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

Abstract

Background. High compliance is crucial for the success of a mass drug administration program to achieve lymphatic filariasis elimination. However, the presence of persistently noncompliant individuals might delay the elimination target. Besides, although context-based research is essential to designing effective strategies, only a few studies have focused on identifying factors that play a role in noncompliance with mass drug administration in Africa. Therefore, this study was conducted to identify the factors associated with noncompliance to prevent mass drug administration using ivermectin-with-albendazole for the elimination of lymphatic filariasis in Northwest Ethiopia. Methods. A case-control study was conducted in Jawi District, Northwest Ethiopia. All individuals who are permanently living in the study area and registered on the annual chemotherapy registration book since 2015 were included in this study. A two-proportion formula was used to estimate the required sample size and 348 cases and 348 controls were selected by identification number on the village chemotherapy registration book using a systematic sampling technique. Data were collected by face-to-face interviews using a structured questionnaire developed through an intensive literature review. Then, data were entered and cleaned by using the EPI DATA software, and analyses were conducted using SPSS version 26. Finally, a logistic regression analysis technique was applied to identify the risk factors using adjusted odds ratio as measures of effect. Results. A total of 690 (99.1%) participants, 345 cases and 345 controls, were included in the study. Younger age (AOR = 1.60; 95%CI: 1.10, 2.33), female sex (AOR = 1.56; 95%CI: 1.24, 3.93), thought of not being susceptible to the disease (AOR = 2.36, 95%CI: 1.80, 4.32), lack of disease knowledge (AOR = 1.88; 95% CI: 1.38, 3.81), fear of drug side effect (AOR = 2.45; 95% CI:1.23, 4.86), and not participating in community drug distributors selection (AOR = 2.58; 95% CI: 1.70, 3.91) were found to be the risk factors significantly associated with noncompliance. Conclusion. Noncompliance with lymphatic filariasis mass drug administration therapy was associated with specific demographic, individual, program, and drug delivery characteristics. This finding has important implications for program effectiveness and would be used to accelerate the elimination of lymphatic filariasis in the study area and other endemic settings.

Optimizing seeding rates for irrigated bread wheat (Triticum aestivum L.) varieties in the lowland area of Jawi, northwestern Ethiopia

“…The global positioning of the experimental site is 11°00′7″ N (longitude) and 36°02′0″ E (latitude) with an altitude of 1254 m.a.s.l (Direct GPS reading). The climate alternates with long summer rain fall (June-September) and a winter dry season (October-May) with a mean annual rainfall of 1569.4 mm (Mihretu et al, 2022). The district is warm and humid lowland.…”

“…Therefore importing about 1.5 million tons of wheat annually is draining 300-400 million USD from the national treasury (FAOSTAT, 2021). Enhancement of bread wheat production is thus expected to be achieved through expansion of irrigation agriculture, mechanization (Mihratu et al, 2018), land expansion (EIAR, 2020), provision of quality agricultural inputs, use of economically viable and ecologically adaptable varieties for lowland areas (Gedifew, 2022) and application of good agronomic practices for all crop production systems (Khan et al, 2020).…”