Factors affecting the uptake of preventive chemotherapy treatment for schistosomiasis in Sub-Saharan Africa: A systematic review

Abstract

Background Schistosomiasis affects nearly 220 million people worldwide, mainly in Sub-Saharan Africa (SSA). Preventive chemotherapy (PC) treatment, through regular mass-drug administration (MDA) of Praziquantel tablets remains the control measure of choice by Ministries of Health. Current guidelines recommend that 75% of school-aged children receive treatment. Many programmes, however, struggle to achieve this target. Given the risk of high reinfection rates, attaining sustained high levels of treatment coverage is essential. This study provides a comprehensive review of the barriers and facilitators operating at different levels of analysis, from the individual to the policy level, conditioning the uptake of PC for schistosomiasis in SSA. Methodology/Principal findings A systematic literature search was conducted in several databases for publications released between January 2002 and 2019 that examined factors conditioning the uptake of Praziquantel in the context of MDA campaigns in SSA. A total of 2,258 unique abstracts were identified, of which 65 were selected for full text review and 30 met all eligibility criteria. Joanna Briggs Institute’s Critical Appraisal and the Mixed-Methods Assessment tools were used to assess the strength of the evidence. This review was registered with PROSPERO (CRD42017058525). A meta-synthesis approach was used. Results indicated publication bias, with the literature focusing on East African rural settings and evidence at the individual and programmatic levels. The main influencing factors identified included material wellbeing, drug properties, knowledge and attitudes towards schistosomiasis and MDAs, fears of side effects, gender values, community and health systems support, alongside programme design features, like training, sensitisation, and provision of incentives for drug-distributors. The effect of these factors on determining Praziquantel uptake were explored in detail. Conclusions/Significance Multiple determinants of treatment uptake were found in each level of analysis examined. Some of them interact with each other, thus affecting outcomes directly and indirectly. The promotion of context-based transdisciplinary research on the complex dynamics of treatment uptake is not only desirable, but essential, to design effective strategies to attain high levels of treatment coverage.

Utilization of deworming medication and its associated factors among pregnant married women in 26 sub-Saharan African countries: a multi-country analysis

“…Based on available evidence on factors associated with uptake of deworming medication [ 5 , 7 , 17 – 19 , 25 – 27 ], we included the following explanatory variables and categorized them primarily based on the DHS guide [ 26 ] and also used available studies on same topic. These included women’s age (15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49), women’s educational status (no formal education, primary school, secondary school, higher), husband’s educational status (no formal education, primary school, secondary school, higher), women’s occupation (not working, professional/technical/managerial, agricultural, manual, others), family size (<5, 5+), place of residence (urban, rural), religion (Christian, Muslim, others), timing of antenatal care (ANC) visits (≤3 months, >3 months), number of ANC visit (<4 months, ≥4 months), and wanted last birth (wanted then, wanted later, wanted no more).…”

“…Few studies on deworming medication are available in SSA. However, most of the available studies have focused on the estimation of coverage [ 5 , 26 ], efficacy, safety, and tolerability of deworming medication [ 17 ]; effect of mass deworming [ 7 ] on schistosomiasis and all age of population [ 27 ], deceptive report [ 28 ], and on single health facility of a single country [ 26 ]. As a result, there is scarcity of evidence about both coverage and utilization of deworming medication and its associated factors among pregnant women in SSA.…”

Correlates of prior HIV testing and schistosomiasis treatment: baseline survey findings from the “creating demand for fishermen’s schistosomiasis HIV services” (FISH) cluster-randomized trial in Mangochi, Malawi

“…Furthermore, limited information to the fisherfolks on the significance of early testing and subsequent interventions using the approved medications is also a key contributor to low utilization of health services in this population (18). Consequently, individual, peer and societal attitudes towards drugs used to treat schistosomiasis and ART also lead to increased misinformation and heighten refusal of free drugs (19,20).…”

Risk Factors of Noncompliance to Preventive Mass Drug Administration for Eliminating Lymphatic Filariasis: A Case-Control Study in Jawi District, Northwest Ethiopia

“…e possible reasons might be that women are usually busy with their domestic duties and might be prohibited by their husbands from participating in MDA because of their husbands' negative beliefs about the drug [33].…”

“…Hence, the high nationwide prevalence [14,15], the failure to eliminate [21,25,32], and the persistent transmission of LF in Ethiopia after a decade of MDA [21,22,25], might be linked to the high MDA noncompliance [27]. Furthermore, although context-based research finding is essential to designing effective preventive MDA program strategies [30,33], only a few studies have focused on identifying factors that play a role in noncompliance to prevent MDA in Africa [30,31]. erefore, the current study was conducted to identify the factors associated with noncompliance with preventive MDA of ivermectin-with-albendazole for the elimination of lymphatic filariasis in Northwest Ethiopia.…”