Individual adherence to mass drug administration in neglected tropical disease control: A probability model conditional on past behaviour.

Abstract:

:We present a general framework which describes the systematic (binary) scenario of individuals either taking treatment or not for any reason, over the course of mass drug administration (MDA)-which we refer to as 'adherence' and 'non-adherence'. The probability models developed can be informed by observed adherence behaviour as well as employed to explore how different patterns influence the impact of MDA programmes, by the use of mathematical models of transmission and control. We demonstrate the interpretative value of the developed probability model employing a dataset collected in the TUMIKIA project, a randomised trial of deworming strategies to control soil-transmitted helminths (STH) by MDA conducted in coastal Kenya. We stratify our analysis by age and sex, although the framework which we introduce here may be readily adapted to accommodate other stratifications. Our findings include the detection of specific patterns of non-adherence in all age groups to varying extents. This is particularly apparent in men of ages 30+. We then demonstrate the use of the probability model in stochastic individual-based simulations by running two example forecasts for the elimination of STH transmission employing MDA within the TUMIKIA trial setting with different adherence patterns. This suggested a substantial reduction in the probability of elimination (between 23-43%) when comparing observed adherence patterns with an assumption of independence, with important implications for programmes. The results here demonstrate the considerable impact and utility of considering non-adherence on the success of MDA programmes to control neglected tropical diseases (NTDs).

journal_name

PLoS Negl Trop Dis

authors

Hardwick RJ,Truscott JE,Oswald WE,Werkman M,Halliday KE,Pullan RL,Anderson RM

doi

10.1371/journal.pntd.0009112

subject

Has Abstract

pub_date

2021-01-22 00:00:00

pages

e0009112

issue

1

eissn

1935-2727

issn

1935-2735

pii

PNTD-D-20-01615

journal_volume

15

pub_type

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