Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study

Abstract

BackgroundThe antibiotic treatment of people with trachoma helps to prevent transmission the disease in a community. Currently, Zithromax is the drug recommended for mass drug administration (MDA). MDA should be carried out annually for three to five years in trachoma endemic areas. Coverage survey is essential to track progress towards program goals and to identify communities with poor coverage in order to permit timely and appropriate actions. We assessed mass Zithromax administration coverage, social mobilization and campaign challenges in south and southeast zones of Tigray, Ethiopia.MethodWe conducted a survey in community in Southern and South East zones of Tigray region from August 15 to August 31, 2016. The survey included nine Woredas. It was supported by qualitative methods. A total of 3741 individuals were enrolled from 933 households using multistage sampling. We used structured questionnaire. In-depth interview and focus group discussion were also applied. Descriptive statistics was performed using SPSS version 20.We thematically analyzed the qualitative data using Atlas 7.ResultThe overall coverage of Zithromax MDA was 93.3%. It ranges from 90.0% in Seharti Samre to 97.9% in Endamokoni. The coverage was 93.4% for males and 93.1% for females. A higher proportion (98.3%) of children aged 5 to 15 years and 409 (87.8%) under five children took Zithromax. The coverage was 94% in rural and 91.2% in urban. Women development army (43.3%) and health extension workers (32.5%) were the main source of information. Frequent occurrence of drug side effects, rumors, lack of community and leaders’ engagement in the campaign, fasting, shortage of human power and short term unavailability of supplies were barriers during the campaign.ConclusionThe Zithromax MDA coverage in the study zones was higher than the minimum WHO set criteria of 80%. There was a wide difference in coverage among Woredas and Kebeles. The MDA coverage was lower in urban than rural. Misconceptions and poor mobilization were common challenges. Thus, proper planning, community mobilization and uniform training will need to be done ahead of the campaign in the future.

Knowledge, Attitudes, and Practices about Trachoma in Rural Communities of Tigray Region, Northern Ethiopia: Implications for Prevention and Control

“…Regarding attitudes and practices of respondents in the current study, the majority, 86.1%, of respondents agreed that taking mass drug administration is important to prevent and control trachoma and 88.1% of the respondents took mass drug administration. This result is almost comparable with the other reports from Amhara and Tigray regions, and the coverage of mass drug administration ranged from 76.8% to 93.3% [ 20 – 22 ]. On the other hand, 88.1% of respondents agreed that trachoma can be prevented by utilizing latrine.…”

“…Effective health education is the key to building the favorable attitudes on trachoma prevention and control among communities to achieve the goal of eliminating trachoma as a public health problem [ 28 , 29 ]. In Ethiopia, health extension workers and WDG leaders are giving health education to communities on personal hygiene, environmental sanitation, and mass drug administration for prevention and control of trachoma [ 22 ]. This could be the possible explanation that if mothers have received health education on trachoma, they may feel responsibility and accountability to prevent their children and families from trachoma infection.…”

Knowledge, perceptions and experiences of trachoma among Maasai in Tanzania: Implications for prevention and control

“…In our study, a few women said they heard the drug can cause infertility. This is similar to studies in Ethiopia and Kenya in which women perceived azithromycin as a form of family planning [44, 45]. The origin of rumors can be complex.…”

Coverage assessment survey following trachoma mass drug administration (MDA) in six districts of Oromia, Western Ethiopia, 2017

“…Fear of side-effects, absence during the MDA campaign, drug distributor no-shows and under age status were the mentioned reason for not swallowing the drug—these are similar findings to a study conducted previously in Amhara and Tigray regional states [12, 15]. Another study conducted in Kenya also showed similar results, in which, lack of awareness, fear of side-effects, migration and grazing animals were reported as barriers to swallowing medication [16].…”