Serme Mamadou, Zida Adama, Bougma Roland, Kima Appolinaire, Nassa Christophe, Ouedraogo Micheline, Kabre Cathérine, Zoromé Harouna, Guire Issa, Nare Dieudonné, Bougouma Clarisse
Programme national de lutte contre les maladies tropicales négligées (PNMTN), Burkina Faso.
École doctorale Sciences et Santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.
Med Trop Sante Int. 2022 Dec 13;2(4). doi: 10.48327/mtsi.v2i4.2022.174. eCollection 2022 Dec 31.
BACKGROUND & RATIONALE: Burkina Faso has been implementing preventive chemotherapy against lymphatic filariasis since 2001. While 61 health districts (HDs) have stopped mass drug administration (MDA), transmission persists in 9 HDs despite good reported MDA coverage. To validate the reported coverage, an independent post-MDA survey was conducted in Tenkodogo and Fada N'Gourma HDs in September 2018.
MATERIALS & METHODS: The study population consisted of all persons in the visited communities. The Coverage survey sample builder (CSSB) tool was used to calculate the sample size and to conduct the random selection of households. A total of 30 villages per HD were selected. The investigators were Ministry of Education agents and health workers not involved in MDA. Data were collected on smartphones through the KoBoCollect application regarding age, sex, drug ingestion (ivermectin + albendazole), adverse events, and whether respondents understood MDA guidelines. Stata Version 14 software was used for data analysis.
A total of 3,741 individuals were surveyed, 53.3% were female and the median age was 14 years. Surveyed epidemiological coverage was 74% [95% CI: 72-76.1] in Fada N'Gourma and 79.1% [95% CI: 77.2-80.9] in Tenkodogo, compared to reported coverages of 82.6% and 83% respectively. Village-level coverage ranged from 32.9% to 100% in Fada N'Gourma and from 56.7% to 93.3% in Tenkodogo. In total, 99% of those treated said they had swallowed the drugs in front of the community drug distributor (CDD) and confirmed the use of dose poles. The main reasons for non-treatment were non-visitation of the compound by CDD (54%) and absences during MDA (43%). Results showed that surveyed coverage was lower than reported coverage in both HDs, yet both were above the 65% threshold recommended by WHO. However, major variations of coverage have been noted among villages. Directly observed treatment appeared to have been well respected.
DISCUSSION & CONCLUSION: The main challenges to increase coverage will be the systematic revisiting of households with absentees and the targeting of all households in each village.
布基纳法索自2001年以来一直在实施针对淋巴丝虫病的预防性化疗。虽然61个卫生区已停止大规模药物给药（MDA），但尽管报告的MDA覆盖率良好，仍有9个卫生区存在传播。为了验证报告的覆盖率，2018年9月在滕科多戈和法达恩古尔马卫生区进行了一次独立的MDA后调查。
研究人群包括受访社区的所有人员。使用覆盖率调查样本生成器（CSSB）工具计算样本量并随机选择家庭。每个卫生区共选择30个村庄。调查人员是教育部工作人员和未参与MDA的卫生工作者。通过KoBoCollect应用程序在智能手机上收集有关年龄、性别、药物摄入（伊维菌素+阿苯达唑）、不良事件以及受访者是否理解MDA指南的数据。使用Stata 14版软件进行数据分析。
共调查了3741人，其中53.3%为女性，年龄中位数为14岁。法达恩古尔马的调查流行病学覆盖率为74%[95%置信区间：72 - 76.1]，滕科多戈为79.1%[95%置信区间：77.2 - 80.9]，而报告的覆盖率分别为82.6%和83%。法达恩古尔马村级覆盖率在32.9%至100%之间，滕科多戈在56.7%至93.3%之间。总共有99%接受治疗的人表示他们在社区药物分发员（CDD）面前吞下了药物，并确认使用了剂量杆。未接受治疗的主要原因是CDD未到访住所（54%）和MDA期间不在场（43%）。结果表明，两个卫生区的调查覆盖率均低于报告覆盖率，但均高于世界卫生组织建议的65%阈值。然而，各村庄之间的覆盖率存在重大差异。直接观察治疗似乎得到了很好的遵守。
提高覆盖率的主要挑战将是系统地回访有缺席者的家庭以及针对每个村庄的所有家庭。
