Determinants of uptake of praziquantel, chemotherapy for schistosomiasis treatment during mass drug administration in Busia County, Kenya.

Abstract

Background: Schistosomiasis is a life-threatening parasitic disease that affects nearly 250 million people worldwide, and over 780 million people are at risk of infection globally. Sub-Saharan Africa bears the highest burden, accounting for approximately 280,000 deaths annually. In Kenya, over 17.6 million people are at risk, and approximately 10 million are infected. Busia County, an endemic region, has a prevalence of 17.6%. In past MDAs, the County recorded a praziquantel coverage level of 64.11%, below the WHO-recommended threshold of over 75%. This study aimed to identify the determinants of PZQ uptake during MDA for schistosomiasis treatment in Busia County, Kenya.

Methods: An analytical, cross-sectional study was conducted among individuals aged ≥ 10 years who met the inclusion criteria. Multistage sampling was used to sample the study site. The study had a sample size of 660 participants. Quantitative data were collected through structured questionnaires that captured sociodemographic characteristics, knowledge, drug perceptions, and self-reported PZQ uptake. STATA software version 17.0 was used to analyze the data. Ethical clearance was obtained from the KU Scientific and Ethical Review Unit.

Results: Data were collected from 613 study participants, corresponding to a response rate of 92.9%. Of the 613 study participants, the majority (53.7%, n = 325) were females. The coverage of PZQ uptake was 62%. Overall, 55.5% demonstrated a high level of knowledge of schistosomiasis. Community sensitization before the MDA was statistically significant predictor of PZQ uptake. Participants who had received sensitization were 41 times more likely to take the medicine compared with those who had not (AOR = 41.65; 95% CI: 12.34-138.3; p < 0.001).

Conclusion: The findings indicate that PZQ uptake was below the WHO-recommended level. Effective community sensitization prior to MDA is a critical determinant of improving PZQ coverage and schistosomiasis MDA. Community sensitization should be enhanced to address individual drug-related perceptions in the target community, which leads to better MDA outcomes.