Mass drug administration for lymphatic filariasis elimination in a coastal state of India: a study on barriers to coverage and compliance

Infectious Diseases of Poverty

Sanghamitra Pati²  Shridhar Kadam²  Subhashisa Swain²  Ashok K Sitha¹  Mohammad A Hussain³ 

[1] Government of Odisha, Odisha, India;Public Health Foundation of India, Indian Institute of Public Health, Bhubaneswar, Odisha, India;School of Population Health, The University of Queensland, Herston, Brisbane, QLD 4006, Australia

关键词: Elimination;    Consumption;    Compliance;    Mass drug administration;    Lymphatic filariasis;   

Others  :  1136029
DOI  :  10.1186/2049-9957-3-31

 received in 2014-01-13, accepted in 2014-08-11,  发布年份 2014

【 摘 要 】

Background

Lymphatic filariasis is targeted for elimination in India through mass drug administration (MDA) with diethylcarbamazine (DEC) combined with albendazole (ABZ). For the strategy to be effective, >65% of those living in endemic areas must be covered by and compliant to MDA. Post the MDA 2011 campaign in the endemic district of Odisha, we conducted a survey to assess: (i) the filariasis knowledge in the community, (ii) the coverage and compliance of MDA from the community perspective, and (iii) factors affecting compliance, as well as the operational issues involved in carrying out MDA activities from the drug distributor’s perspective.

Methods

A sample of 691 participants – both male and female, aged two years or above – were selected through multistage stratified sampling and interviewed using a semi-structured questionnaire. Additionally, drug distributors and the medical officers in charge of the MDA were also interviewed to understand some of the operational issues encountered during MDA.

Results

Ninety-nine percent of the study participants received DEC and ABZ tablets during MDA, of which only just above a quarter actually consumed the drugs. The cause of non-compliance was mostly due to fear of side effects, lack of awareness of the benefits of MDA, and non-attendance of health staff in the villages. Lack of adequate training of drug distributors and poor health communication activities before the MDA campaign commenced and the absence of follow-up by health workers following MDA were a few of the operational difficulties encountered during the MDA campaign.

Conclusion

Currently MDA is restricted to the distribution of drugs only and the key issues of implementation in compliance, health education, managing side effects, and logistics are not given enough attention. It is therefore essential to address the issues linked to low compliance to make the program more efficient and achieve the goal of filariasis elimination.

【 授权许可】

   
2014 Hussain et al.; licensee BioMed Central Ltd.

【 图 表 】

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