Participation in three consecutive mass drug administrations in Leogane, Haiti

Summary Objectives In the global effort to eliminate lymphatic filariasis, mass drug administrations (MDAs) are organised annually. The success of this strategy depends on achieving high levels of drug coverage, which reduce the number of persons with circulating microfilariae and consequently transmission. Persons who consistently fail to participate in MDAs represent a potential threat to the goal of filariasis elimination. We wanted to know the drug coverage, the proportion of persons who were systematically non‐compliant and factors associated with this behaviour. Methods We conducted three surveys following the third annual MDA of a filariasis elimination program in Leogane, Haiti: (1) a total population survey to determine coverage; (2) an adult survey to determine non‐compliance and associated factors and (3) an urban survey to make a rural–urban comparison. Results During the third MDA, the overall surveyed coverage was 78.5% [95% confidence interval (CI) 74.4–82.6] A survey among adult population showed coverage estimates for persons >14 years old of 59.4% (95% CI 52.0–66.7), 61.0% (95% CI 55.0–67.4) and 67.3% (95% CI 60.5–74.0), for the first, second and third MDA respectively. The coverage in rural areas (78.3%) was significantly higher than in urban areas (68.3%, P 14 years of age, 18% never took the drugs during any of three MDAs. These persons did not differ significantly from MDA participants by age, gender or other characteristics that we assessed. Conclusion More research is needed to identify characteristics of systematically non‐compliant persons in order to refine health education messages and improve distribution strategies to increase drug coverage. Objectifs Dans l'effort global d’élimination de la filariose lymphatique, des administrations massives de médicament ont été organisées annuellement. Le succès de cette stratégie dépend de l'atteinte d'un haut niveau de l’étendue de couverture médicamenteuse, ce qui réduira le nombre de personnes porteuses de microfilaires circulant et par conséquent réduira la transmission de la maladie. Les personnes qui ne participant pas à ces administrations massives de médicaments représentent une menace potentielle pour le but de l’élimination de la filariose. Nous avons voulu connaître l’étendue de la couverture médicamenteuse, la proportion de personnes systématiquement non compliantes et les facteurs associés au comportement de non compliance. Méthodes Nous avons