Kiesolo Felix Nzonzi, Sampa Mutale, Moonga Given, Michelo Charles, Jacobs Choolwe
Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.
Strategic Centre for Health Systems Metrics & Evaluation, School of Public Health, University of Zambia, Lusaka, Zambia.
Front Epidemiol. 2023 Apr 24;3:1168282. doi: 10.3389/fepid.2023.1168282. eCollection 2023.
The burden of schistosomiasis in Zambia has remained high over the years. The World Health Assembly recommended adequate mass drug administration coverage for schistosomiasis using Praziquantel chemotherapy for school-aged children and all at-risks adults. We aimed at investigating the coverage and the factors associated to the uptake for MDA for schistosomiasis in Ng'ombe township of Lusaka, Zambia. A cross-sectional survey was conducted in May and June 2021 phone calls to the residents of Ng'ombe township. Commcare software was used in the conduct of the survey. Pearson's Chi-square test and multiple logistic regression were conducted using the STATA version 15.0. 769 study participants were randomly selected using systematic sampling, of which 76.3% were younger than 40 years, 64.9% were female, 64.4% were married, 56.3% had reached the secondary educational level and 51.9% were employed. Coverage for MDA for schistosomiasis in Ng'ombe township in 2018 was found to be 49.8% (95% CI: 46.2%-53.4%). Positive predictors of the MDA were prior knowledge of the occurrence of the MDA in 2018 (aOR: 2.892, < 0.001) and believing that the provision of incentives like snacks was important during the MDA with PZQ in Ng'ombe township (aOR: 1.926, = 0.001), whereas age (aOR:0.979, = 0.009), marital status (aOR:0.620, = 0.006), employment status (aOR:0.587, = 0.001) were negative predictors of the MDA. Elimination of the burden of schistosomiasis in endemic settings needs the attainment of an optimum coverage and uptake during MDA with PZQ. Therefore, prior knowledge about an impending intervention and the provision of incentives like snacks during the intervention should be prioritized by MDA implementers, while background characteristics such as age, marital status, and employment status need to be taken into consideration when planning and promoting uptake in future MDAs.
多年来,赞比亚血吸虫病的负担一直居高不下。世界卫生大会建议,对学龄儿童和所有有感染风险的成年人,使用吡喹酮化疗进行充分的血吸虫病群体药物管理。我们旨在调查赞比亚卢萨卡恩贡贝镇血吸虫病群体药物管理的覆盖率以及与服药率相关的因素。2021年5月和6月,通过给恩贡贝镇居民打电话进行了一项横断面调查。调查使用了Commcare软件。使用STATA 15.0版本进行了Pearson卡方检验和多元逻辑回归分析。采用系统抽样随机选取了769名研究参与者,其中76.3%年龄小于40岁,64.9%为女性,64.4%已婚,56.3%达到中等教育水平,51.9%有工作。2018年恩贡贝镇血吸虫病群体药物管理的覆盖率为49.8%(95%置信区间:46.2%-53.4%)。群体药物管理的阳性预测因素是对2018年群体药物管理情况的先验知识(调整后比值比:2.892,P<0.001)以及认为在恩贡贝镇使用吡喹酮进行群体药物管理期间提供零食等激励措施很重要(调整后比值比:1.926,P=0.001),而年龄(调整后比值比:0.979,P=0.009)、婚姻状况(调整后比值比:0.620,P=0.006)、就业状况(调整后比值比:0.587,P=0.001)是群体药物管理的阴性预测因素。在流行地区消除血吸虫病负担需要在使用吡喹酮进行群体药物管理期间达到最佳覆盖率和服药率。因此,如果要在未来的群体药物管理中规划和促进服药率,群体药物管理实施者应优先考虑即将进行的干预措施的先验知识以及在干预期间提供零食等激励措施,同时需要考虑年龄、婚姻状况和就业状况等背景特征。