Factors Influencing Drug Uptake during Mass Drug Administration for Control of Lymphatic Filariasis in Rural and Urban Tanzania
Identifieur interne : 002A92 ( Main/Exploration ); précédent : 002A91; suivant : 002A93Factors Influencing Drug Uptake during Mass Drug Administration for Control of Lymphatic Filariasis in Rural and Urban Tanzania
Auteurs : William J. Kisoka [Tanzanie] ; Paul E. Simonsen [Danemark] ; Mwelecele N. Malecela [Tanzanie] ; Britt P. Tersb L [Danemark] ; Declare L. Mushi [Tanzanie] ; Dan W. Meyrowitsch [Danemark]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient (), Adolescent, Adulte, Albendazole (usage thérapeutique), Enfant, Enfant d'âge préscolaire, Femelle, Filariose lymphatique (traitement médicamenteux), Filariose lymphatique (épidémiologie), Humains, Ivermectine (usage thérapeutique), Jeune adulte, Mâle, Population rurale (), Population urbaine (), Tanzanie (épidémiologie), Études transversales.
- MESH :
- traitement médicamenteux : Filariose lymphatique.
- usage thérapeutique : Albendazole, Ivermectine.
- épidémiologie : Filariose lymphatique, Tanzanie.
- Acceptation des soins par le patient, Adolescent, Adulte, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Jeune adulte, Mâle, Population rurale, Population urbaine, Études transversales.
English descriptors
- KwdEn :
- Adolescent, Adult, Albendazole (therapeutic use), Child, Child, Preschool, Cross-Sectional Studies, Elephantiasis, Filarial (drug therapy), Elephantiasis, Filarial (epidemiology), Female, Humans, Ivermectin (therapeutic use), Male, Patient Acceptance of Health Care (statistics & numerical data), Rural Population (statistics & numerical data), Tanzania (epidemiology), Urban Population (statistics & numerical data), Young Adult.
- MESH :
- chemical , therapeutic use : Albendazole, Ivermectin.
- geographic , epidemiology : Tanzania.
- drug therapy : Elephantiasis, Filarial.
- epidemiology : Elephantiasis, Filarial.
- statistics & numerical data : Patient Acceptance of Health Care, Rural Population, Urban Population.
- Adolescent, Adult, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Young Adult.
Abstract
In most countries of Sub-Saharan Africa, control of lymphatic filariasis (LF) is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole. Treatment coverages are however often suboptimal for programmes to reach the goal of transmission interruption within reasonable time. The present study aimed to identify predictors and barriers to individual drug uptake during MDA implementation by the National LF Elimination Programme in Tanzania.
A questionnaire based cross sectional household survey was carried out in two rural and two urban districts in Lindi and Morogoro regions shortly after the 2011 MDA. 3279 adults (≥15 years) were interviewed about personal characteristics, socio-economic status, MDA drug uptake among themselves and their children, reasons for taking/not taking drugs, and participation in previous MDA activities for LF control.
The overall drug uptake rate was 55.1% (range of 44.5–75.6% between districts). There was no overall major difference between children (54.8%) and adults (55.2%) or between females (54.9%) and males (55.8%), but the role of these and other predictors varied to some extent between study sites. Major overall predictors of drug uptake among the interviewed adults were increasing age and history of previous drug uptake. Being absent from home during drug distribution was the main reason for not taking the drugs (50.2%) followed by clinical contraindications to treatment (10.8%), missing household visits of drug distributors (10.6%), and households not being informed about the distribution (9.0%).
Drug uptake relied more on easily modifiable provider-related factors than on individual perceptions and practices in the target population. Limited investments in appropriate timing, dissemination of accurate timing information to recipients and motivation of drug distributors to visit all households (repeatedly when residents are absent) are likely to have considerable potential for increasing drug uptake, in support of successful LF transmission elimination.
