Compliance to a Five-Year Biannual Ivermectin Treatment for Onchocerciasis Elimination and Its Determinants among Adults in the Bench Maji Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study

Abstract

Background. Community-directed treatment with ivermectin twice a year is a major action to control onchocerciasis in endemic countries. Even though the community-directed treatment with ivermectin was proven effective in treating the disease, the level of compliance to the treatment and its contributing factors was not well addressed in our study area. Therefore, the current study was aimed at determining the magnitude of compliance with the five-year (2013-2017 years) biannual ivermectin treatment and its associated factors among adults living in the Bench Maji Zone, Ethiopia. Methods. A community-based cross-sectional study was done on 572 randomly selected people aged greater than or equal to 15 years. Data were collected by a face-to-face interview. Descriptive statistics were used to summarize descriptive data. Binary logistic regression was done to assess statistical associations. Adjusted odds ratio and its 95% CI were, respectively, used to measure the strength of statistical association and its significance. Result. Five hundred fifty-three (553) people had participated in the study making the response rate 96.7%. The overall magnitude of compliance to the five-year biannual ivermectin treatment was 361 (65.3%). The results of the multivariable logistic regression showed that age, positive attitude towards community drug distributers’ performance, positive attitude towards height measurement for the treatment dose determination, and involvement in community-directed treatment with ivermectin were independently associated with compliance to ivermectin treatment at $P$ value < 0.05. Conclusions. Even though the Ethiopian government has set a goal to eliminate onchocerciasis through community-directed treatment with the ivermectin, which is proven effective in treating the disease, the magnitude of compliance with the treatment among adults aged ≥15 years in the Semen Bench District is still unacceptably low. The Bench Maji Zonal Health Department and other stakeholders working on onchocerciasis prevention, control, and elimination should give due emphasis to behavioral change communication through community-based education and other social media to promote community’s awareness on community-directed treatment with ivermectin giving due focus to adults aged 45 years and above.