Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Factors Associated With Coverage in Community-directed Treatment With Ivermectin for Onchocerciasis Control in Savanah and Forest Areas in Central African Republic: A Cross-sectional Study

  • Sylvain Honore Woromogo (Doctoral School of Human and Veterinary Sciences, University of Bangui) ;
  • Stephanie Inesse Garoua-Adjou (Doctoral School of Human and Veterinary Sciences, University of Bangui) ;
  • Ange Donatien Ngouyombo (Doctoral School of Human and Veterinary Sciences, University of Bangui) ;
  • Rodrigue Herman Doyama-Woza (Department of Public Health, Faculty of Health Sciences, University of Bangui) ;
  • Henri Saint Calvaire Diemer (Department of Public Health, Faculty of Health Sciences, University of Bangui) ;
  • Jean de Dieu Longo (Department of Public Health, Faculty of Health Sciences, University of Bangui)
  • Received : 2024.06.07
  • Accepted : 2024.08.01
  • Published : 2024.09.30
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Abstract

Objectives: The aim of this study was to identify factors associated with coverage in community-directed treatment with ivermectin for onchocerciasis control in savannah and forest areas in the Central African Republic. Methods: A cross-sectional study was conducted in 2 districts where onchocerciasis is endemic. We employed a pretested and validated questionnaire that included questions about the socio-demographic characteristics of the respondents and variables relevant to coverage assessment. Multivariate logistic regression analyses were performed to identify the associations between surveyed mass drug administration (MDA) coverage and the variables considered, while accounting for potential confounding factors. A p-value <0.05 was considered statistically significant. Results: At the district level, the MDA program achieved a reach of 87.29% (95% confidence interval [CI], 86.03 to 88.55) in Bossangoa and 61.74% (95% CI, 59.56 to 63.92) in Kemo, compared to the reported rates of 90.02% and 91.70%, respectively. Women in both Bossangoa and Kemo were 1.28 times more likely to have taken ivermectin than men (95% CI, 1.12 to 1.47; p=0.008; 95% CI, 1.09 to 2.00; p=0.041, respectively). The age groups of 5-14, 15-24, and 25-34 were statistically associated with better distribution coverage in both districts. Individuals with knowledge of onchocerciasis were more likely to receive ivermectin compared to those without knowledge, with adjusted odds ratios of 1.41 (95% CI, 1.11 to 2.01; p=0.030) and 3.19 (95% CI, 2.91 to 4.08; p=0.001), respectively. Conclusions: The authors recommend implementing measures to improve MDA coverage in future campaigns. These measures should include allocating sufficient time for MDA activities, providing health education, and mobilising the entire population.

Keywords

Acknowledgement

We are thankful to the administrative and health districts of Bossangoa and Kemo, the village leaders, and. the residents of the studied communities for their cooperation. We are also grateful to the Ministry of Public Health and Population of Central African Republic for allowing this study.

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