Url:
DOI: 10.1371/journal.pone.0109316
PubMed: 25296034
PubMed Central: 4190414
Affiliations:
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Kisoka</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>National Institute for Medical Research, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>National Institute for Medical Research, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Tumaini University, Kilimanjaro Christian Medical University College, Moshi, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Tumaini University, Kilimanjaro Christian Medical University College, Moshi</wicri:regionArea><wicri:noRegion>Moshi</wicri:noRegion></affiliation></author><author><name sortKey="Simonsen, Paul E" sort="Simonsen, Paul E" uniqKey="Simonsen P" first="Paul E." last="Simonsen">Paul E. Simonsen</name><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>Department of Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark</addr-line></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Veterinary Disease Biology, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Malecela, Mwelecele N" sort="Malecela, Mwelecele N" uniqKey="Malecela M" first="Mwelecele N." last="Malecela">Mwelecele N. Malecela</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>National Institute for Medical Research, Dar es Salaam, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>National Institute for Medical Research, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Tersb L, Britt P" sort="Tersb L, Britt P" uniqKey="Tersb L B" first="Britt P." last="Tersb L">Britt P. Tersb L</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark</addr-line></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Mushi, Declare L" sort="Mushi, Declare L" uniqKey="Mushi D" first="Declare L." last="Mushi">Declare L. Mushi</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Tumaini University, Kilimanjaro Christian Medical University College, Moshi, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Tumaini University, Kilimanjaro Christian Medical University College, Moshi</wicri:regionArea><wicri:noRegion>Moshi</wicri:noRegion></affiliation></author><author><name sortKey="Meyrowitsch, Dan W" sort="Meyrowitsch, Dan W" uniqKey="Meyrowitsch D" first="Dan W." last="Meyrowitsch">Dan W. Meyrowitsch</name><affiliation wicri:level="3"><nlm:aff id="aff5"><addr-line>Department of Public Health, University of Copenhagen, Copenhagen, Denmark</addr-line></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Public Health, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Albendazole (therapeutic use)</term><term>Child</term><term>Child, Preschool</term><term>Cross-Sectional Studies</term><term>Elephantiasis, Filarial (drug therapy)</term><term>Elephantiasis, Filarial (epidemiology)</term><term>Female</term><term>Humans</term><term>Ivermectin (therapeutic use)</term><term>Male</term><term>Patient Acceptance of Health Care (statistics & numerical data)</term><term>Rural Population (statistics & numerical data)</term><term>Tanzania (epidemiology)</term><term>Urban Population (statistics & numerical data)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par le patient ()</term><term>Adolescent</term><term>Adulte</term><term>Albendazole (usage thérapeutique)</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Filariose lymphatique (traitement médicamenteux)</term><term>Filariose lymphatique (épidémiologie)</term><term>Humains</term><term>Ivermectine (usage thérapeutique)</term><term>Jeune adulte</term><term>Mâle</term><term>Population rurale ()</term><term>Population urbaine ()</term><term>Tanzanie (épidémiologie)</term><term>Études transversales</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Albendazole</term><term>Ivermectin</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Tanzania</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Elephantiasis, Filarial</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Elephantiasis, Filarial</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Patient Acceptance of Health Care</term><term>Rural Population</term><term>Urban Population</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Filariose lymphatique</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Albendazole</term><term>Ivermectine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Filariose