Oyibo W A, Fagbenro-Beyioku A F
Medicare Program for Africa, 203 Igbosere Road, Lagos, Nigeria.
Parasitol Res. 2002 Jul;88(7):704-7. doi: 10.1007/s00436-001-0579-y. Epub 2002 Apr 25.
The evaluation of repeated annual treatment with ivermectin in onchocerciasis-endemic communities using output indicators such as acceptance rate (AR) and community compliance rate (CCR) are invaluable tools for assessing community response to onchocerciasis control measures. These indicators were employed in evaluating the responses to annual ivermectin treatment in ten communities in Lade District, Kwara State, Nigeria, where annual ivermectin treatment had reached the fourth round in 1995. The mean AR in all of the communities at the first round of treatment (Tx1) was 95.18% while the mean for Tx1-Tx4 varied between the communities and ranged from 62.82% to 98.49%. The CCR also differed between the communities and ranged from 38.56% to 96.97%. Adverse reactions to ivermectin treatment at Tx1 brought about non-compliance in Lile (CCR of 38.46%), one of the communities studied. AR in Lile also decreased from 94.87% at Tx1 to 61.54% at Tx2, 53.85% at Tx3 and 41.03% at Tx4. (The commencement of community mobilization in defaulting communities after Tx4 restored the acceptance at the next round of annual treatment. The drop in participation in Lile due to adverse reactions would have been averted if annual ivermectin treatment were properly monitored. This study advocates the need for the continuous monitoring and evaluation of onchocerciasis-endemic communities currently receiving treatment, especially in the implementation of the Community-Directed Treatment with Ivermectin (CDTI) programme, so that feedback from the communities can permit proper intervention if necessary.
使用接受率（AR）和社区依从率（CCR）等产出指标，对盘尾丝虫病流行社区进行伊维菌素重复年度治疗的评估，是评估社区对盘尾丝虫病控制措施反应的宝贵工具。这些指标被用于评估尼日利亚夸拉州拉德区十个社区对年度伊维菌素治疗的反应，1995年这些社区的年度伊维菌素治疗已进行到第四轮。所有社区第一轮治疗（Tx1）的平均接受率为95.18%，而Tx1 - Tx4的平均值在不同社区之间有所不同，范围从62.82%到98.49%。社区依从率在不同社区之间也存在差异，范围从38.56%到96.97%。在研究的社区之一利莱，Tx1时伊维菌素治疗的不良反应导致依从性不佳（社区依从率为38.46%）。利莱的接受率也从Tx1时的94.87%降至Tx2时的61.54%、Tx3时的53.85%和Tx4时的41.03%。（Tx4后在违约社区开展社区动员，恢复了下一轮年度治疗的接受情况。如果对年度伊维菌素治疗进行适当监测，利莱因不良反应导致的参与率下降本可避免。本研究主张有必要对目前正在接受治疗的盘尾丝虫病流行社区进行持续监测和评估，特别是在实施伊维菌素社区定向治疗（CDTI）项目时，以便社区反馈能在必要时允许进行适当干预。
