Factors Associated with Ivermectin Non-Compliance and Its Potential Role in Sustaining Onchocerca volvulus Transmission in the West Region of Cameroon

Journal article


Senyonjo, L, Oye, J, Bakajika, D, Biholong, B, Tekle, A, Boakye, D, Schmidt, E and Elhassan, E (2016). Factors Associated with Ivermectin Non-Compliance and Its Potential Role in Sustaining Onchocerca volvulus Transmission in the West Region of Cameroon. PLoS Neglected Tropical Diseases. 10 (8), pp. e0004905-e0004905.
AuthorsSenyonjo, L, Oye, J, Bakajika, D, Biholong, B, Tekle, A, Boakye, D, Schmidt, E and Elhassan, E
Abstract

Background Community Directed Treatment with ivermectin is the cornerstone of current efforts to eliminate onchocerciasis. However recent studies suggest there are foci where long-term annual distribution of the drug alone has failed to ensure elimination thresholds are reached. It is important to achieve high levels of compliance in order to obtain elimination targets. An epidemiological and entomological evaluation conducted in the western region of Cameroon in 2011 revealed that two health districts remained with a high prevalence of infection, despite long-term distribution of ivermectin since 1996. This paper explores potential factors that may have contributed to the non-interruption of transmission, focusing on ivermectin treatment compliance and the importance of systematic non-compliance within the population. Methodology/Principal findings A mixed methods approach was used, including a population-based survey to assess treatment compliance and factors associated and qualitative assessments including focus group discussions and in-depth interviews with key programme stakeholders and drug distributors. Compliance was reported at 71.2%(95%CI: 61.7–79.2%;n = 853/1198). The key factors related to compliance in the most recent round related to either programmatic and delivery issues, primarily absenteeism at the time of the campaign or alternatively individual determinants. An individual’s experience of side effects in the past was strongly associated with non-compliance to ivermectin. Other factors included ethnicity, how long lived in the village and age. There was a high percentage of reported systematic non-compliance at 7.4% (95% CI: 4.3–12.3%; n = 86/1165), higher amongst females. This group may be important in facilitating the sustainment of on-going transmission.

Keywords06 Biological Sciences; 11 Medical And Health Sciences; Tropical Medicine
Year2016
JournalPLoS Neglected Tropical Diseases
Journal citation10 (8), pp. e0004905-e0004905
PublisherLondon South Bank University
ISSN1935-2735
Digital Object Identifier (DOI)doi:10.1371/journal.pntd.0004905
Publication dates
Print16 Aug 2016
Publication process dates
Deposited04 Apr 2018
Accepted14 Jul 2016
Accepted author manuscript
License
CC BY 4.0
EditorsFischer, PU
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https://openresearch.lsbu.ac.uk/item/872w1

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