Factors associated with non-compliance in community directed treatment with ivermectin for onchocerciasis control in Rungwe district, South West Tanzania

A descriptive cross-sectional study was udertaken in Rungwe district, South West Tanzania during May - June 2002. The main objective was to determine the factors associated with non-compliance in community directed treatment with ivermectin for the control of onchocerciasis in Rungwe district. A total of 212 individuals aged 15-70 years above were interviewed. Information on factors associated with non-compliance was obtained using a three-step approach involving structured interviews, focus group discussions and in - depth interviews with key informants. The results showed that the respondents were aware of onchocerciasis (66%) but knowledge on the causes was low (29.3%). Similarly, knowledge on symptoms and signs of onchocerciasis was low. Furthermore, only 35.4% knew the side effects of ivermectin and of those 84% could mention 3-4 related side effects. Awareness of the programme and the drug used was high (75.9 and 88.4% respectively). However, knowledge on other programme activities was generally lacking. The concern of ivermectin side effects as one of the factors influencing compliance was expressed. However, 50% of the respondents did not believe it would affect taking the drug in the next treatment cycle. Other factors identified to be affecting programme implementation and associated with non-compliance were local beliefs and the lifestyle of alcoholism existing within the communities. The findings provide guidance for the National Onchocerciasis Control Programme on the importance of improving health education, strengthening during treatment, regular sensitization meetings and improvement of mobilization during treatment. Appropriate recommendations have been made. However, further studies have to be conducted to document local beliefs and test their association with compliance.