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

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

Affiliations

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

Rosie Maddren et al. PLoS Negl Trop Dis. .

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).

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Conflict of interest statement

The authors declare no completing interests.

Figures

Fig 1
Fig 1. Decision tree of MDA treatment behaviour, showing the three behavioural decision points of MDA delivery and their definitions, according to these previously defined parameters by Shuford et al. (2016) [8].
Abbreviations: CDD–community drug distributor.
Fig 2
Fig 2. Choropleth map of studies published globally from 2016 to 2022 (Papers).
Countries where no papers were published are shown in grey. Four studies are represented as 11 datapoints where studies reported data for more than one country, totalling 96 datapoints from 89 studies. (LF, OV, STH, SCH, Trachoma) Maps showing total population of each country requiring treatment for each of the five (PC)-NTDs. Note: STH map shows total preSAC and SAC population only requiring treatment. All maps have been focused to latitude less than 50 degrees. Data taken from WHO global observatory PCT databank [28]. Abbreviations: LF–lymphatic filariasis, OV–Onchocerciasis, SCH–schistosomiasis, STH–soil-transmitted helminths. Map data acquired from the open source tidyverse package using the map_data() function [29].
Fig 3
Fig 3. The variety of parameters used to describe cross-sectional and longitudinal compliance.
The display shows the most frequently used parameters both correctly and incorrectly used to describe compliance. The frequency of parameter definition is proportional to circle size. Compliance is used most frequently to describe longitudinal compliance (n = 8), whereas treatment coverage was most frequently used to describe cross-sectional compliance (n = 4). The number of circles represent the number of parameters employed to define compliance. Figure hand-drawn by authors.
Fig 4
Fig 4
The difference between coverage and compliance figures reported by 21 studies as either proportions (A), raw data (B) or other parameters (C). Datapoints are coloured by the study type, either cross-sectional (13 studies, 69 datapoints) or longitudinal (8 studies, 104 datapoints). An average trendline of the reported data is shown in solid grey. The shaded line represents the conditional mean function using a linear model calculated by geom_smooth within the ggplot2 R package [21]. A guideline through intercept = 0 is shown to highlight the discrepancy between the two parameters.

References

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