Manyeh Alfred Kwesi, Ibisomi Latifat, Ramaswamy Rohit, Baiden Frank, Chirwa Tobias
Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Parktown, Johannesburg, South Africa.
Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana.
PLoS Negl Trop Dis. 2020 Aug 17;14(8):e0007009. doi: 10.1371/journal.pntd.0007009. eCollection 2020 Aug.
Ghana has been implementing Mass Drug Administration (MDA) since the year 2001, and Lymphatic Filariasis transmission has been interrupted in 76 out of the 98 targeted districts. The remaining districts have a microfilaria prevalence above the 1% threshold needed for the interruption of transmission. This study assesses the level of lymphatic filariasis MDA coverage and explored factors affecting the quality of implementation of the MDA in the Bole and Central Gonja Districts of Northern Ghana. A concurrent mixed methods study design approach was used to provide both a quantitative and qualitative insight. A descriptive analysis was carried out, and the results are presented in tables and charts. The transcripts of the qualitative interviews were imported into Nvivo and framework methods of analysis were used. The results were summarized based on the themes and buttressed with narratives with key quotes presented within the texts. The overall MDA coverage in Central Gonja is 89.3% while that of Bole district is 82.9%. Refusal to ingest the drug and adverse drug reactions were higher in Bole district than the Central Gonja District. The persistent transmission of lymphatic filariasis in Bole District was characterized by poor community mobilization and sensitization, nonadherence to the directly observed treatment strategy, refusal to ingest the drug due to the fear of adverse drug reactions, inadequate knowledge and misconceptions about the disease. Reported mass drug administration coverage will not necessarily result into interruption of transmission of the disease without strict compliance to the directly observed treatment strategy, strong stakeholder engagement coupled with evidence-based context-specific multi-channel community education strategies with key educational messages on the cause of the disease and adverse drug reactions. While the clock for the elimination of lymphatic filariasis by the year 2020 and meeting of the Sustainable Development Goal 3 target 3.3 by 2030 is ticking, there is an urgent need for a concerted effort to improve the fidelity of the ongoing lymphatic filariasis MDA campaigns in the Bole District of Northern Ghana.
自2001年以来，加纳一直在实施群体药物给药（MDA），在98个目标地区中的76个地区，淋巴丝虫病传播已被阻断。其余地区的微丝蚴患病率高于传播阻断所需的1%阈值。本研究评估了加纳北部博莱和中戈贾地区淋巴丝虫病群体药物给药的覆盖水平，并探讨了影响群体药物给药实施质量的因素。采用了同步混合方法研究设计方法，以提供定量和定性的见解。进行了描述性分析，结果以表格和图表形式呈现。定性访谈的文字记录被导入Nvivo，并使用了框架分析方法。结果根据主题进行了总结，并用文本中呈现的关键引语进行了叙述支撑。中戈贾地区的群体药物给药总体覆盖率为89.3%，而博莱地区为82.9%。博莱地区拒绝服药和药物不良反应的情况高于中戈贾地区。博莱地区淋巴丝虫病的持续传播表现为社区动员和宣传不力、未遵守直接观察治疗策略、因害怕药物不良反应而拒绝服药、对疾病的认识不足和误解。如果不严格遵守直接观察治疗策略、利益相关者的有力参与以及基于证据的针对具体情况的多渠道社区教育策略，并传达有关疾病病因和药物不良反应的关键教育信息，报告的群体药物给药覆盖率不一定会导致疾病传播的阻断。虽然到2020年消除淋巴丝虫病以及到2030年实现可持续发展目标3的具体目标3.3的时间在滴答作响，但迫切需要共同努力，提高加纳北部博莱地区正在进行的淋巴丝虫病群体药物给药运动的保真度。
