Individual longitudinal compliance to neglected tropical disease mass drug administration programmes, a systematic review

PLoS Negl Trop Dis. 2023 Jul 17;17(7):e0010853. doi: 10.1371/journal.pntd.0010853. eCollection 2023 Jul.

Abstract

Repeated distribution of preventative chemotherapy (PC) by mass drug administration forms the mainstay of transmission control for five of the 20 recognised neglected tropical diseases (NTDs); soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. The efficiency of such programmes is reliant upon participants swallowing the offered treatment consistently at each round. This is measured by compliance, defined as the proportion of eligible participants swallowing treatment. Individually linked longitudinal compliance data is important for assessing the potential impact of MDA-based control programmes, yet this accurate monitoring is rarely implemented in those for NTDs. Longitudinal compliance data reported by control programmes globally for the five (PC)-NTDs since 2016 is examined, focusing on key associations of compliance with age and gender. PubMed and Web of Science was searched in January 2022 for articles written in English and Spanish, and the subsequent extraction adhered to PRISMA guidelines. Study title screening was aided by Rayyan, a machine learning software package. Studies were considered for inclusion if primary compliance data was recorded for more than one time point, in a population larger than 100 participants. All data analysis was conducted in R. A total of 89 studies were identified containing compliance data, 57 were longitudinal studies, of which 25 reported individually linked data reported by varying methods. The association of increasing age with the degree of systematic treatment was commonly reported. The review is limited by the paucity of data published on this topic. The varying and overlapping terminologies used to describe coverage (receiving treatment) and compliance (swallowing treatment) is reviewed. Consequently, it is recommended that WHO considers clearly defining the terms for coverage, compliance, and longitudinal compliance which are currently contradictory across their NTD treatment guidelines. This review is registered with PROSPERO (number: CRD42022301991).

Publication types

  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Helminths*
  • Humans
  • Mass Drug Administration
  • Neglected Diseases / drug therapy
  • Neglected Diseases / epidemiology
  • Neglected Diseases / prevention & control
  • Onchocerciasis* / drug therapy
  • Schistosomiasis* / drug therapy
  • Schistosomiasis* / epidemiology
  • Schistosomiasis* / prevention & control
  • Tropical Medicine*

Grants and funding

This research was funded by the Children’s Investment Fund Foundation (CIFF), UK through a grant to Ethiopian Public Health Institute, Ethiopia under grant number R-1805-02741. The funders had no role in the design of the study, collection, analysis and interpretation of the data. The finding and conclusion of the study reflect the view of the authors only.