Participation in three consecutive mass drug administrations in Leogane, Haiti

Abstract

Summaryobjectives In the global effort to eliminate lymphatic filariasis, mass drug administrations (MDAs) are organised annually. The success of this strategy depends on achieving high levels of drug coverage, which reduce the number of persons with circulating microfilariae and consequently transmission. Persons who consistently fail to participate in MDAs represent a potential threat to the goal of filariasis elimination. We wanted to know the drug coverage, the proportion of persons who were systematically noncompliant and factors associated with this behaviour.methods We conducted three surveys following the third annual MDA of a filariasis elimination program in Leogane, Haiti: (1) a total population survey to determine coverage; (2) an adult survey to determine non-compliance and associated factors and (3) an urban survey to make a rural-urban comparison.results During the third MDA, the overall surveyed coverage was 78.5% [95% confidence interval (CI) 74.4-82.6] A survey among adult population showed coverage estimates for persons >14 years old of 59.4% (95% CI 52.0-66.7), 61.0% (95% CI 55.0-67.4) and 67.3% (95% CI 60.5-74.0), for the first, second and third MDA respectively. The coverage in rural areas (78.3%) was significantly higher than in urban areas (68.3%, P < 0.05). Of the population >14 years of age, 18% never took the drugs during any of three MDAs. These persons did not differ significantly from MDA participants by age, gender or other characteristics that we assessed.conclusion More research is needed to identify characteristics of systematically non-compliant persons in order to refine health education messages and improve distribution strategies to increase drug coverage.

Socioeconomic factors associated with compliance with mass drug administration for lymphatic filariasis elimination in Kenya: Descriptive study results

“…It was also apparent from the participants' sentiments that knowledge about the consequences of the disease enhanced compliance. Similarly, a study done in Leogane, Haiti Mathieu et al, [21] found that persons who knew that LF was transmitted by mosquitoes were more likely to have participated in MDA than persons who did not. However, generally the study populations had relatively low levels of knowledge of cause of LF.…”

The Effect of Compliance on the Impact of Mass Drug Administration for Elimination of Lymphatic Filariasis in Egypt

“…Other investigators have grappled with this problem. 8,9 It is expensive to provide supplemental rounds of MDA to entire populations in hopes of treating people who have been missed in the early rounds. Additional rounds of MDA after rounds 4 or 5 mostly treat people who do not need further treatment and miss most of the systematically noncompliant population.…”

“…Mathematical models that simulate LF transmission 3,4 and GPELF guidelines emphasize the importance of achieving high MDA coverage rates. 5,6 Reported MDA coverage rates vary, [7][8][9] and compliance rates (percentage of people who report having taken the medications) are sometimes much lower than coverage rates (percentage of people who received the medications) reported by public health authorities. 10 Compliance rates have decreased after several rounds of MDA in some areas 11 but have increased in others.…”

“…10 Compliance rates have decreased after several rounds of MDA in some areas 11 but have increased in others. 8,12 A number of factors contribute to MDA noncompliance, including ignorance or indifference in the target population regarding LF, fear of adverse events from treatment, distrust of government programs, and failure to receive the medications. 8,10,13 Bancroftian filariasis has been endemic in Egypt for centuries.…”

Aspectos da realidade social de crianças e adolescentes atendidos em serviço de referência para filariose bancroftiana, Recife, estado de Pernambuco

“…Poderiam ser lembrados o hábito social de ingesta alcoólica e a precocidade do trabalho; a questão da paridade, na fase etária estudada, pois a gestante deve ser excluída do processo até o ano seguinte e, nesse meio tempo, se não houver um controle de busca ativa, poderá estar novamente grávida no próximo tratamento em massa e, assim, ser excluída do processo novamente. O conhecimento desses dados e o planejamento adequado para garantir o tratamento do indivíduo faltoso, assegurando a cobertura mínima, pode influenciar o sucesso ou o fracasso em interromper a transmissão ao longo dos 5-6 anos de tratamento antifilarial em massa 17 .…”