Implementing population-based mass drug administration for malaria: experience from a high transmission setting in North Eastern Uganda

Malaria Journal

Richard Elliot¹  Jean-Pierre Van Geertruyden²  Adoke Yeka³  Ronald Mulebeke⁴  Dorothy Echodu⁴  Fred Bukenya⁴  Humphrey Wanzira⁴  Thomas Eganyu⁴  Kathryn Collborn⁵ 

[1] Boise State University;Global Health Institute, University of Antwerp;Makerere University School of Public Health;Pilgrim Africa;University of Colorado Denver;

关键词: Malaria;    Mass drug administration;    High transmission setting;    Uganda;   

DOI  :  10.1186/s12936-019-2902-z

来源: DOAJ

【 摘 要 】

Abstract Background Mass drug administration (MDA) is a suggested mean to accelerate efforts towards elimination and attainment of malaria-free status. There is limited evidence of suitable methods of implementing MDA programme to achieve a high coverage and compliance in low-income countries. The objective of this paper is to assess the impact of this MDA delivery strategy while using coverage measured as effective population in the community and population available. Methods Population-based MDA was implemented as a part of a larger program in a high transmission setting in Uganda. Four rounds of interventions were implemented over a period of 2 years at an interval of 6 to 8 months. A housing and population census was conducted to establish the eligible population. A team of 19 personnel conducted MDA at established village meeting points as distribution sites at every village. The first dose of dihydroartemisinin–piperaquine (DHA-PQ) was administered via a fixed site distribution strategy by directly observed treatment on site, the remaining doses were taken at home and a door-to-door follow up strategy was implemented by community health workers to monitor adherence to the second and third doses. Results Based on number of individuals who turned up at the distribution site, for each round of MDA, effective coverage was 80.1%, 81.2%, 80.0% and 80% for the 1st, 2nd, 3rd and 4th rounds respectively. However, coverage based on available population at the time of implementing MDA was 80.1%, 83.2%, 82.4% and 82.9% for rounds 1, 2, 3 and 4, respectively. Intense community mobilization using community structures and mass media facilitated community participation and adherence to MDA. Conclusion A hybrid of fixed site distribution and door-to-door follow up strategy of MDA delivery achieved a high coverage and compliance and seemed feasible. This model can be considered in resource-limited settings.

【 授权许可】

Unknown