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Ivermectin distribution using community volunteers in Kabarole district, Uganda
W Kipp1, G Burnham, J Bamuhiiga
1Ministry of Health/German Agency for Technical Cooperation (GTZ) Fort Portal, Uganda.
Health Policy and Planning
|May 7, 1998
Summary
Mass distribution of ivermectin in Uganda significantly reduced community microfilarial load (CMFL) for onchocerciasis control. A community-based program achieved high treatment coverage and low costs.
Area of Science:
- Public Health
- Tropical Medicine
- Parasitology
Background:
- Onchocerciasis control in Uganda initiated mass ivermectin distribution in 1991.
- The Kabarole district program targeted 32,000 infected and 110,000 at-risk individuals.
Purpose of the Study:
- To describe a community-based ivermectin distribution program for onchocerciasis control.
- To evaluate the impact of mass drug administration on community microfilarial load (CMFL).
Main Methods:
- Community volunteers conducted annual ivermectin distribution, supervised by medical assistants.
- Nodule prevalence surveys identified high-risk villages, and skin snips measured CMFL.
- A social marketing component supported distributors through condom sales.
Main Results:
- CMFL reductions ranged from 40-62% after two treatments and 69-84% after four treatments.
- After four years, 85% of eligible individuals received ivermectin annually.
- Volunteer dropout rates were below 20%, and direct treatment cost was $0.29 per person.
Conclusions:
- Community-based ivermectin distribution is effective in reducing CMFL for onchocerciasis control.
- Integration into district health structures and strong supervision contributed to program success and cost-effectiveness.
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