Review of MDA registers for Lymphatic Filariasis: Findings, and potential uses in addressing the endgame elimination challenges
Ghana
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Reference ID
NMIMR_LYPHATIC_FILARIASIS_2019
Producer(s)
Dziedzom K. de Souza
Collections
Created on
Jun 07, 2023
Last modified
Jul 14, 2023
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683
Identification
Survey ID Number
NMIMR_LYPHATIC_FILARIASIS_2019
Title
Review of MDA registers for Lymphatic Filariasis: Findings, and potential uses in addressing the endgame elimination challenges
Country
| Name | Country code |
|---|---|
| Ghana | GH |
Kind of Data
sample survey data[ssd]
Version
Version Description
v1
Scope
Notes
Background
Lymphatic filariasis (LF) is endemic in Ghana, and the country has implemented the GPELF
strategy since 2000 with significant progress made in the control of the disease. However,
after several years of mass drug administration (MDA) implementation, there is persistent
transmission in 17 of the 98 endemic districts in the country. Current approaches to surveillance
are clearly unable to target untreated individuals and new strategies are required to
address the endgame challenges to enhance LF elimination as a public health problem in
endemic countries. Community registers are used during MDAs to enumerate community
members, their age, gender, house numbers, and records of their participation in MDAs.
These MDA registers represent an untapped opportunity to identify and characterize noncompliance
and inform appropriate programmatic actions. In this study, we analyzed the
data presented in the registers to assess the coverage and individuals’ compliance in MDA.
Methods
The information in the MDA registers were assessed to verify the reported coverages
obtained from the district. The community registers were obtained from the district health
offices and the data from each individual record was entered into a database. A simple questionnaire
was used to cross-check the participation of study participants in the 2017 MDA.
The questionnaire solicited data on: participation in the 2017 MDA, reasons for not taking
part in the MDA, adverse events experienced, what was done for the adverse events, and
willingness to participate in subsequent MDAs.
Results
We found that 40.1% of the population in the registers missed at least one MDA in 3 years
(2016–2018) and the majority of them were between 10–30 years of age. The results of the
questionnaire assessment indicated that 13.8% of the respondents did not receive treatment
in 2017 for various reasons, the most prominent among them being “absence/travel”
(37.1%). Data in the registers were used to verify the treatment coverage for the years 2017
and 2018, and reviewed against the reported coverage obtained from the district. Significant
differences between the reported and verified coverages were only observed in four communities.
However, the assessment also revealed that the reported coverage was only
accurate in 33.3% of cases.
Conclusions
The MDA registers allow for the identification of eligible individuals who were not reached
during any MDA round. Thus, the MDA registers could be utilized at the community and programme
levels to identify missing and untreated individuals, appropriately address their
non-compliance to MDA, and thereby improve MDA coverage in each implementation unit
and monitor the progress towards elimination of LF. The challenges observed through the
review of the registers also offer opportunities to improve the training given to the community
drug distributors.
Lymphatic filariasis (LF) is endemic in Ghana, and the country has implemented the GPELF
strategy since 2000 with significant progress made in the control of the disease. However,
after several years of mass drug administration (MDA) implementation, there is persistent
transmission in 17 of the 98 endemic districts in the country. Current approaches to surveillance
are clearly unable to target untreated individuals and new strategies are required to
address the endgame challenges to enhance LF elimination as a public health problem in
endemic countries. Community registers are used during MDAs to enumerate community
members, their age, gender, house numbers, and records of their participation in MDAs.
These MDA registers represent an untapped opportunity to identify and characterize noncompliance
and inform appropriate programmatic actions. In this study, we analyzed the
data presented in the registers to assess the coverage and individuals’ compliance in MDA.
Methods
The information in the MDA registers were assessed to verify the reported coverages
obtained from the district. The community registers were obtained from the district health
offices and the data from each individual record was entered into a database. A simple questionnaire
was used to cross-check the participation of study participants in the 2017 MDA.
The questionnaire solicited data on: participation in the 2017 MDA, reasons for not taking
part in the MDA, adverse events experienced, what was done for the adverse events, and
willingness to participate in subsequent MDAs.
Results
We found that 40.1% of the population in the registers missed at least one MDA in 3 years
(2016–2018) and the majority of them were between 10–30 years of age. The results of the
questionnaire assessment indicated that 13.8% of the respondents did not receive treatment
in 2017 for various reasons, the most prominent among them being “absence/travel”
(37.1%). Data in the registers were used to verify the treatment coverage for the years 2017
and 2018, and reviewed against the reported coverage obtained from the district. Significant
differences between the reported and verified coverages were only observed in four communities.
However, the assessment also revealed that the reported coverage was only
accurate in 33.3% of cases.
Conclusions
The MDA registers allow for the identification of eligible individuals who were not reached
during any MDA round. Thus, the MDA registers could be utilized at the community and programme
levels to identify missing and untreated individuals, appropriately address their
non-compliance to MDA, and thereby improve MDA coverage in each implementation unit
and monitor the progress towards elimination of LF. The challenges observed through the
review of the registers also offer opportunities to improve the training given to the community
drug distributors.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Dziedzom K. de Souza | Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana |
Funding Agency/Sponsor
| Name | Abbreviation | Grant number |
|---|---|---|
| EDCTP2 programme supported by the European Union | EDCTP2 | 98595 |
Data Collection
Data Collection Mode
Review of MDA registers and Questionnaire
Access policy
Contacts
| Name | Affiliation | |
|---|---|---|
| Dziedzom K. de Souza | Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon-Accra, Ghana | DdeSouza@noguchi.ug.edu.gh |
Access authority
| Name | Affiliation | URL | |
|---|---|---|---|
| Dziedzom K. de Souza | Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana | www.noguchi@ug.edu.gh | DdeSouza@noguchi.ug.edu.gh |
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Noguchi Memorial Institute for Medical Research