Knowledge, attitudes and perceptions regarding lymphatic filariasis: study on systematic noncompliance with mass drug administration

Abstract

The aim of this study was to investigate the epidemiological characteristics, antigenic profile, perceptions, attitudes and practices of individuals who have been systematically non-compliant in mass drug administration (MDA) campaigns targeting lymphatic filariasis, in the municipality of Olinda, State of Pernambuco, Northeastern Brazil. A pretested questionnaire was used to obtain information on socioenvironmental demographics, perceptions of lymphatic filariasis and MDA, and reasons for systematic noncompliance with treatment. A rapid immunochromatographic test (ICT) was performed during the survey to screen for filariasis. It was found that the survey subjects knew about filariasis and MDA. Filariasis was identified as a disease (86.2%) and 74.4% associated it with the presence of swelling in the legs. About 80% knew about MDA, and the main source of information was healthcare workers (68.3%). For men the main reasons for systematic noncompliance with MDA were that “the individual had not received the medication” (p=0.03) and for women “the individual either feared experiencing adverse reactions”. According to the ICT, the prevalence of lymphatic filariasis was 2%. The most important causes of systematic noncompliance were not receiving the drug and fear of side-effects. For successful implementation of MDA programs, good planning, educational campaigns promoting the benefits of MDA, adoption of measures to minimize the impact of adverse effects and improvement of drug distribution logistics are needed.

Prospects for elimination of soil-transmitted helminths

“…Key parameters include the dominant species of STH in each setting; the pre-MDA transmission intensity (R 0 ) for the dominant species; the age profile of infection; effective coverage of MDA, a combination of coverage, compliance, and drug efficacy; and immigration of new hosts and parasites into the community being treated [31,34, ] and highlight the need for more consistent definitions and longitudinal studies of compliance and coverage when MDA is delivered to communities and directly observed therapy may not always be feasible. In addition, systematic nonparticipation in MDA, in which some individuals are less likely to be offered [67,68] or to accept [69,70] MDA -as opposed to random distribution of noncompliance at a given coverage level -is particularly challenging, increasing the predicted number of rounds of MDA required to interrupt transmission even at levels of noncompliance less than 10% [58 & ]. Noncompliance may increase with treatment fatigue in the community, particularly as morbidity, and perceived need for intervention is reduced.…”

Qualitative Study: Leverage and Barrier Factors of Mass Drug Administration for Lymphatic Filariasis Elimination Program in Tangerang and Subang Regency

“…Increased knowledge in health workers is expected to be capital for the dissemination to the community level. Several studies revealed that the elimination strategy for compliant MDA-LF program to be successful was making the population involved aware of the disease [18]. MDA was performed by family healthcare professionals in Brazil, which had different strategy in India; the most important people were those who administered the drug.…”

A study on assessment of mass drug administration for elimination of lymphatic filariasis in Datia district, Madhya Pradesh

“…Same reason was found in Bankura district, West Bengal and was consistent with another study conducted in northern Brazil where the fear of side effects was a concerning cause among the non-compliant population. 8,9 Noncompliance is shown to have different reasons among males and females. 9 Another study conducted in Haiti found that lack of awareness about the disease, its control program and the medication was primary cause of noncompliance.…”

“…8,9 Noncompliance is shown to have different reasons among males and females. 9 Another study conducted in Haiti found that lack of awareness about the disease, its control program and the medication was primary cause of noncompliance. 10 Lack of awareness about the disease and its control can be attributed to suboptimal IEC activities as observed in the community.…”