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Multicenter Study
. 2017 Aug 14;11(8):e0005849.
doi: 10.1371/journal.pntd.0005849. eCollection 2017 Aug.

Adherence to ivermectin is more associated with perceptions of community directed treatment with ivermectin organization than with onchocerciasis beliefs

Fanny Nadia Dissak-Delon  1   2   3 , Guy-Roger Kamga  1   3   4 , Perrine Claire Humblet  2 , Annie Robert  4 , Jacob Souopgui  2 , Joseph Kamgno  5   6 , Marie José Essi  6 , Stephen Mbigha Ghogomu  3 , Isabelle Godin  2
Affiliations
Multicenter Study

Adherence to ivermectin is more associated with perceptions of community directed treatment with ivermectin organization than with onchocerciasis beliefs

Fanny Nadia Dissak-Delon et al. PLoS Negl Trop Dis. .

Abstract

Background: The fight against onchocerciasis in Africa has boomed thanks to the Community Directed Treatment with Ivermectin (CDTI) program. However, in Cameroon, after more than 15 years of mass treatment, onchocerciasis prevalence is still above the non-transmission threshold. This study aimed to explore a possible association between people's beliefs/perceptions of onchocerciasis and of CDTI program, and their adherence to ivermectin in three regions of Cameroon.

Methodology/principal findings: A cross sectional survey was carried out in three health districts with persistent high onchocerciasis prevalence. Participants were randomly selected in 30 clusters per district. Adherence to ivermectin was comparable between Bafang and Bafia (55.0% and 48.8%, respectively, p>0.05) and lower in Yabassi (40.7%). Among all factors related to program perceptions and disease representations that were studied, perceptions of the program are the ones that were most determinant in adherence to ivermectin. People who had a "not positive" opinion of ivermectin distribution campaigns were less compliant than those who had a positive opinion about the campaigns (40% vs 55% in Bafang, and 48% vs 62% in Bafia, p<0.01), as well as those who had a negative appreciation of community drug distributors' commitment (22% vs 53% in Bafang, 33% vs 59% in Bafia, 27% vs 47% in Yabassi; p<0.01). The most common misconception about onchocerciasis transmission was the lack of hygiene, especially in Bafia and Yabassi. In Bafang, high proportions of people believed that onchocerciasis was due to high consumption of sugar (31% vs less than 5% in Bafia and Yabassi, p<0.001).

Conclusion/significance: There are still frequent misconceptions about onchocerciasis transmission in Cameroon. Perceptions of ivermectin distribution campaigns are more strongly associated to adherence. In addition to education/sensitisation on onchocerciasis during the implementation of the CDTI program, local health authorities should strive to better involve communities and more encourage community distributors' work.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Beliefs on onchocerciasis in Bafang, Bafia and Yabassi health districts.
(a) Beliefs on filaria causes*. (b) Opinion on best treatment for filaria** *: Multiple answers possible. **: Only for those who said that filaria is curable.
Fig 2
Fig 2. Perceived people’s role in ivermectin campaign organization system.
(Multiple answers possible).
See this image and copyright information in PMC

References

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