Improved assessment of mass drug administration and health district management performance to eliminate lymphatic filariasis



Maroto-Camino, Carmen, Hernandez-Pastor, Pilar, Awaca, Naomi, Safari, Lebon, Hemingway, Janet, Massangaie, Marilia, Whitson, Donald, Jeffery, Caroline ORCID: 0000-0002-8023-0708 and Valadez, Joseph J ORCID: 0000-0002-6575-6592
(2019) Improved assessment of mass drug administration and health district management performance to eliminate lymphatic filariasis. PLOS NEGLECTED TROPICAL DISEASES, 13 (7). e0007337-.

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Abstract

Lymphatic filariasis (LF) elimination as a public health problem requires the interruption of transmission by administration of preventive mass drug administration (MDA) to the eligible population living in endemic districts. Suboptimal MDA coverage leads to persistent parasite transmission with consequential infection, disease and disability, and the need for continuing MDA rounds, requiring considerable investment. Routine coverage reports must be verified in each MDA implementation unit (IU) due to incorrect denominators and numerators used to calculate coverage estimates with administrative data. IU are usually the health districts. Coverage is verified so IU teams can evaluate their outreach and take appropriate action to improve performance. Mozambique and the Democratic Republic of Congo (DRC) have conducted MDA campaigns for LF since 2009 and 2014, respectively. To verify district reports and assess the declared achievement using administrative data of the minimum 80% coverage of eligible people (or 65% of the total population), both countries conducted rapid probability surveys using Lot Quality Assurance Sampling (LQAS)(n = 1102) in 2015 and 2016 in 58 IU in 49 districts. The surveys identified IU with suboptimal coverage, reasons residents did not take the medication, place where the medication was received, information sources, and knowledge about diseases prevented by the MDA. LQAS identified four inadequately covered IU triggering district team performance reviews with provincial and national teams and district retreatment. Provincial estimates using probability samples (weighted by populations sizes) were 10 and 17 percentage points lower than reported coverage in DRC and Mozambique. The surveys identified: absence from home during annual MDA rounds as the main reason for low performance and provided valuable information about pre-campaign and campaign activities resulting in improved strategies and continued progress towards elimination of LF and co-endemic Neglected Tropical Diseases.

Item Type: Article
Uncontrolled Keywords: Animals, Humans, Wuchereria bancrofti, Elephantiasis, Filarial, Filaricides, Public Health, Endemic Diseases, Quality Assurance, Health Care, Democratic Republic of the Congo, Mozambique, Neglected Diseases, Disease Eradication, Mass Drug Administration, Outcome and Process Assessment, Health Care
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 08 Sep 2023 09:23
Last Modified: 08 Sep 2023 09:53
DOI: 10.1371/journal.pntd.0007337
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3172624