lymphatique</term><term>Tanzanie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Child</term><term>Child, Preschool</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Acceptation des soins par le patient</term><term>Adolescent</term><term>Adulte</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Population rurale</term><term>Population urbaine</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>In most countries of Sub-Saharan Africa, control of lymphatic filariasis (LF) is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole. Treatment coverages are however often suboptimal for programmes to reach the goal of transmission interruption within reasonable time. The present study aimed to identify predictors and barriers to individual drug uptake during MDA implementation by the National LF Elimination Programme in Tanzania.</p></sec><sec><title>Methods</title><p>A questionnaire based cross sectional household survey was carried out in two rural and two urban districts in Lindi and Morogoro regions shortly after the 2011 MDA. 3279 adults (≥15 years) were interviewed about personal characteristics, socio-economic status, MDA drug uptake among themselves and their children, reasons for taking/not taking drugs, and participation in previous MDA activities for LF control.</p></sec><sec><title>Findings</title><p>The overall drug uptake rate was 55.1% (range of 44.5–75.6% between districts). There was no overall major difference between children (54.8%) and adults (55.2%) or between females (54.9%) and males (55.8%), but the role of these and other predictors varied to some extent between study sites. Major overall predictors of drug uptake among the interviewed adults were increasing age and history of previous drug uptake. Being absent from home during drug distribution was the main reason for not taking the drugs (50.2%) followed by clinical contraindications to treatment (10.8%), missing household visits of drug distributors (10.6%), and households not being informed about the distribution (9.0%).</p></sec><sec><title>Conclusion</title><p>Drug uptake relied more on easily modifiable provider-related factors than on individual perceptions and practices in the target population. Limited investments in appropriate timing, dissemination of accurate timing information to recipients and motivation of drug distributors to visit all households (repeatedly when residents are absent) are likely to have considerable potential for increasing drug uptake, in support of successful LF transmission elimination.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ahorlu, Ck" uniqKey="Ahorlu C">CK Ahorlu</name></author><author><name sortKey="Dunyo, Sk" uniqKey="Dunyo S">SK Dunyo</name></author><author><name sortKey="Asamoah, G" uniqKey="Asamoah G">G Asamoah</name></author><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ottesen, Ea" uniqKey="Ottesen E">EA Ottesen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hotez, Pj" uniqKey="Hotez P">PJ Hotez</name></author><author><name sortKey="Kamath, A" uniqKey="Kamath A">A Kamath</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Mwakitalu, Me" uniqKey="Mwakitalu M">ME Mwakitalu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Michael, E" uniqKey="Michael E">E Michael</name></author><author><name sortKey="Malecela Lazaro, Mn" uniqKey="Malecela Lazaro M">MN Malecela-Lazaro</name></author><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Pedersen, Em" uniqKey="Pedersen E">EM Pedersen</name></author><author><name sortKey="Barker, G" uniqKey="Barker G">G Barker</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Krentel, A" uniqKey="Krentel A">A Krentel</name></author><author><name sortKey="Fischer, Pu" uniqKey="Fischer P">PU Fischer</name></author><author><name sortKey="Weil, Gj" uniqKey="Weil G">GJ Weil</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gunawardena, S" uniqKey="Gunawardena S">S Gunawardena</name></author><author><name sortKey="Ismail, M" uniqKey="Ismail M">M Ismail</name></author><author><name sortKey="Bradley, M" uniqKey="Bradley M">M Bradley</name></author><author><name sortKey="Karunaweera, N" uniqKey="Karunaweera N">N Karunaweera</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Amarillo, Ml" uniqKey="Amarillo M">ML Amarillo</name></author><author><name sortKey="Belizario, Vy" uniqKey="Belizario V">VY Belizario</name></author><author><name