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Free Content Predictors of compliance with a mass drug administration programme for lymphatic filariasis in Orissa State, India 2008

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Summary Objectives  To assess the performance of an educational campaign to increase adherence to a mass-administered DEC regimen against lymphatic filariasis (LF) in Orissa, and to identify factors that could enhance future campaigns. Method  Randomized cluster survey, comparing areas that did and did not receive the educational campaign, using a household coverage survey and knowledge, attitudes and practices (KAP) survey. Results  LF MDA coverage for the entire population ( = 3449) was 56% (95% CI: 50.0–61.9). There was no statistical difference between the areas that did and did not receive the educational campaign. The most common barriers to adherence were fear of medication side effects (47.4%) and lack of recognition of one’s risk for LF (15.8%). Modifiable, statistically significant, multivariable predictors of adherence were knowing that DEC prevents LF (aOR = 2.6, 95% CI: 1.4–5.1), knowing that mosquitoes transmit LF (aOR = 1.9, 95% CI: 1.1–3.2), and knowing both about the mass drug administration (MDA) in advance and that mosquitoes transmit LF (aOR = 5.4, 95% CI: 2.8–10.4). Conclusions  India needs to increase compliance with MDA programmes to reach its goal of interrupting LF transmission. Promoting a simple public health message before MDA distribution, which takes into account barriers to and predictors of adherence, could raise compliance with the LF MDA programme.


Evaluer la performance d’une campagne d’éducation visant à accroître l’adhésion à un schéma d’administration de DEC en masse (ADM) contre la filariose lymphatique (FL) à Orissa et identifier les facteurs susceptibles d’améliorer les futures campagnes. Méthode: 

Surveillance en grappes aléatoires comparant des régions qui ont et qui n’ont pas reçu la campagne d’éducation. Enquêtes sur la couverture, les connaissances, les attitudes et les pratiques. Résultats: 

La couverture de l’ADM contre la FL pour la population (n = 3449) était de 56% (IC95%: 50,0-61,9). Il n’y avait pas de différence statistique entre les deux régions. Les obstacles les plus communs à l’adhésion étaient la crainte des effets secondaires des médicaments (47,4%) et le manque de reconnaissance du risque pour la FL (15,8%). Les facteurs prédictifs multivariés, statistiquement significatifs et modifiables de l’adhésion étaient: savoir que la DEC prévient contre la FL (OR a = 2,6, IC 95%: 1.4-5.1), savoir que les moustiques transmettent FL (rapport de cotes ajustés aOR= 1,9; IC95%: 1,1-3,2) et savoir à la fois au sujet de l’ADM à l’avance et que les moustiques transmettent la FL (aOR= 5,4; IC95%: 2,8-10,4). Conclusions: 

Afin d’atteindre son objectif d’interrompre la transmission de la FL, l’Inde a besoin d’un accroissement de la compliance avec les programmes d’ADM. La promotion d’un simple message de santé publique avant l’ADM, qui tient compte des prédicteurs et des obstacles à l’adhésion, pourrait accroître la compliance au programme d’ADM contre la FL.

Keywords: Inde; India; administración masiva de medicamentos; administration massive de médicaments; filariasis linfática; filariose lymphatique; lymphatic filariasis; mass drug administration; prevención; prevention; prévention

Document Type: Research Article


Affiliations: 1:  Church’s Auxiliary for Social Action, Bhubaneswar, India 2:  Division of Parasitic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

Publication date: 2010-02-01

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