Socioeconomic factors associated with compliance with mass drug administration for lymphatic filariasis elimination in Kenya: Descriptive study results
Socioeconomic factors associated with compliance with mass drug administration for lymphatic filariasis elimination in Kenya: Descriptive study results
复制标题
DOI：
10.4103/1755-6783.95962
复制
发表时间：
2012-03-01
期刊：
影响因子：
--
通讯作者：
Njenga, Sammy M.
中科院分区：
文献类型：
--
作者：
Njomo, Doris W.;Amuyunzu-Nyamongo, M.;Njenga, Sammy M.
背景：每年至少对 65 - 80% 的高危人群进行大规模药物注射 (MDA) 对于消除淋巴丝虫病 (LF) 是必要的。在肯尼亚，基于二乙基卡马嗪和阿苯达唑的 MDA，采用社区指导治疗 (ComDT) 方法，已在 Kwale 和 Malindi 地区实施了三次。为了确定影响 MDA 依从性的社会经济因素，在 2008 年 MDA 后在两个地区进行了一项回顾性横断面研究。材料和方法：在 Kwale，Tsimba 位置代表高覆盖率，Gadini 代表低覆盖率，而在 Malindi，Goshi 位置代表高覆盖率，Gongoni 代表低覆盖率。通过系统抽样，从四个地点中选择了九个村庄。定量数据收集自 965 名系统选择的户主，并使用 SPSS v. 15 进行分析。对于定性数据，根据研究的核心主题进行手动分析，有目的地选择并采访 80 名意见领袖和 80 名有临床症状的 LF 患者，并与成年和青年男性和女性群体进行 16 次焦点小组讨论 (FGD)。结果：与穆斯林（34.3%）相比，基督徒在高合规性区域中的比例略高（49.1%），而在低合规性区域中，穆斯林占主导地位（40.6%），而与基督徒（29%）相比。从收入水平来看，低收入地区的27%有主要职业，高达标地区的这一比例为12.2%，收入水平较高；低收入地区的95%拥有土地，高达标地区的78%拥有土地，这也表明经济地位较高。对四肢肿胀原因的准确了解在高依从性区域中较高（37%），而在低顺应性区域中这一比例为 25.8%；对生殖器肿胀原因的准确了解也是如此（高依从性区域为 26.8%，而低依从性区域为 14%）。高合规性区域的风险感知较高（52% 比 45%），与低合规性区域相比，高合规性区域似乎更容易获得 MDA 信息。来自高依从性地区的患者患有慢性病的平均年数较高（15.2 比 9.7）。结论：需要进行更多投资来接触 MDA 期间经常被遗漏的群体。必须制定不同的策略来接触特定宗教团体和临时工。这可能包括延长 MDA 的持续时间，以吸引那些在一周内外出寻找临时工作和其他形式工作的人。
Background: Annual Mass Drug Administration (MDA) to at least 65 - 80% of the population at risk is necessary for Lymphatic Filariasis (LF) elimination. In Kenya, MDA based on diethylcarbamazine and albendazole, using the community-directed treatment (ComDT) approach has been implemented thrice in the Kwale and Malindi districts. To identify the socioeconomic factors influencing compliance with MDA, a retrospective cross-sectional study was conducted in the two districts after the 2008 MDA. Materials and Methods: In Kwale, the Tsimba location was selected for high and Gadini for low coverage, while in Malindi, the Goshi location represented high and Gongoni, low coverage. Using systematic sampling, nine villages were selected from the four locations. Quantitative data was collected from 965 systematically selected household heads and analyzed using SPSS v. 15. For qualitative data, which was analyzed manually according to core themes of the study, 80 opinion leaders and 80 LF patients with clinical signs were purposively selected and interviewed, and 16 focus group discussions (FGDs) conducted with adult and youth male and female groups. Results: Christians were slightly more (49.1%) in the high compliance areas compared to Muslims (34.3%), while Muslims prevailed (40.6%) in the low compliance areas compared to Christians (29%). On the income level, 27% from the low compared to 12.2% from the high compliance areas had a main occupation, indicative of a higher income, and 95% from the low compared to 78% from high compliance areas owned land, also an indicator of higher economic status. Accurate knowledge of the cause of swollen limbs was higher (37%) in the high compared to 25.8% in the low compliance areas, and so was accurate knowledge about the cause of swollen genitals (26.8% in high compared to 14% in low). Risk perception was higher in the high compliance areas (52% compared to 45%) and access to MDA information seemed to have been better in the high compared to low compliance areas. Patients from the high compliance areas had a higher mean number of years with chronic disease (15.2 compared to 9.7). Conclusions: There is a need for more investment in reaching out to groups that are often missed during MDAs. Different strategies have to be devised to reach those in specific religious groupings and those in casual employment. This could include prolonging the duration of MDA to capture those who are out during the week seeking for casual and other forms of employment.