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Population coverage and factors associated with participation following a mass drug administration of azithromycin for trachoma elimination in Amhara, Ethiopia
Author(s) -
Ebert Caleb D.,
Astale Tigist,
Sata Eshetu,
Zerihun Mulat,
Nute Andrew W.,
Stewart Aisha E. P.,
Gessese Demelash,
Ayenew Gedefaw,
Ayele Zebene,
Melak Berhanu,
Chanyalew Melsew,
Gashaw Bizuayehu,
Tadesse Zerihun,
Callahan E. Kelly,
Jenness Samuel M.,
Nash Scott D.
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13208
Subject(s) - trachoma , azithromycin , mass drug administration , medicine , logistic regression , environmental health , public health , population , odds ratio , demography , confidence interval , biology , nursing , pathology , sociology , microbiology and biotechnology , antibiotics
Summary Objectives Mass drug administration (MDA) with azithromycin is a core component of the WHO‐recommended strategy to eliminate trachoma as a public health problem, but low participation rates in MDA campaigns may undermine the effectiveness of this intervention. We explored factors associated with individual MDA participation at the individual, head of household and household levels in Amhara, Ethiopia. Methods We conducted four district‐level, multilevel cluster random coverage surveys to collect data on self‐reported MDA participation and predictors. Random‐effects logistic regression modelling was used to identify correlates of MDA participation while adjusting for nesting of individuals at the household and village level. Results The district‐level self‐reported participation in the trachoma MDA ranged from 78.5% to 86.9%. Excellent and fair health status (Odds ratio [OR] = 5.77; 95% Confidence interval [CI]: 3.04, 10.95; OR = 7.08; 95% CI: 3.47, 14.46), advanced knowledge of the MDA campaign (OR = 2.93; 95% CI: 2.04, 4.21) and knowledge of trachoma (OR = 1.60; 95% CI: 1.17, 2.19) were all positively associated with MDA participation. When excluding heads of household from the model, correlates retained similar positive associations to participation, in addition to the head of household participation (OR = 3.34; 95% CI: 2.46, 4.54). Conclusions To increase the impact of MDA campaigns, MDA mobilisation strategies—including comprehensive trachoma and azithromycin messaging and MDA campaign awareness—should target heads of household, those in poorer health and older age groups.