Yirga Daniel, Deribe Kebede, Woldemichael Kifle, Wondafrash Mekite, Kassahun Wondosen
Fayyaa Integrated Development Association-NCMI, PEPFAR-New Partners Initiative, Addis Ababa, Ethiopia.
Parasit Vectors. 2010 Jun 2;3:48. doi: 10.1186/1756-3305-3-48.
Although ivermectin is distributed free of charge through the African Programme for Onchocerciasis Control (APOC), not all eligible individuals within communities receive the annual treatment. This poses a serious threat to efforts aimed to control onchocerciasis. This study attempts to determine factors associated with compliance to Community Directed Treatment with Ivermectin (CDTI) and provides a basis for trying to understand how best to sustain long-term compliance in order to achieve success in the control of onchocerciasis.
An unmatched case-control study was conducted in Bebeka coffee plantation southwest Ethiopia. Cases were, compliant i.e., those individuals who had been registered on the relevant treatment registers and had taken all the five annual doses of Ivermectin. Controls were non-compliant, i.e. those individuals who had been recorded in the relevant treatment registers during the first treatment round(2003), and did not take at least two doses of which one being in the last treatment round (2007). Data were collected using a pre-tested interviewer administered structured questionnaire. Data were edited, cleaned, coded and analyzed using SPSS version 12.0.1 for Microsoft Windows. Multiple logistic regression models was used to identify factors associated with compliance to ivermectin.
From the total of 456 individuals selected for administration of the survey questionnaire, 450(225 cases and 225 controls) were contacted and completed the study 2 refused and 4 were unavailable. Five factors associated with compliance were identified: high risk perception [Adjusted Odds Ratio(AOR) = 1.98, 95% Confidence Interval (CI), 1.32-2.95], one's family support [AOR = 1.86, 95% CI, 1.22-2.84], perceiving that the Community Drug Distributors (CDDs) are doing their work well [AOR = 2.84, 95% CI, 1.50-5.37] and perceiving measuring height is the best way to determine a person's treatment dose [AOR = 6.37, 95% CI, 2.10-19.29] are positive predictors of compliance to ivermectin.
Interventions to improve compliance in the area should focus on health education using epidemiological data in order to increase risk perception and dispelling misconceptions. Motivation and continued support to improve CDD's performance including training and incentives are crucial.
尽管伊维菌素通过非洲盘尾丝虫病控制计划（APOC）免费分发，但社区内并非所有符合条件的个体都接受年度治疗。这对盘尾丝虫病控制工作构成了严重威胁。本研究试图确定与伊维菌素社区导向治疗（CDTI）依从性相关的因素，并为理解如何最好地维持长期依从性以实现盘尾丝虫病控制的成功提供依据。
在埃塞俄比亚西南部的贝贝卡咖啡种植园进行了一项非匹配病例对照研究。病例为依从者，即那些已在相关治疗登记册上登记并服用了全部五剂年度伊维菌素的个体。对照为不依从者，即那些在第一轮治疗（2003年）期间被记录在相关治疗登记册上，且至少未服用两剂（其中一剂为最后一轮治疗，即2007年）的个体。使用预先测试的由访谈员管理的结构化问卷收集数据。数据使用适用于Microsoft Windows的SPSS 12.0.1版本进行编辑、清理、编码和分析。使用多元逻辑回归模型确定与伊维菌素依从性相关的因素。
在总共456名被选来进行调查问卷管理的个体中，450名（225例病例和225名对照）被联系并完成了研究，2名拒绝，4名无法联系到。确定了与依从性相关的五个因素：高风险认知[调整优势比（AOR）=1.98，95%置信区间（CI），1.32 - 2.95]、家庭支持[AOR = 1.86，95%CI，1.22 - 2.84]、认为社区药品分发员（CDDs）工作做得好[AOR = 2.84，95%CI，1.50 - 5.37]以及认为测量身高是确定个人治疗剂量的最佳方法[AOR = 6.37，95%CI，2.10 - 19.29]是伊维菌素依从性的积极预测因素。
该地区提高依从性的干预措施应侧重于利用流行病学数据进行健康教育，以提高风险认知并消除误解。激励并持续支持以改善CDD的表现，包括培训和激励措施至关重要。
