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BACKGROUND: The most prevalent neglected tropical diseases are treated through blanket drug distribution that is reliant on lay community medicine distributors (CMDs). Yet, treatment rates achieved by CMDs vary widely and it is not known which CMDs treat the most people. METHODS: In Mayuge District, Uganda, we tracked 6779 individuals (aged 1+ years) in 1238 households across 31 villages. Routine, community-based mass drug administration (MDA) was implemented for schistosomiasis, lymphatic filariasis, and soil-transmitted helminths. For each CMD, the percentage of eligible individuals treated (offered and ingested medicines) with at least one drug of praziquantel, albendazole, or ivermectin was examined. CMD attributes (more than 25) were measured, ranging from altruistic tendencies to socioeconomic characteristics to MDA-specific variables. The predictors of treatment rates achieved by CMDs were selected with least absolute shrinkage and selection operators and then analyzed in ordinary least squares regression with standard errors clustered by village. The influences of participant compliance and the ordering of drugs offered also were examined for the treatment rates achieved by CMDs. RESULTS: Overall, only 44.89% (3043/6779) of eligible individuals were treated with at least one drug. Treatment rates varied amongst CMDs from 0% to 84.25%. Treatment rate increases were associated (p value

Original publication

DOI

10.1186/s12916-019-1303-z

Type

Journal article

Journal

BMC Med

Publication Date

28/03/2019

Volume

17

Keywords

Albendazole, Compliance, Coverage, Ivermectin, Lymphatic filariasis, Mass drug administration, Praziquantel, Schistosomiasis, Soil-transmitted helminths, Sub-Saharan Africa, Adolescent, Adult, Aged, Aged, 80 and over, Animals, Antiparasitic Agents, Child, Child, Preschool, Community Medicine, Delivery of Health Care, Efficiency, Organizational, Elephantiasis, Filarial, Female, Helminthiasis, Humans, Infant, Male, Mass Drug Administration, Middle Aged, Prevalence, Schistosomiasis, Soil, Uganda, Work Performance, Young Adult