sortKey="Sadiang Abay, Jt" uniqKey="Sadiang Abay J">JT Sadiang-Abay</name></author><author><name sortKey="Sison, Sa" uniqKey="Sison S">SA Sison</name></author><author><name sortKey="Dayag, Am" uniqKey="Dayag A">AM Dayag</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Babu, Bv" uniqKey="Babu B">BV Babu</name></author><author><name sortKey="Mishra, S" uniqKey="Mishra S">S Mishra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="King, Jd" uniqKey="King J">JD King</name></author><author><name sortKey="Zielinski Gutierrez, E" uniqKey="Zielinski Gutierrez E">E Zielinski-Gutierrez</name></author><author><name sortKey="Pa Au, M" uniqKey="Pa Au M">M Pa'au</name></author><author><name sortKey="Lammie, P" uniqKey="Lammie P">P Lammie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nujum, Zt" uniqKey="Nujum Z">ZT Nujum</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Njomo, Dw" uniqKey="Njomo D">DW Njomo</name></author><author><name sortKey="Amuyunzu Nyamongo, M" uniqKey="Amuyunzu Nyamongo M">M Amuyunzu-Nyamongo</name></author><author><name sortKey="Magambo, Jk" uniqKey="Magambo J">JK Magambo</name></author><author><name sortKey="Njenga, Sm" uniqKey="Njenga S">SM Njenga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Offei, M" uniqKey="Offei M">M Offei</name></author><author><name sortKey="Anto, F" uniqKey="Anto F">F Anto</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mcmahon, Je" uniqKey="Mcmahon J">JE McMahon</name></author><author><name sortKey="Magayuka, Sa" uniqKey="Magayuka S">SA Magayuka</name></author><author><name sortKey="Kolstrup, N" uniqKey="Kolstrup N">N Kolstrup</name></author><author><name sortKey="Mosha, Fw" uniqKey="Mosha F">FW Mosha</name></author><author><name sortKey="Bushrod, Fm" uniqKey="Bushrod F">FM Bushrod</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Meyrowitsch, Dw" uniqKey="Meyrowitsch D">DW Meyrowitsch</name></author><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Makunde, Wh" uniqKey="Makunde W">WH Makunde</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Meyrowitsch, Dw" uniqKey="Meyrowitsch D">DW Meyrowitsch</name></author><author><name sortKey="Makunde, Wh" uniqKey="Makunde W">WH Makunde</name></author><author><name sortKey="Magnussen, P" uniqKey="Magnussen P">P Magnussen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Meyrowitsch, Dw" uniqKey="Meyrowitsch D">DW Meyrowitsch</name></author><author><name sortKey="Jaoko, Wg" uniqKey="Jaoko W">WG Jaoko</name></author><author><name sortKey="Malecela, Mn" uniqKey="Malecela M">MN Malecela</name></author><author><name sortKey="Mukoko, D" uniqKey="Mukoko D">D 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Lammie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="El Setouhy, M" uniqKey="El Setouhy M">M El-Setouhy</name></author><author><name sortKey="Elaziz, Kma" uniqKey="Elaziz K">KMA Elaziz</name></author><author><name sortKey="Helmy, H" uniqKey="Helmy H">H Helmy</name></author><author><name sortKey="Farid, Ha" uniqKey="Farid H">HA Farid</name></author><author><name sortKey="Kamal, Ha" uniqKey="Kamal H">HA Kamal</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Danemark</li><li>Tanzanie</li></country><region><li>Hovedstaden</li></region><settlement><li>Copenhague</li></settlement></list><tree><country name="Tanzanie"><noRegion><name sortKey="Kisoka, William J" sort="Kisoka, William J" uniqKey="Kisoka W" first="William J." last="Kisoka">William J. Kisoka</name></noRegion><name sortKey="Kisoka, William J" sort="Kisoka, William J" uniqKey="Kisoka W" first="William J." last="Kisoka">William J. Kisoka</name><name sortKey="Malecela, Mwelecele N" sort="Malecela, Mwelecele N" uniqKey="Malecela M" first="Mwelecele N." last="Malecela">Mwelecele N. Malecela</name><name sortKey="Mushi, Declare L" sort="Mushi, Declare L" uniqKey="Mushi D" first="Declare L." last="Mushi">Declare L. Mushi</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Simonsen, Paul E" sort="Simonsen, Paul E" uniqKey="Simonsen P" first="Paul E." last="Simonsen">Paul E. Simonsen</name></region><name sortKey="Meyrowitsch, Dan W" sort="Meyrowitsch, Dan W" uniqKey="Meyrowitsch D" first="Dan W." last="Meyrowitsch">Dan W. Meyrowitsch</name><name sortKey="Tersb L, Britt P" sort="Tersb L, Britt P" uniqKey="Tersb L B" first="Britt P." last="Tersb L">Britt P. 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