Predictors of compliance with community-directed ivermectin treatment in Uganda: quantitative results

Abstract

In order to identify the factors influencing compliance with mass ivermectin treatment for onchocerciasis control, a cross-sectional study was carried out in Bushenyi District, Uganda. Data were collected by interviewing 839 individuals who were randomly selected from 30 clusters where onchocerciasis is endemic. Information was collected on compliance with ivermectin treatment, socio-demographic characteristics, perception of personal susceptibility to onchocerciasis, knowledge about cause/transmission of onchocerciasis, knowledge of signs and symptoms of onchocerciasis, treatment of onchocerciasis, benefits and dangers of taking ivermectin, organization of distribution of ivermectin, work and selections of community drug distributors (CDDs), social influence and support to take ivermectin and on barriers and supports towards compliance with ivermectin treatment. The major factors favouring compliance were: perceiving CDDs as doing their work well, believing that measuring height is the best way to determine one's dose of ivermectin, having social support from one's family, saying that ivermectin treatment costs nothing, perceiving personal risk of onchocerciasis, believing that ivermectin prevents onchocerciasis and perceiving radios as supporting treatment with ivermectin. The strongest predictor of compliance with ivermectin treatment is perceiving CDDs as doing their work well with adjusted odds ratios of 5.54 (95% CI: 3.19-9.62). In order to improve compliance with ivermectin treatment, CDDs need to be well-facilitated and ivermectin distribution should be free. Health education is necessary so that people perceive themselves to be at risk of onchocerciasis and to understand the rationale of using height for dose determination. The health education should target the family and use radios.