Community Attitudes Toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases After the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia.

Lincoln Gankpala,Gary J. Weil,Joshua Bogus,Alison Krentel,Karsor Kollie,Peter U. Fischer,Fatorma K. Bolay,Kerstin Fischer

doi:10.4269/ajtmh.15-0591

Lincoln Gankpala, Gary J. Weil + Show 6 more

Open Access

https://doi.org/10.4269/ajtmh.15-0591

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Abstract

The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD.

Highlights

Liberia is a post-conflict country in West Africa with a population of approximately 4.3 million
We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in mass drug administration (MDA) and are located in an area that was an early epicenter of the Ebola virus disease (EVD) outbreak
A total of 140 community leaders were interviewed in 32 Death to Onchocerciasis and Lymphatic Filariasis (DOLF) study villages in Lofa County (Table 1)

Summary

Introduction

Liberia is a post-conflict country in West Africa with a population of approximately 4.3 million. Like many other countries in sub-Saharan Africa, Liberia is endemic for a number of neglected tropical diseases (NTDs) that disproportionately affect poor populations in rural areas. Liberia’s national NTD control and elimination program prioritizes onchocerciasis, lymphatic filariasis (LF), schistosomiasis, soil-transmitted helminth infections (STH), leprosy, and buruli ulcer, and it has only recently been scaled-up to reach all of the country’s at-risk population. The program achieved 100% MDA geographic coverage with albendazole and ivermectin for LF and ivermectin for onchocerciasis in all 13 and 15 endemic counties, respectively.[2] The national NTD program director reported treatment coverage for both LF and onchocerciasis was approximately 82% in 2012 and 2013

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