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Nditanchou, R, Dixon, R, Atekem, K, Akongo, S, Biholong, B, Ayisi, F, Nwane, P, Wilhelm, A, Basnet, S, Selby, R, Wanji, S, Bakajika, D, Oye, J, Kamgno, J, Boakye, D, Schmidt, E and Senyonjo, L (2023) Acceptability of test and treat with doxycycline against Onchocerciasis in an area of persistent transmission in Massangam Health District, Cameroon. PLoS Neglected Tropical Diseases, 17 (4). e0011185. ISSN 1935-2727
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Acceptability of test and treat with doxycycline against Onchocerciasis in an area of persistent transmission in Massangam H.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
The main onchocerciasis elimination strategy is annual Community-Directed Treatment with ivermectin (CDTi). However, as a response to persistent high infection prevalence in Mas-sangam Health District in Cameroon, two rounds of alternative treatments including bian-nual CDTi, ground larviciding and test and treat with doxycycline (TTd) were implemented. This led to a significant prevalence reduction from 35.7% to 12.3% (p<0.001) as reported by Atekem and colleagues. Here we report on the acceptability of TTd component based on qualitative and quantitative data. The TTd involved microscopic examination for microfilaria in skin biopsy and those infected were offered doxycycline 100 mg daily for 35 days by com-munity-directed distributors (CDDs). Participation level was significantly high with 54% of eli-gible population (age > 8, not pregnant, not breastfeeding, not severely ill,) participating in the test in each round, increasing to 83% over the two rounds. Factors associated with non-participation included mistrust, being female; being younger than 26 years; short stay in the community; and belonging to semi-nomadic sub population due to their remote and disperse settlement, discrimination, their non selection as CDD, and language and cultural barriers. Treatment coverage was high-71% in round 1 and 83% in round 2. People moving away between testing and treatment impacted treatment coverage. Some participants noted mis-match between symptoms and test result; and that ivermectin is better than doxycycline, while others favoured doxycycline. CDD worried about work burden with unmatching com-pensation. Overall, TTd participation was satisfactory. But can be improved through rein-forcing sensitisation, reducing time between test and treatment; combining TTd and CDTi in one outing; augmenting CDDs compensation and/or weekly visit; exploring for frequently excluded populations and adapting strategies to reach them; and use of a sensitive less invasive test.
| Item Type: | Article |
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| Uncontrolled Keywords: | Humans; Onchocerciasis; Ivermectin; Doxycycline; Prevalence; Pregnancy; Cameroon; Female; Male; Humans; Female; Pregnancy; Male; Onchocerciasis; Ivermectin; Doxycycline; Cameroon; Prevalence; 06 Biological Sciences; 11 Medical and Health Sciences; Tropical Medicine |
| Subjects: | G Geography. Anthropology. Recreation > GE Environmental Sciences R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RE Ophthalmology |
| Divisions: | Public Health Institute |
| Publisher: | Public Library of Science (PLoS) |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 04 Jul 2023 10:39 |
| Last Modified: | 04 Jul 2023 10:45 |
| DOI or ID number: | 10.1371/journal.pntd.0011185 |
| Editors: | Gómez-Morales, MA |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/20197 |
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