Desmond Nicola, Solomon Anthony W, Massae Patrick A, Lema Ndeeshi, Anemona Alessandra, Foster Allen, Mabey David C W
MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RG, UK.
Trans R Soc Trop Med Hyg. 2005 Sep;99(9):656-63. doi: 10.1016/j.trstmh.2005.03.006.
Trachoma causes blindness; the prevention strategy includes mass antibiotic treatment. In a community in Northern Tanzania offered mass treatment with azithromycin for the control of trachoma, we used focus group discussions, individual interviews, questionnaires and direct observation to quantify, explore and contextualize reasons for acceptance or refusal of the drug. In the village studied, 76% of the population eligible to receive azithromycin were treated. Uptake was significantly higher among women (79% treated) than men (72%). Factors affecting acceptability included: local prevention norms (such as the belief that injections, rather than oral medicine, should be used for prevention); perceptions of drugs in general and azithromycin in particular; perceptions of the distribution team's expertise; witnessing adverse effects in others; and the timing, quality and quantity of information about azithromycin and its availability. Familiarity with trachoma as a blinding disease was significantly associated with uptake. Individuals who refused treatment seemed to be less altruistic than other respondents. Neither socio-economic status nor use of traditional healers was related to uptake. Pre-distribution community assessment and community education, advance notice of the distribution, standardized distribution guidelines and improved distributor training are recommended to maximize acceptance of azithromycin in future campaigns.
沙眼可导致失明；预防策略包括大规模抗生素治疗。在坦桑尼亚北部一个为控制沙眼而提供阿奇霉素大规模治疗的社区，我们采用焦点小组讨论、个人访谈、问卷调查和直接观察等方法，对接受或拒绝该药的原因进行量化、探究并结合具体情况分析。在所研究的村庄中，有76%符合条件接受阿奇霉素治疗的人口接受了治疗。女性的接受率（79%接受治疗）显著高于男性（72%）。影响接受度的因素包括：当地预防规范（例如认为预防应使用注射剂而非口服药）；对一般药物尤其是阿奇霉素的看法；对分发团队专业水平的看法；目睹他人出现的不良反应；以及关于阿奇霉素及其可获得性的信息的时间、质量和数量。对沙眼作为致盲疾病的熟悉程度与接受率显著相关。拒绝治疗的个体似乎不如其他受访者那么利他。社会经济地位和是否使用传统治疗师均与接受率无关。建议在分发前进行社区评估和社区教育、提前通知分发事宜、制定标准化分发指南并加强分发人员培训，以在未来的活动中最大限度地提高对阿奇霉素的接受度。
