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Risk factors for Lymphatic Filariasis and Mass Drug Administration non-Participation in Mandalay Region, Myanmar
- Source :
- Parasites & Vectors, Parasites & Vectors, Vol 14, Iss 1, Pp 1-14 (2021)
- Publication Year :
- 2020
- Publisher :
- Research Square Platform LLC, 2020.
-
Abstract
- Background Myanmar commenced a lymphatic filariasis (LF) elimination programme in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere; however, there remains little information on the factors that contribute in Myanmar. Methods We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and, if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and, if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for non-participation (never taking MDA). Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results After adjustment for covariates and survey design, being CFA positive was significantly associated with age [odds ratio (OR) 1.03, 95% CI 1.01–1.06), per year], male gender (OR 3.14, 1.27–7.76), elevation (OR 0.96, 0.94–0.99, per metre) and the density of people per household room (OR 1.59, 1.31–1.92). LF-related hydrocoele was associated with age (OR 1.06, 1.03–1.09, per year) and residing in Amarapura Township (OR 8.93, 1.37–58.32). Never taking MDA was associated with male gender [OR 6.89 (2.13–22.28)] and age, particularly in females, with a significant interaction term. Overall, compared to those aged 30–44 years, the proportion never taking MDA was higher in all age groups (OR highest in those 60 years, ranging from 3.37 to 12.82). Never taking MDA was also associated with residing in Amarapura township (OR 2.48, 1.15–5.31), moving to one’s current village from another (OR 2.62, 1.12–6.11) and ever having declined medication (OR 11.82, 4.25–32.91). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.16, 0.03–0.74) and the number visits by the MDA programme (OR 0.69, 0.48–1.00). Conclusions These results contribute to the understanding of LF and MDA participation-related risk factors and will assist Myanmar to improve its elimination and morbidity management programmes. Graphical Abstract
- Subjects :
- Male
Myanmar
Logistic regression
0302 clinical medicine
Risk Factors
Surveys and Questionnaires
Prevalence
030212 general & internal medicine
Child
Lymphatic filariasis
Aged, 80 and over
Univariate analysis
Family Characteristics
Hydrocoele
Participation
Middle Aged
Infectious Diseases
Mass drug administration
Child, Preschool
Female
Infection
Compliance
Adult
medicine.medical_specialty
Asia
Coverage
Adolescent
030231 tropical medicine
Biology
Microfilaria
Filariasis
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Young Adult
Elephantiasis, Filarial
medicine
Humans
lcsh:RC109-216
Disease Eradication
Aged
Research
Community Participation
Infant, Newborn
Infant
Odds ratio
medicine.disease
Cross-Sectional Studies
Filaricides
Tropical medicine
Parasitology
Demography
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Parasites & Vectors, Parasites & Vectors, Vol 14, Iss 1, Pp 1-14 (2021)
- Accession number :
- edsair.doi.dedup.....a1aa8e6677c9e70ce2587b4667bf3fb9