Non-compliance Factors and Side Effects of Ivermectin in a Community Directed Treatment of Onchocerciasis in a Rainforest Focus of Nigeria

Abstract

Community directed ivermectin distribution was carried out in Jago Village around Asejire dam, Oyo State, Nigeria in 2004. Jago is a mesoendemic rainforest focus of onchocerciasis. A total of 550 residents including 50 distributors were randomly selected and mobilized. The community designed the method of delivery of the drug and test subjects were left to decide whether or not to come for the 3-day ivermectin distribution. Non-compliance to ivermectin was described as voluntary rejection of the drug which is failure to turn up within the 3 days. Non compliers were 135 (24.5%), subject, 108 (19.6%) were women and 18 (3.3%) were pregnant. Religious occupational and health reasons were given as reasons for non-compliers. Post treatment reporting indicated that 308 (74.2%) felt better after the treatment and mild itching with rashes was the most reported side effect. There were no significant differences between non-pregnant and pregnant women in terms of side effect but differences between males and females differed significantly in terms of non-compliance and effects of ivermectin. Side effects were mild showing that the community was not also endemic for Loa loa.. Intense targeted health education campaigns involving psychosocial counseling directed specially at women should be taken as a priority before mass drug distribution, for high degree of compliance.

Keywords: Onchocerciasis, Ivermectin, Non-Compliance.

Nigerian Journal of Health and Biomedical Sciences Vol. 6 (2) 2007: pp. 4-8