Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, 547 Pedro Gil St, Ermita, Manila 1000, Philippines.
Parasit Vectors. 2008 May 27;1(1):14. doi: 10.1186/1756-3305-1-14.
Mass drug administration (MDA) has been one of the strategies endorsed by the World Health Assembly for lymphatic filariasis (LF) elimination. Many factors, however, affect the acceptability of the MDA in the Philippines with acceptability defined as the ingestion of drugs -diethylcarbamazine and albendazole during MDA. These drugs were mainly distributed in fixed sites and mopping up activities were conducted through house-to-house visits to increase treatment coverage. The aim of conducting the study was to determine the MDA acceptance rate among a population endemic for LF, and the factors associated with MDA acceptance.
In April 2005, a stratified cluster survey involving 437 respondents aged 18 years old and above in Agusan del Sur, Philippines was conducted. Key informant interviews and focused group discussions were performed among community leaders and health service providers. Descriptive statistics and coverage estimates were calculated with appropriate sampling weights applied to all analyses. Factors assessed for association with receipt of antifilarial drugs and MDA acceptance were respondents' socio-demographic characteristics, knowledge, attitudes, beliefs and perceptions on LF. Pearson chi-squared test was used to determine factors associated with MDA acceptance.
Results showed that 63.3% of the sampled population received the antifilarial drugs; of these, 94.5% ingested the drugs, yielding an acceptance rate of 60%. Half of the sampled population received the drugs from a fixed site, while only 13% was mopped up. A majority of the sampled population were aware of LF and MDA. Knowledge on LF prevention, cause, treatment and diagnosis and adverse events was low to moderate. Knowledge on LF and perceived benefits of antifilarial drugs were found to be associated with MDA acceptance (p = 0.08). Health workers remain the front liners in the MDA implementation. Local government units were aware of LF and MDA, but support was insufficient.
The proportion of the sampled population that received and ingested the antifilarial drugs was much lower than the reported coverage. The target coverage rate of 85% may be achieved with sufficient groundwork for MDA, buy-in from the local government, greater efforts exerted to increase the people's knowledge on LF and MDA and their understanding of perceived benefits of the drugs. These would contribute to the successful elimination of LF in the province.
大规模药物治疗（MDA）是世界卫生大会支持的消灭淋巴丝虫病（LF）的策略之一。然而，菲律宾 MDA 的可接受性受到许多因素的影响，可接受性定义为在 MDA 期间服用药物——乙胺嗪和阿苯达唑。这些药物主要在固定地点分发，并通过挨家挨户的扫荡活动来增加治疗覆盖率。开展这项研究的目的是确定 LF 流行地区人群对 MDA 的接受率，以及与 MDA 接受率相关的因素。
2005 年 4 月，在菲律宾 Agusan del Sur 进行了一项涉及 437 名 18 岁及以上人群的分层聚类调查。对社区领导和卫生服务提供者进行了关键知情人访谈和焦点小组讨论。对所有分析均应用适当的抽样权重计算描述性统计和覆盖率估计。评估与接受抗丝虫药物和 MDA 接受相关的因素包括受访者的社会人口特征、对 LF 的知识、态度、信念和看法。采用 Pearson 卡方检验确定与 MDA 接受相关的因素。
结果表明，抽样人群中有 63.3%接受了抗丝虫药物；其中，94.5%的人服用了药物，接受率为 60%。抽样人群中有一半人从固定地点获得药物，而只有 13%的人被扫荡。大多数抽样人群都了解 LF 和 MDA。对 LF 预防、病因、治疗和诊断以及不良反应的了解程度较低至中等。对 LF 的了解以及对抗丝虫药物益处的认识与 MDA 接受率相关（p=0.08）。卫生工作者仍然是 MDA 实施的第一线人员。地方政府单位了解 LF 和 MDA，但支持不足。
接受并服用抗丝虫药物的抽样人群比例远低于报告的覆盖率。如果为 MDA 做好充分的基础工作，获得地方政府的支持，加大力度提高人们对 LF 和 MDA 的认识以及对药物益处的理解，就有可能实现 85%的目标覆盖率。这将有助于该省成功消灭 LF。
