Factors associated with never treatment and acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana, 2021

Claudia Duguay; Reza A Niles-Robin; Charles R Thickstun; Horace Cox; Annastacia Sampson; Jean Seme-Fils Alexandre; Nathely Caleb-Mars; Charles W Goss; Ana Morice; Ronaldo G Carvalho Scholte; Alison Krentel

doi:10.1371/journal.pgph.0001985

Factors associated with never treatment and acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana, 2021

PLOS Glob Public Health. 2024 Apr 25;4(4):e0001985. doi: 10.1371/journal.pgph.0001985. eCollection 2024.

Authors

Affiliations

¹ School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
² Neglected Tropical Diseases Programme-Vector control Services, Ministry of Health, Georgetown, Guyana.
³ Bruyère Research Institute, Ottawa, Ontario, Canada.
⁴ Neglected, Tropical, and Vector Borne Diseases, Pan American Health Organization, Washington, DC, United States of America.
⁵ Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States of America.

Abstract

Guyana remains one of four countries in the Americas endemic for lymphatic filariasis (LF). Elimination of LF requires repeated annual mass drug administration (MDA) with sufficient levels of coverage for success. This study assesses the acceptability and never treatment of LF MDA using data from a routine assessment survey in 2021. A subset of individuals, over 20 years of age (n = 2498), were selected to receive an expanded questionnaire to examine factors associated with acceptability and never treatment. Assessed factors include respondent demographics, knowledge, risk perceptions of LF, and opinions on the MDA programme. The majority (73%) of those with scores above the acceptability threshold (score ≥22.5) reported participating in MDA two or more times. Factors strongly and positively associated with scoring above the acceptability threshold include beliefs in importance of participation in MDA for their community (aOR = 2.8, 95%CI (1.1-7.2)), perception of importance of LF treatment (6.9 (3.2-14.7)), receiving treatment in 2021 (2.9 (1.5-5.4)), and the number of self-reported times taking treatment for LF (2.2 (1.1-4.4)). Ten percent of respondents participated in the MDA for the first time in 2021, while 15% reported never treatment during any round of LF MDA. Three factors were statistically associated with participation in MDA across the two levels of the models (level 1: took LF treatment once versus never, and level 2: took LF treatment twice versus never) included: 1) scoring above the acceptability threshold (aOR = 6.2, 95%CI(3.8-10.0)), 2) self-reported importance of participation in MDA for their community (7.1 (2.9-17.8)), and 3) personal beliefs that they should take LF treatment even if they are not sick (2.6 (1.7-3.9)). As Guyana moves closer to LF elimination, these results provide further insight and understanding into programmatic results and could inform further action following MDA activities-particularly if an approach is needed to address never treatment during MDA.

Copyright: © 2024 Duguay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This research was funded through the Pan American Health Organization. Some authors are staff members of the Pan American Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the decisions or policies of the Pan American Health Organization. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. CD and CT received funding to support data analysis for this manuscript as part of PAHO/WHO Consultant Contract CDE/VT. AK received financial support from the Bill & Melinda Gates Foundation through their support of the Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD) grant. COR-NTD is funded at The Task Force for Global Health primarily by the Gates Foundation and the United States Agency for International Development (USAID).