasarasi [22] however associated alcohol use among community members with non-adherence.…”

Section: Discussionmentioning

confidence: 93%

The Role of Personal Opinions and Experiences in Compliance with Mass Drug Administration for Lymphatic Filariasis Elimination in Kenya

et al. 2012

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“…Lakwo (2006) studied factors associated with non-adherence to community directed treatment with ivermectin for onchocerciasis control in the focus, and observed that, although the knowledge on the disease was relatively high, knowledge on its causes was rather low, while about one-third of those interviewed had no idea of its cause. The author found that there was generally inadequate health education in the communities, and local negative beliefs and alcoholism contributed to non-adherence to treatment schedules.…”

Section: Discussionmentioning

confidence: 99%

Onchocerciasis situation in the Tukuyu focus of southwest Tanzania after ten years of ivermectin mass treatment

Mweya¹,

Kalinga²,

Kabula³

et al. 2008

Tanzania J Hlth Res

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A purposive cross-sectional epidemiological study was conducted in the Tukuyu Onchocerciasis focus in south-western Tanzania in 2004, ten years after launching the ivermectin mass treatment programme, and 23 years after establishing focal parasite prevalence. The objective was to assess contemporary Onchocerciasis clinical and parasitological situation and assess community knowledge about the disease and its control. From historical data, five villages with high parasite prevalence were selected, two each on the Lufilyo and Kiwira Rivers and one on lower Lumbira River. Skin biopsies were taken from the iliac crest on the left and right buttocks, for examination of Onchocerca volvulus microfilariae. Onchocercal skin lesions were checked using natural light, while nodules were palpated from head to ankles and scored. A structured questionnaire was administered to participants. A total of 438 persons (age=16-99 years) were examined. No skin microfilariae (mf) were detected. Onchocercal skin symptoms were found in 170 (38.8%), of which 30 (6.9%) had nodules, 48 (11.0%) chronic onchodermatitis and 92 (21%) itching. One-third (34.5%) had correct knowledge that black flies ("tusunya") are vectors of onchocerciasis. Half of the respondents (n=217) confirmed taking ivermectin for onchocerciasis treatment, and 428 (97.7%) were willing to continue for any duration. It is concluded that the undetectable skin microfilariae in the study sample was partly attributable to the consequences of ongoing ivermectin mass treatment. It is recommended that the control efforts, as well as monitoring and evaluation be sustained to determine its long term impact, and that a more sensitive technique be used to check O. volvulus skin mf prevalence.

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“…2004; Semiyaga et al. 2005; Lakwo & Gasarasi 2006). Social support and drug perceptions are other factors that have influenced coverage, and hence may impact on compliance (Nuwaha et al.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of persons who complied with and failed to comply with annual ivermectin treatment

Brieger

Okeibunor

Abiose

et al. 2012

Tropical Med Int Health

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Abstractobjective To assess individual compliance with annual ivermectin treatment in onchocerciasisendemic villages.methods Multi-site study in eight APOC-sponsored projects in Cameroon, Nigeria and Uganda to identify the socio-demographic correlates of compliance with ivermectin treatment. A structured questionnaire was administered on 2305 persons aged 10 years and above. Two categories of respondents were purposively selected to obtain both high and low compliers: people who took ivermectin 6-8 times and 0-2 times previously. Simple descriptive statistics were employed in characterizing the respondents into high and low compliers, while some socio-demographic and key perceptual factors were employed in regression models constructed to explain levels of compliance among the respondents.results Some demographic and perceptual factors associated with compliance were identified. Compliance was more common among men (54.4%) (P < 0.001). Adults (54.6%) had greater rates of high compliance (P < 0.001. The mean age of high compliers (41.5 years) was significantly older (35.8 years) (t = 8.46, P < 0.001). Perception of onchocerciasis and effectiveness of ivermectin influenced compliance. 81.4% of respondents saw benefits in annual ivermectin treatment, high compliance among those who saw benefits was 59.3% compared to 13.3% of those who did not (P < 0.001).conclusion Efforts to increase compliance with ivermectin treatment should focus on providing health education to youth and women. Health education should also highlight the benefits of taking ivermectin.

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Non-adherence to community directed treatment with ivermectin for onchocerciasis control in Rungwe district, Southwest Tanzania

Cited by 23 publications

References 0 publications

The Role of Personal Opinions and Experiences in Compliance with Mass Drug Administration for Lymphatic Filariasis Elimination in Kenya

The Role of Personal Opinions and Experiences in Compliance with Mass Drug Administration for Lymphatic Filariasis Elimination in Kenya

Onchocerciasis situation in the Tukuyu focus of southwest Tanzania after ten years of ivermectin mass treatment

Characteristics of persons who complied with and failed to comply with annual ivermectin treatment

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