Mekuria Asnakew Asfaw1, Chernet Hailu2, Tariku J Beyene3. 1. Collaborative Research and Training Centre for NTDs, Arba Minch University, Arba Minch, Ethiopia. 2. Jimma University, Faculty of Public Health, Department of Epidemiology, Jimma, Ethiopia. 3. Center for Surgical Outcomes Research, Research Institute at Nationwide Children's Hospital, Columbus, OH, 43015, USA.
Abstract
BACKGROUND: Soil-transmitted helminth (STH) infections are prevalent in most developing countries, including Ethiopia, with school-age children (SAC) at high risk of infection. In Ethiopia, despite substantial progress being made on mass drug administration (MDA) coverage for STH infections, its implementation is facing challenges in hard-to-reach areas. This study thus aimed at assessing equity and coverage in MDA and identifying factors associated with drug coverage for STH infections among SAC in the hard-to-reach setting of southern Ethiopia. METHODS: A community-based cross-sectional survey was conducted in the North Ari district, South Omo Zone in July 2019. Sample size was estimated following WHO drug-coverage evaluation guidelines. Factors associated with drug uptake for STH infections were identified using multivariate logistic regression. RESULTS: Of 956 SAC participating in this study, the overall MDA coverage for STH was found to be 27.5% (95% CI 24.7%-30.5%). The odds of having taken drugs were highest among school-enrolled children and in those who knew the purpose of MDA: about about double their counterparts. In contrast, the odds of drug uptake were lower by 69% among those who had got informed only when the drugs delivered and by 92% among those who needed to travel >30 minutes to reach drug-distribution points than their counterparts. CONCLUSION: Achieving effective and equitable MDA coverage is facing serious challenges in the hard-to-reach setting of southern Ethiopia. The very low (27.5%) and inequitable MDA coverage found in this study are associated with school nonenrollment, inaccessibility, and lack of information, awareness, and mobilization. Social mobilization should be scaled up to inform and create awareness in the community ahead of MDA. Further, school-based deworming in settings with low school enrollment needs a modified strategy to reach those in need of drugs.
BACKGROUND: Soil-transmitted helminth (STH) infections are prevalent in most developing countries, including Ethiopia, with school-age children (SAC) at high risk of infection. In Ethiopia, despite substantial progress being made on mass drug administration (MDA) coverage for STH infections, its implementation is facing challenges in hard-to-reach areas. This study thus aimed at assessing equity and coverage in MDA and identifying factors associated with drug coverage for STH infections among SAC in the hard-to-reach setting of southern Ethiopia. METHODS: A community-based cross-sectional survey was conducted in the North Ari district, South Omo Zone in July 2019. Sample size was estimated following WHO drug-coverage evaluation guidelines. Factors associated with drug uptake for STH infections were identified using multivariate logistic regression. RESULTS: Of 956 SAC participating in this study, the overall MDA coverage for STH was found to be 27.5% (95% CI 24.7%-30.5%). The odds of having taken drugs were highest among school-enrolled children and in those who knew the purpose of MDA: about about double their counterparts. In contrast, the odds of drug uptake were lower by 69% among those who had got informed only when the drugs delivered and by 92% among those who needed to travel >30 minutes to reach drug-distribution points than their counterparts. CONCLUSION: Achieving effective and equitable MDA coverage is facing serious challenges in the hard-to-reach setting of southern Ethiopia. The very low (27.5%) and inequitable MDA coverage found in this study are associated with school nonenrollment, inaccessibility, and lack of information, awareness, and mobilization. Social mobilization should be scaled up to inform and create awareness in the community ahead of MDA. Further, school-based deworming in settings with low school enrollment needs a modified strategy to reach those in need of drugs.
Authors: Jade Benjamin-Chung; Arifa Nazneen; Amal K Halder; Rashidul Haque; Abdullah Siddique; Muhammed Salah Uddin; Kim Koporc; Benjamin F Arnold; Alan E Hubbard; Leanne Unicomb; Stephen P Luby; David G Addiss; John M Colford Journal: PLoS Negl Trop Dis Date: 2015-12-01
Authors: Daniel A Cohn; Maureen P Kelly; Kalpana Bhandari; Kathryn L Zoerhoff; Wilfrid E Batcho; François Drabo; Nebiyu Negussu; Benjamin Marfo; André Goepogui; Jean-Frantz Lemoine; Sitti Ganefa; Marilia Massangaie; Pradip Rimal; Issa Gnandou; Ifeoma N Anagbogu; Mamadou Ndiaye; Yakuba Madina Bah; Upendo J Mwingira; Marcel S Awoussi; Edridah M Tukahebwa; Rachel D Stelmach; Pia C Mingkwan; Bolivar Pou; Joseph B Koroma; Lisa A Rotondo; John D Kraemer; Margaret C Baker Journal: Int Health Date: 2019-09-02 Impact factor: 2.473