Patterns of individual compliance with anthelmintic treatment for soil-transmitted helminth infections in southern Ethiopia over six rounds of community-wide mass drug administration.

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2024-05-01 DOI:10.1093/trstmh/trad079
R Maddren, B Collyer, A E Phillips, S Rayment Gomez, B Abtew, U Anjulo, D Tadele, A Sharma, A Tamiru, E Firdawek Liyew, M Chernet, R M Anderson
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Abstract

Background: The mainstay of soil-transmitted helminth (STH) control is repeated mass drug administration (MDA) of anthelmintics to endemic populations. Individual longitudinal compliance treatment patterns are important for identifying pockets of infected individuals who remain untreated and serve as infection reservoirs.

Methods: The Geshiyaro Project censused the study population in Wolaita, Ethiopia at baseline in 2018. Individual longitudinal compliance was recorded for six rounds of community-wide MDA (cMDA). The probability distribution of treatment frequency was analysed by age and gender stratifications. Probabilities of transmission interruption for different compliance patterns were calculated using an individual-based stochastic model of Ascaris lumbricoides transmission.

Results: The never-treated (0.42%) population was smaller than expected from a random positive binomial distribution. The observed compliance frequency was well described by the beta-binomial distribution. Preschool-age children (odds ratio [OR] 10.1 [95% confidence interval {CI} 6.63 to 15.4]) had the highest never-treated proportion of the age groups. Conversely, school-age children (SAC) and adults (OR 1.03 [95% CI 0.98 to 1.09]) had the highest always-treated proportion of the age groups.

Conclusions: The study reports the largest dataset of individual longitudinal compliance to cMDA for STH control. Clear pattens are shown in the age-dependent distribution of individual compliance behaviour. The impact of compliance on the probability of elimination is significant, highlighting the importance of recording the full frequency distribution, not just the never-treated proportion.

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埃塞俄比亚南部在6轮社区范围内大规模给药期间对土壤传播蠕虫感染进行驱虫治疗的个人依从性模式。
背景:控制土壤传播蠕虫(STH)的主要方法是对流行人群反复给药(MDA)。个体纵向依从性治疗模式对于识别那些仍未得到治疗并成为感染宿主的感染者非常重要。方法:Geshiyaro项目于2018年对埃塞俄比亚Wolaita的研究人群进行基线普查。记录6轮社区范围MDA (cMDA)的个体纵向依从性。按年龄和性别分层分析治疗频率的概率分布。采用基于个体的类蛔虫传播随机模型,计算了不同顺应模式下的传播中断概率。结果:未治疗人群(0.42%)小于随机正二项分布的预期。观察到的依从性频率由β二项分布很好地描述。学龄前儿童(优势比[OR] 10.1[95%可信区间{CI} 6.63至15.4])在各年龄组中未接受治疗的比例最高。相反,学龄儿童(SAC)和成人(OR 1.03 [95% CI 0.98至1.09])的总治疗比例最高。结论:该研究报告了最大的个体纵向依从cMDA用于STH控制的数据集。个体依从性行为的年龄依赖性分布显示出清晰的模式。依从性对消除概率的影响是显著的,突出了记录全频率分布的重要性,而不仅仅是从未处理过的比例。
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来源期刊
Transactions of The Royal Society of Tropical Medicine and Hygiene
Transactions of The Royal Society of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.00
自引率
9.10%
发文量
115
审稿时长
4-8 weeks
期刊介绍: Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.
期刊最新文献
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