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

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Dissak-Delon, Fanny Nadia [ULB] Kamga, Guy-Roger [UCL] Humblet, Perrine Claire Robert, Annie [UCL] Souopgui, Jacob Godin, Isabelle

(eng) 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.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2017
Language Anglais
Journal information "PLoS neglected tropical diseases" - Vol. 11, no. 8, p. e0005849 [1-17] (2017)
Peer reviewed yes
Publisher Public Library of Science ((United States) San Francisco, CA)
issn 1935-2727
e-issn 1935-2735
Publication status Publié
Affiliation UCL - SSS/IREC/EPID - Pôle d'épidémiologie et biostatistique
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Bibliographic reference Dissak-Delon, Fanny Nadia ; Kamga, Guy-Roger ; Humblet, Perrine Claire ; Robert, Annie ; Souopgui, Jacob ; et. al. Adherence to ivermectin is more associated with perceptions of community directed treatment with ivermectin organization than with onchocerciasis beliefs.. In: PLoS neglected tropical diseases, Vol. 11, no. 8, p. e0005849 [1-17] (2017)
Permanent URL http://hdl.handle.net/2078.1/202745