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Healthy Skepticism Library item: 2073

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Nuwaha F, Okware J, Ndyomugyenyi R.
Predictors of compliance with community-directed ivermectin treatment in Uganda: quantitative results.
Trop Med Int Health 2005 Jul; 10:(7):659-67
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-3156.2005.01436.x?cookieSet=1


Abstract:

In order to identify the factors influencing compliance with mass ivermectin treatment for onchocerciasis control, a cross-sectional study was carried out in Bushenyi District, Uganda. Data were collected by interviewing 839 individuals who were randomly selected from 30 clusters where onchocerciasis is endemic. Information was collected on compliance with ivermectin treatment, socio-demographic characteristics, perception of personal susceptibility to onchocerciasis, knowledge about cause/transmission of onchocerciasis, knowledge of signs and symptoms of onchocerciasis, treatment of onchocerciasis, benefits and dangers of taking ivermectin, organization of distribution of ivermectin, work and selections of community drug distributors (CDDs), social influence and support to take ivermectin and on barriers and supports towards compliance with ivermectin treatment. The major factors favouring compliance were: perceiving CDDs as doing their work well, believing that measuring height is the best way to determine one’s dose of ivermectin, having social support from one’s family, saying that ivermectin treatment costs nothing, perceiving personal risk of onchocerciasis, believing that ivermectin prevents onchocerciasis and perceiving radios as supporting treatment with ivermectin. The strongest predictor of compliance with ivermectin treatment is perceiving CDDs as doing their work well with adjusted odds ratios of 5.54 (95% CI: 3.19-9.62). In order to improve compliance with ivermectin treatment, CDDs need to be well-facilitated and ivermectin distribution should be free. Health education is necessary so that people perceive themselves to be at risk of onchocerciasis and to understand the rationale of using height for dose determination. The health education should target the family and use radios.

Keywords:
MeSH Terms: Adult Anthelmintics/administration & dosage Anthelmintics/therapeutic use* Attitude to Health Body Height Community Health Services/methods Cross-Sectional Studies Drug Administration Schedule Endemic Diseases Female Health Knowledge, Attitudes, Practice Humans Ivermectin/administration & dosage Ivermectin/therapeutic use* Male Onchocerciasis/drug therapy* Onchocerciasis/epidemiology Onchocerciasis/prevention & control Patient Compliance* Research Support, Non-U.S. Gov't Social Support Socioeconomic Factors Uganda/epidemiology Substances: Anthelmintics Ivermectin

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963