Acceptability Of Azithromycin Mass Treatment For Trachoma Elimination In Injibara Town And Adjacent Banja Woreda Of Awi Zone Amhara Region

Trachoma is the leading cause of infectious blindness worldwide. Globally 1.2 billion people livernin endemic areas. In Ethiopia, approximately 67 million people are at risk for trachoma. ThernAmhara National Regional State of Ethiopia is the most trachoma-endemic among all ninernregional states and two city administrations, with Trachomatous inflammation Follicularrnprevalence of 62.6%. Mass azithromycin treatment is the one arm of the SAFE strategy. Therntrachoma elimination program would be successful if and only if the coverage is as high asrnpossible with full community participation. If not all the community members attend the massrntreatment, the trachoma infection will return to the baseline prevalence after the treatmentrnstopped due to high transmission rate. The objective of this study was to assess the acceptabilityrnof the azithromycin mass treatment and its determinants in Injibara town and the adjacent Banjarnworeda of Awi zone, Amhara National Regional State. A community based cross sectionalrnsurvey with both quantitative and qualitative methods was conducted from July 7-25, 2013.rnHouseholds’ survey with structured questionnaire, FGDs and key informant interviews werernused for data collection. A total of 5826 eligible household members from 1267 households werernenrolled in the survey. The 2012 annual azithromycin mass treatment coverage obtained from thernpresent study was 92.9%. From the total 6 rounds of azithromycin mass treatment in the studyrnarea, only half (50.6%) of the community took for more than three times. On average, eachrnillegible person in the community had taken the drug for 3.6 times. The percentage of ruralrnhousehold members who had taken azithromycin more than three times was higher than therncorresponding urban members. The rural residents were at better performance in taking the 2012rntreatment as compared to the urban residents (AOR=2.35; 95%CI [1.80-3.06]). Household headsrninterference with the drug uptake of their family members’ has negative association withrnazithromycin uptake (AOR=0.153; CI=95% (0.086-0.272). All the study participants who werernXrngreater than 30 years more likely took azithromycin more than 3 times as compared withrnchildren less than 15 years (COR=2.81, AOR=2.74, 95% CI [1.95-3.02]). Azithromycin uptakernstatus of female household heads was less than the corresponding male household headsrn(AOR=0.41; 95% CI [0.24-0.720]). Household heads awareness about trachoma (AOR=2.55;rn95% CI [1.19-5.44]) and azithromycin mass treatment (AOR=7.19; 95% CI [3.27-15.82]) hadrnpositive association with acceptability. The 2012 azithromycin mass treatment coverage inrnInjibara town and Banja woreda was higher than the WHO minimum target. But, concerning tornthe overall coverage, the data taken from the present study contradicts the coverage data takenrnfrom the woreda. The communities’ Azithromycin mass treatment acceptability had increased inrnthe recent campaigns as compared to the previous campaigns. There is low coverage andrnacceptability of the treatment in the urban community as compared to the rural residents.rnSupplementary benefits of azithromycin, health education about trachoma and the drug,rnwillingness and being old are some of the factors positively related with acceptability whereasrneducational status, marital status and experience with side effects were not associated with therndrug uptake status. Strengthen the program in the urban and consideration of additionalrncampaigns for both areas as well as providing additional health education with skilled healthrnprofessionals is mandatory.rnKey words: Azithromycin mass treatment, Mass drug administration, Acceptability, Trachoma,rnTrachoma elimination

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