Coverage and predictors of the uptake of the mass drug administration of praziquantel chemotherapy for schistosomiasis in a selected urban setting in Zambia

Felix Nzonzi Kiesolo; Mutale Sampa; Given Moonga; Charles Michelo; Choolwe Jacobs

doi:10.3389/fepid.2023.1168282

Coverage and predictors of the uptake of the mass drug administration of praziquantel chemotherapy for schistosomiasis in a selected urban setting in Zambia

Front Epidemiol. 2023 Apr 24:3:1168282. doi: 10.3389/fepid.2023.1168282. eCollection 2023.

Authors

Felix Nzonzi Kiesolo¹, Mutale Sampa¹, Given Moonga¹, Charles Michelo^{2

3}, Choolwe Jacobs^{1

4}

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.
² Strategic Centre for Health Systems Metrics & Evaluation, School of Public Health, University of Zambia, Lusaka, Zambia.
³ Harvest Research Institutes, Harvest University, Lusaka, Zambia.
⁴ Women in Global Health, Lusaka, Zambia.

Abstract

The burden of schistosomiasis in Zambia has remained high over the years. The World Health Assembly recommended adequate mass drug administration coverage for schistosomiasis using Praziquantel chemotherapy for school-aged children and all at-risks adults. We aimed at investigating the coverage and the factors associated to the uptake for MDA for schistosomiasis in Ng'ombe township of Lusaka, Zambia. A cross-sectional survey was conducted in May and June 2021 via phone calls to the residents of Ng'ombe township. Commcare software was used in the conduct of the survey. Pearson's Chi-square test and multiple logistic regression were conducted using the STATA version 15.0. 769 study participants were randomly selected using systematic sampling, of which 76.3% were younger than 40 years, 64.9% were female, 64.4% were married, 56.3% had reached the secondary educational level and 51.9% were employed. Coverage for MDA for schistosomiasis in Ng'ombe township in 2018 was found to be 49.8% (95% CI: 46.2%-53.4%). Positive predictors of the MDA were prior knowledge of the occurrence of the MDA in 2018 (aOR: 2.892, p < 0.001) and believing that the provision of incentives like snacks was important during the MDA with PZQ in Ng'ombe township (aOR: 1.926, p = 0.001), whereas age (aOR:0.979, p = 0.009), marital status (aOR:0.620, p = 0.006), employment status (aOR:0.587, p = 0.001) were negative predictors of the MDA. Elimination of the burden of schistosomiasis in endemic settings needs the attainment of an optimum coverage and uptake during MDA with PZQ. Therefore, prior knowledge about an impending intervention and the provision of incentives like snacks during the intervention should be prioritized by MDA implementers, while background characteristics such as age, marital status, and employment status need to be taken into consideration when planning and promoting uptake in future MDAs.

Keywords: bilharzia; intervention coverage; mass drug administration; praziquantel chemotherapy; schistosomiasis; uptake.

Grants and funding

FNK is a recipient of a TDR scholarship under the postgraduate training scheme in implementation research at the University of Zambia, School of Public Health. We are grateful for the support from the training scheme, as provided by the UNICEF/UNDP/World Bank/WHO special programme for Research and Training in Tropical Diseases (TDR).