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Challenges in the implementation of mass drug administration programs with ivermectin for the control and elimination
Kenny Geomor1, Kathrin Bogensberger2,3,4, Antje van der Zee-Neuen2,3,4,5
1Center for Public Health and Healthcare Research, Master Programme Public Health, Paracelsus Medical University, Salzburg, Austria.
Objective:
The aim of the scoping review is to elucidate challenges in mass drug administration programs with ivermectin to control or eliminate onchocerciasis in endemic countries.
Introduction:
The filarial nematode Onchocerca volvulus causes onchocerciasis, a neglected tropical disease that can lead to blindness. Although ivermectin, a potent antifilarial drug, was introduced in 1991 and has been used successfully in mass drug administration programs, complex challenges have prevented the elimination of onchocerciasis, a goal set by the World Health Organization in 2009. A comprehensive understanding of these challenges could help program managers and policymakers better target their efforts to control and eliminate onchocerciasis.
Eligibility Criteria:
This review will consider literature that includes individuals affected by onchocerciasis who are living in endemic countries. Literature describing the challenges of implementing mass drug administration programs with ivermectin to control or eliminate onchocerciasis will be considered.
Methods:
The review will be conducted according to the JBI methodology for scoping reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). MEDLINE (Ovid), Web of Science Core Collection, CINAHL (EBSCOhost), Cochrane Central Register of Controlled Trials (CENTRAL), Emcare (Ovid), Embase (Ovid), Scopus, and SciELO will be searched. Primary and gray literature in any language from January 1991 onward will be included. Additional studies will be identified by screening the reference lists of included articles. Study selection and data extraction will be done independently by 2 reviewers. Data will be analyzed descriptively and presented in tables, graphs, and narrative format.
Review Registration:
OSF https://osf.io/e2q49.
Insights
This scoping review identifies challenges in mass drug administration (MDA) programs using ivermectin to combat onchocerciasis. Understanding these obstacles is crucial for controlling and eliminating this blinding neglected tropical disease.
Area of Science:
- Public Health
- Infectious Diseases
- Tropical Medicine
Background:
- Onchocerciasis, caused by the filarial nematode Onchocerca volvulus, is a neglected tropical disease leading to blindness.
- Ivermectin, introduced in 1991, is a key drug in mass drug administration (MDA) programs for onchocerciasis control.
- Despite MDA efforts, complex challenges hinder the elimination of onchocerciasis, a World Health Organization goal.
Purpose of the Study:
- To conduct a scoping review elucidating the multifaceted challenges encountered in mass drug administration programs utilizing ivermectin for onchocerciasis control and elimination.
- To provide a comprehensive understanding of these challenges to inform program managers and policymakers for more effective intervention strategies.
- To support global efforts in controlling and potentially eliminating onchocerciasis in endemic regions.
Main Methods:
- The review adheres to JBI methodology for scoping reviews and PRISMA-ScR reporting guidelines.
- A systematic search of multiple databases (MEDLINE, Web of Science, CINAHL, CENTRAL, Emcare, Embase, Scopus, SciELO) will be performed.
- Inclusion of primary and gray literature in any language from January 1991 onwards, with independent data extraction and descriptive analysis.
Main Results:
- This section will present a descriptive analysis of the identified challenges in ivermectin-based MDA programs for onchocerciasis.
- Results will be synthesized and presented through tables, graphs, and narrative summaries.
- Key themes and patterns of challenges will be highlighted to provide actionable insights.
Conclusions:
- A thorough understanding of the challenges in ivermectin MDA programs is essential for achieving onchocerciasis control and elimination goals.
- This review will identify critical barriers, informing targeted interventions and resource allocation.
- Findings aim to guide public health strategies and policy decisions for neglected tropical diseases.
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