Adherence To Community Directed Treatment With Ivermectin For Onchocerciasis Elimination In Abekwai, Tain District, Ghana

ABSTRACT Introduction Onchocerciasis is one of the debilitating neglected tropical diseases that manifests in blindness at later stages. Ivermectin has been proven to clear microfilariae and is therefore being distributed in endemic communities. Adherence to ivermectin treatment is a major challenge in the implementation of the community directed treatment strategy. Some individuals do not adhere to the bi-annual treatment accounting for the continuity of onchocerciasis transmission. Objective The objective of this study was therefore to determine the level of adherence to ivermectin treatment under the community directed treatment strategy in the Abekwai community in the Tain district. Methods A population-based cross-sectional study involving community members in Abekwai was conducted to determine the proportion of community members who swallowed ivermectin during the 2015 mass distribution treatment round. Two hundred and fifty one participants were selected randomly to take part in the study. Factors likely to influence adherence was elicited from the community members using a pre-tested structured questionnaire. Data were analyzed using Stata version 13. Chi square test was used to determine significance of the individual level factors against drug uptake. vi Results Out of the total of 251 participants (age range 18-75, mean age 37.6, SD 14.3), 94% (236/251) received ivermectin; while 86.9% (205/236) adhered by swallowed it. The most common reason for not receiving or swallowing the drug was that the CDD did not come to their houses 63% (29/46). Individual level factors found to be significantly associated with adherence to taking the drug included: knowledge of onchocerciasis as a disease, its vector and mode of transmission. Other factors were knowledge of the signs and symptoms of the disease, its seriousness and how common they perceived it to be in their community, their perceived level of risk and perceived importance of Community Directed Treatment with Ivermectin (CDTI) as well as whether they knew any Community Directed Distributor (CDD). Conclusion It has been established that 18.3% of the participants did not swallow ivermectin. Educational activities and mop-ups are therefore needed to be carried out on regular bases by the district health directorate to encourage regular uptake while implementation research be carried out for an overall improvement in uptake.