Abstract
BackgroundCompliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation. There are individuals who do not comply with the annual mass treatment, which contributes to the continuity for disease transmission. Hence, ensuring high treatment coverage and sustained compliance should be given due emphasis in the control of onchocerciasis. The aim of this study was to determine CDTI compliance rate and predictors of compliance where the CDTI was in its 9th round in Kabo area, southwestern Ethiopia.MethodsCommunity-based cross-sectional study was conducted in Kabo area, three weeks after the 9th round of annual ivermectin distribution. Systematic random sampling was used to select head of households and structured, pre-tested questionnaire was used to interview the study participants. Data was analyzed using SPSS version 16. Descriptive statistics was used to compute mean and standard deviation of continuous variables and frequency for categorical variables, while bivariate and multivariate logistic regressions were used to assess the effects of independent variables on the outcome variable. Variables which showed association in multivariate analysis were considered as final predictors of compliance and strength of association was measured through adjusted odds ratio (AOR).ResultsA total of 308 respondents (age range 18-70, mean age ± SD, 32.21 ± 9.64) participated in the study. Of these, 249 (80.8%) reported that they took ivermectin during the 9th round annual treatment. Significantly higher rate of treatment compliance was reported by participants age ≥35 years (AOR = 5.48, 95% CI; 1.97 - 15.23), participants who stayed in the area for more than ten years (AOR = 3.86, 95% CI; 1.83- 8.11), participants who perceive that they are at risk of contracting the disease(AOR = 7.05, 2.70- 18.43), participants who perceive community drug distributors (CDDs) are doing their work well (AOR = 2.35 95% CI; 1.15- 4.83) and participants who know at least one CDD in their village (AOR = 2.83, 95% CI; 1.26- 6.40).ConclusionThe majority of the study participants in the present study area complied with ivermectin treatment. Nevertheless, intervention packages should consider factors such as age, residence duration and community’s perception of the disease to improve compliance and make drug distribution sustainable.
Highlights
Compliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation
Community-based treatment with ivermectin (Mectizan®) for the control of onchocerciasis was initiated in the area in 2004 by World Health Organization (WHO)/African Program for Onchocerciasis Control (APOC) in partnership with Ethiopian Federal Ministry of Health (FMOH), The Carter Centre, the local administration and the communities [23]
The mean age (±SD) of respondents who comply with the treatment and those that did not comply with the treatment was 32.92 (±9.35) and 29.20 (±1.03), respectively
Summary
Compliance with annual ivermectin treatment is a major challenge in community-directed treatment with ivermectin (CDTI) implementation. Ensuring high treatment coverage and sustained compliance should be given due emphasis in the control of onchocerciasis. The disease is public health and socio-economic threat in many African countries [2,3]. Worldwide there are more than 120 million people at risk of contracting the disease, while 18 million people are already infected. Onchocerciasis affects the working age population, and it is the second-leading infectious cause of blindness worldwide, being responsible for about 500,000 blindness [5,6]. In Ethiopia, it is estimated that 3 million people are already infected, whereas 7.3 million are at risk of infection. Onchocerciasis has been targeted for control and eventually elimination, as a disease of public health and socio-economic problems in Ethiopia along with 19 other African countries [1]
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