Date of Award

Fall 12-20-2012

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Christine Stauber

Second Advisor

Dr. Els Mathieu

Abstract

Health education and preventive chemotherapy are main strategies to control or eliminate neglected tropical diseases (NTDs) such as lymphatic filariasis (LF), trachoma, onchocerciasis, schistosomiasis (SCH), and soil-transmitted helminthiasis (STH). Integrated MDA for LF, onchocerciasis, SCH, STH, and trachoma were organized in the Koza district of Cameroon from July to August 2011. Ivermectin (IVM) and albendazole (ALB) were distributed for LF to the entire population except pregnant or lactating women, children <90 cm in height, and the severely ill. Azithromycin was distributed at least one week after the LF MDA to all persons older than 6 months of age. Praziquantel (PZQ), targeting school age children (SAC), was only distributed in schools. In order to validate reported coverage and assess the knowledge and attitude of the population towards NTDs and MDAs, an independent coverage and Knowledge, Attitudes, and Practice (KAP) survey was administered. The WHO recommended population based 30-cluster coverage survey was implemented. Clusters were selected by Probability Proportional to Estimated Size and in each cluster, 10 houses were selected using the improved expanded program on immunization random walk. Coverage questions were administered by trained interviewers to each person living in selected houses and KAP questions were asked to a randomly selected adult in the house. A total of 1301 persons participated in the coverage survey and 149 adults answered the KAP questions. The survey coverage estimates for IVM /ALB and azithromycin are 76.9% (95% CI 72.0-81.9), 86.8% (95% CI 80.9-92.7), respectively, while the reported coverage is 80.3% and 93%, respectively. The survey coverage estimated for PZQ among SAC is 39.9% (95% CI 30.7-49.1), reported coverage is unknown. There was no significant association between participation in the MDA and age, gender, or knowing the disease. SAC who attended school were 269 times as likely to have taken PZQ and 3 times as likely to have taken LF drugs as SAC not attending school. Less than 50% of respondents had heard of LF and only 31.8% could mention at least one LF symptom. More than 70% of respondents had heard of STH, SCH, and trachoma, but only 52.3%, 40%, 30%, respectively, knew at least one way to prevent or treat STH, SCH, and trachoma. Despite low or incorrect knowledge of LF, SCH, STH, and trachoma, overall, MDA coverage was good except for the PZQ which was only distributed in school.

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