Engage and Treat and Test and Treat Strategies to Improve Mass Drug Administration for Lymphatic Filariasis: Insights from Healthcare Workers, Community Drug Distributors, and Community Members in the Ellembelle District of Ghana
Nii Arku Laryea*, Dziedzom K de Souza and Collins Stephen Ahorlu
ABSTRACT
Introduction: Lymphatic filariasis (LF) is one of the neglected tropical diseases (NTDs) targeted for elimination by the World Health Organization (WHO) as a public health concern. Mass drug administration is a universally accepted strategy for the prevention of LF. The study evaluated (“Engage and Treat" (E&T) and "Test and Treat" (T&T) strategies) the process of providing treatment to community members who missed treatment during the initial Mass Drug Administration (MDA) for lymphatic filariasis in the Ellembelle District of Ghana. It aimed at understanding the effectiveness and challenges of delivering treatment to defaulters through follow-up interventions.
Method: Using a mixed-methods approach, we conducted semi-structured interviews with 12 healthcare workers, 11 community drug distributors, and 100 community members. The methodology allowed for a comprehensive exploration of experiences related to treating those who missed MDA. Thematic analysis was performed using the 2020 version of the MAXQDA software.
Result: Data analysis revealed the effectiveness of Engage & Treat and Test & Treat in improving treatment acceptance, addressing misconceptions, and building community trust. Key findings include the role of testing in alleviating treatment fears, the importance of personalized engagement in increasing uptake, and the critical influence of community leaders and health worker training on Mass Drug Administration success. Challenges such as logistical constraints and mistrust highlight the need for targeted strategies. Testing for Lymphatic Filariasis before offering the drugs has influenced the decision to take the drug, regardless of infection status. Education and community involvement emerged as key elements in breaking lymphatic filariasis transmission.
Discussion: These findings underscore the importance of clear communication and correcting misunderstandings about Mass Drug Administration. The value of strategic tools for communication to persuade hesitant individuals in addition to testing before treating, regardless of infection status, has empowered health workers to undertake effective community engagement to enhance Mass Drug Administration acceptance among defaulters. This study underscores the necessity for continual evaluation and adaptation of innovative ways of delivering Mass Drug Administration.
