Amanyi-Enegela Juliana A, Ishaya Rinpan, Kumbur Joseph, Sankar Girija, Adamani William Enan, Ogoshi Christopher, Olobio Nicholas, Qureshi Muhammad Babar, Mpyet Caleb
Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V, CB1 1BH Cambridge, UK.
HANDS, 5A Naomi Jugu Drive, 930103 Rayfield, Jos, Plateau State, Nigeria.
Int Health. 2025 Sep 3;17(5):685-694. doi: 10.1093/inthealth/ihaf014.
Trachoma, a neglected tropical disease, remains a significant public health concern in many regions, particularly in sub-Saharan Africa and in Yobe State, Nigeria. One approach for elimination involves administering tetracycline eye ointment (TEO) to children <6 months of age as part of annual mass drug administration (MDA), aligning with the World Health Organization's 'A' component of the SAFE (Surgery, Antibiotics, Facial hygiene and Environmental sanitation) strategy for elimination of trachoma as a public health problem. However, suboptimal compliance rates in affected populations pose challenges, potentially serving as a reservoir for reinfection and hindering progress toward trachoma elimination. This study focuses on assessing compliance with topical TEO during MDA and explores strategies to enhance adherence in trachoma-endemic areas of Yobe State, Nigeria.
A mixed research approach was carried out involving interviews with households across 30 communities in five local government areas where TEO was administered during the 2022 round of MDA. Focus group discussions were conducted with subsets of the population who received TEO to gain insights into the underlying reasons for non-compliance and ways to improve compliance. Additionally, healthcare provider perspectives on treatment administration, compliance and community health education were explored.
Findings from this study show that there is already a high level of compliance with TEO usage, however, forgetfulness due to competing domestic chores, insufficient quantity of TEO given for 6-week applications, low awareness about the impact of trachoma infection on the eyes and the stinging feeling after application, especially in children <6 months of age, are some barriers that affect TEO usage compliance. Following up with TEO recipients would remind them to use the ointment as required, while incentivizing health workers and community drug distributors to conduct follow-up visits to households, increasing awareness on the impact of trachoma on the eyes. Increasing the quantity of TEO allocation would also improve compliance.
Yobe State has made remarkable progress towards eliminating trachoma as a public health problem, as 12 local government areas no longer require MDA. Sustaining this momentum means ensuring high compliance among the population eligible to receive TEO to prevent any reservoir for reinfection in the state.
沙眼是一种被忽视的热带疾病，在许多地区，尤其是撒哈拉以南非洲和尼日利亚约贝州，仍然是一个重大的公共卫生问题。消除沙眼的一种方法是在年度大规模药物管理（MDA）中，给6个月以下儿童使用四环素眼膏（TEO），这与世界卫生组织消除沙眼作为公共卫生问题的SAFE（手术、抗生素、面部卫生和环境卫生）战略的“A”部分相一致。然而，受影响人群的依从率不理想带来了挑战，这可能成为再次感染的源头，并阻碍沙眼消除工作的进展。本研究聚焦于评估MDA期间局部使用TEO的依从性，并探索提高尼日利亚约贝州沙眼流行地区依从性的策略。
采用混合研究方法，对2022年MDA轮次中发放TEO的五个地方政府辖区的30个社区的家庭进行访谈。与接受TEO的部分人群进行焦点小组讨论，以深入了解不依从的潜在原因和提高依从性的方法。此外，还探讨了医疗服务提供者对治疗给药、依从性和社区健康教育的看法。
本研究结果表明，TEO的使用已经有较高的依从性，然而，由于家务琐事缠身而忘记用药、6周用药期的TEO给药量不足、对沙眼感染对眼睛的影响认识不足以及用药后尤其是6个月以下儿童用药后的刺痛感，是影响TEO使用依从性的一些障碍。对TEO接受者进行随访会提醒他们按要求使用眼膏，同时激励卫生工作者和社区药品分发人员对家庭进行随访，提高对沙眼对眼睛影响的认识。增加TEO的分配量也会提高依从性。
约贝州在消除沙眼作为公共卫生问题方面取得了显著进展，因为12个地方政府辖区不再需要MDA。保持这一势头意味着要确保有资格接受TEO的人群有较高的依从性，以防止该州出现任何再次感染的源头。
