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Compliance to Mass Drug Administration Programme for Lymphatic Filariasis Elimination by Community Members and Volunteers in the Ahanta West District of Ghana
Marian Offei and Francis Anto
Lymphatic Filariasis (LF) is one of the oldest and debilitating neglected tropical diseases. The global strategy for its elimination is based on Mass Drug Administration (MDA) to interrupt transmission. However, elimination can be achieved only when the key players comply with the programme guidelines and requirements. We conducted a household survey in the Ahanta West district of Ghana four weeks after the 2012 MDA to determined the level of compliance to the programme. Fifteen communities were selected from a random list of communities in the district, after which 384 households were randomly selected. Data including socio-demographic characteristics, knowledge and participation in the MDA on all eligible individuals in the selected households were collected through the household head or any responsible adult ≥ 18 years. Multiple logistic regression models was used to identify factors associated with compliance. Compliance as estimated from the current study was significantly lower (43.8%; 95% CI: 41.3-46.3) than that reported by the community-based volunteers (83.6%; 95% CI: 83.3-83.9). Taking the drugs was associated with occupation (p < 0.0001), educational level (p < 0.0001) and age (p=0.007). The odds of not receiving the drugs were significantly associated with the side effects (OR=5.67, 95% CI: 4.45-7.21, p < 0.0001), absence of disease in the family (OR = 0.72, 95% CI: 0.67-0.78, p < 0.0001) and low risk perception (OR = 0.26, 95% CI: 0.12-0.42, p < 0.0001). A high proportion (31.8%) of respondents were not visited by the drug distributors while 18.2% were absent at the time of distribution. The need for revisits has to be emphasized to improve the level of compliance. Improved health education focusing on the safety of drugs and the importance of MDA needs to be undertaken before and during the drug distribution exercises.