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Why onchocerciasis transmission persists after 15 annual ivermectin mass drug administrations in South-West Cameroon.

التفاصيل البيبلوغرافية
العنوان: Why onchocerciasis transmission persists after 15 annual ivermectin mass drug administrations in South-West Cameroon.
المؤلفون: Forrer A; Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK., Wanji S; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Obie ED; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Nji TM; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Department of Sociology and Anthropology, University of Buea, Buea, Cameroon., Hamill L; Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK., Ozano K; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK., Piotrowski H; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK., Dean L; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK., Njouendou AJ; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Ekanya R; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Ndongmo WPC; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Fung EG; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Department of Sociology and Anthropology, University of Buea, Buea, Cameroon., Nnamdi DB; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Department of Sociology and Anthropology, University of Buea, Buea, Cameroon., Abong RA; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Beng AA; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Eyong ME; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Ndzeshang BL; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Nkimbeng DA; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Teghen S; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Suireng A; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon., Ashu EE; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon., Kah E; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Murdoch MM; Watford General Hospital, West Herts Hospitals NHS Trust, Watford, UK., Thomson R; Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK., Theobald S; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK., Enyong P; Department of Disease Control, Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.; Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon., Turner JD; Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK., Taylor MJ; Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK Mark.Taylor@lstmed.ac.uk.
المصدر: BMJ global health [BMJ Glob Health] 2021 Jan; Vol. 6 (1).
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101685275 Publication Model: Print Cited Medium: Print ISSN: 2059-7908 (Print) Linking ISSN: 20597908 NLM ISO Abbreviation: BMJ Glob Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, [2016]-
مواضيع طبية MeSH: Ivermectin*/therapeutic use , Onchocerciasis*/drug therapy , Onchocerciasis*/epidemiology, Adult ; Cameroon/epidemiology ; Child ; Cross-Sectional Studies ; Humans ; Mass Drug Administration
مستخلص: Introduction: Onchocerciasis is targeted for elimination mainly with annual community-directed treatment with ivermectin (CDTI). High infection levels have been reported in South-West Cameroon, despite ≥15 years of CDTI. The aim of this study was to assess factors associated with continued onchocerciasis transmission and skin disease.
Methods: A large-scale cross-sectional study was conducted in 2017 in 20 communities in a loiasis-risk area in South-West Cameroon. A mixed-methods approach was used. Associations between infection levels, skin disease and adherence to CDTI were assessed using mixed regression modelling. Different community members' perception and acceptability of the CDTI strategy was explored using semi-structured interviews.
Results: Onchocerciasis prevalence was 44.4% among 9456 participants. 17.5% of adults were systematic non-adherers and 5.9% participated in ≥75% of CDTI rounds. Skin disease affected 1/10 participants, including children. Increasing self-reported adherence to CDTI was associated with lower infection levels in participants aged ≥15 years but not in children. Adherence to CDTI was positively influenced by perceived health benefits, and negatively influenced by fear of adverse events linked with economic loss. Concern of lethal adverse events was a common reason for systematic non-adherence.
Conclusion: CDTI alone is unlikely to achieve elimination in those high transmission areas where low participation is commonly associated with the fear of adverse events, despite the current quasi absence of high-risk levels of loiasis. Such persisting historical memories and fear of ivermectin might impact adherence to CDTI also in areas with historical presence but current absence of loiasis. Because such issues are unlikely to be tackled by CDTI adaptive measures, alternative strategies are needed for onchocerciasis elimination where negative perception of ivermectin is an entrenched barrier to community participation in programmes.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: control strategies; epidemiology; onchocerciasis; parasitology; public health
المشرفين على المادة: 70288-86-7 (Ivermectin)
تواريخ الأحداث: Date Created: 20210112 Date Completed: 20210624 Latest Revision: 20210624
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7802695
DOI: 10.1136/bmjgh-2020-003248
PMID: 33431378
قاعدة البيانات: MEDLINE
الوصف
تدمد:2059-7908
DOI:10.1136/bmjgh-2020-003248