Contextual determinants of mass drug administration performance: Modelling fourteen years of lymphatic filariasis treatments in West Africa.

Autor: Fuller BB; Helen Keller International, Washington, District of Columbia, United States of America., Harris V; FHI 360, Denver, Colorado, United States of America., Parker C; FHI 360, Durham, North Carolina, United States of America., Martinez A; FHI 360, Durham, North Carolina, United States of America., Toubali E; Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, District of Columbia, United States of America., Ebene BC; National Programme for Onchocerciasis and Lymphatic Filariasis Control, Ministry of Public Health, Yaoundé, Cameroon., Asemanyi-Mensah K; Neglected Tropical Diseases Programme, Disease Control and Prevention Department, Ghana Health Service, Public Health Division, Accra, Ghana., Dembele M; National Programme for the Elimination of LF, Ministry of Health, Bamako, Mali., Salissou AB; Programme Onchocercose et Filariose Lymphatique, Ministry of Health, Niamey, Niger., Kabré C; Programme national de lutte contre les maladies tropicales négligées, Ministry of Health, Ouagadougou, Burkina Faso., Meite A; Programme national de lutte contre les maladies tropicales négligées à chimiothérapie préventive, Ministry of Health, Abidjan, Côte d'Ivoire., Kane NM; National Neglected Tropical Diseases Control Program, Ministry of Health, Dakar, Senegal., Kargbo-Labour I; Neglected Tropical Disease Programme, Ministry of Health and Sanitation, Freetown, Sierra Leone., Batcho W; Programme National de Lutte contre les Maladies Transmissibles, Ministry of Health, Cotonou, Benin., Diaby A; National Neglected Tropical Diseases Control Program, Ministry of Health, Conakry, Guinea., Yevstigneyeva V; Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, District of Columbia, United States of America., Stukel DM; Act to End NTDs | West, FHI 360, Washington, District of Columbia, United States of America.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Feb 24; Vol. 17 (2), pp. e0011146. Date of Electronic Publication: 2023 Feb 24 (Print Publication: 2023).
DOI: 10.1371/journal.pntd.0011146
Abstrakt: Background: Effective mass drug administration (MDA) is the cornerstone in the elimination of lymphatic filariasis (LF) and a critical component in combatting all neglected tropical diseases for which preventative chemotherapy is recommended (PC-NTDs). Despite its importance, MDA coverage, however defined, is rarely investigated systematically across time and geography. Most commonly, investigations into coverage react to unsatisfactory outcomes and tend to focus on a single year and health district. Such investigations omit more macro-level influences including sociological, environmental, and programmatic factors. The USAID NTD database contains measures of performance from thousands of district-level LF MDA campaigns across 14 years and 10 West African countries. Specifically, performance was measured as an MDA's epidemiological coverage, calculated as persons treated divided by persons at risk. This analysis aims to explain MDA coverage across time and geography in West Africa using sociological, environmental, and programmatic factors.
Methodology: The analysis links epidemiological coverage data from 3,880 LF MDAs with contextual, non-NTD data via location (each MDA was specific to a health district) and time (MDA month, year). Contextual data included rainfall, temperature, violence or social unrest, COVID-19, the 2014 Ebola outbreak, road access/isolation, population density, observance of Ramadan, and the number of previously completed MDAs.
Principal Findings: We fit a hierarchical linear regression model with coverage as the dependent variable and performed sensitivity analyses to confirm the selection of the explanatory factors. Above average rainfall, COVID-19, Ebola, violence and social unrest were all significantly associated with lower coverage. Years of prior experience in a district and above average temperature were significantly associated with higher coverage.
Conclusions/significance: These generalized and context-focused findings supplement current literature on coverage dynamics and MDA performance. Findings may be used to quantify typically anecdotal considerations in MDA planning. The model and methodology are offered as a tool for further investigation.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje