Assessing factors influencing communities' acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana

PLoS Negl Trop Dis. 2021 Sep 20;15(9):e0009596. doi: 10.1371/journal.pntd.0009596. eCollection 2021 Sep.

Abstract

Background: Guyana is one of four countries in the Latin American Region where lymphatic filariasis (LF) remains endemic. In preparation for the introduction of a new triple drug therapy regimen (ivermectin, diethylcarbamazine, and albendazole (IDA)) in 2019, an acceptability study was embedded within sentinel site mapping in four regions to assess mass drug administration (MDA) coverage and compliance, acceptability, and perceptions about treatment and disease. The results from this survey would inform the rollout of IDA in Guyana in 2019.

Methods: Data collection for the study occurred in August 2019, using a validated questionnaire administered by trained enumerators. Across all regions, a total of 1,248 participants were sampled by the Filarial Mapping team. Four-hundred and fifty-one participants aged over 18 years were randomly selected for participation in an expanded acceptability questionnaire. All data were captured in Secure Data Kit (SDK).

Results: Acceptability was measured using a mean acceptability score. Unadjusted mean scores ranged from 24.6 to 29.3, with 22.5 as the threshold of acceptability. Regional variation occurred across many indicators of interest: self-rated understanding about LF, mechanisms of LF transmission, LF drug safety and history of treatment during MDA. Region IV (Georgetown) recorded higher knowledge about LF, but lower compliance and acceptability. Number of pills was not perceived as a concern.

Conclusion: Acceptability of MDA was good across all four regions under study. Results from this study set a baseline level for key indicators and acceptability, from which the acceptability of IDA can be measured. Regional variations across indicators suggest that localized approaches should be considered for social mobilization and MDA delivery to capture these contextual differences.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Albendazole / administration & dosage
  • Albendazole / therapeutic use
  • Community Health Services
  • Cross-Sectional Studies
  • Data Collection
  • Diethylcarbamazine / administration & dosage
  • Diethylcarbamazine / therapeutic use
  • Disease Eradication / methods*
  • Drug Combinations
  • Elephantiasis, Filarial / drug therapy*
  • Elephantiasis, Filarial / epidemiology*
  • Guyana / epidemiology
  • Humans
  • Ivermectin / administration & dosage
  • Ivermectin / therapeutic use
  • Mass Drug Administration*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Sentinel Surveillance
  • Surveys and Questionnaires

Substances

  • Drug Combinations
  • Ivermectin
  • Albendazole
  • Diethylcarbamazine

Grants and funding

This research was funded through the Pan American Health Organization. Some authors are staff members of the Pan American Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the decisions or policies of the Pan American Health Organization. Support was also provided through the United States Agency for International Development (USAID) Act to End NTDs | East program led by RTI International, under cooperative agreement No. 7200AA18CA00040. The funders had no role in study design, data collection and analysis. The funders via Clara Burgert contributed to advice for online data management and review of the manuscript. The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government.