@article{28637,
  keywords = {Trachoma, Mass drug administration, Children, Azithromycin},
  author = {Ssemanda E and Mkocha HA and Levens J and Munoz B and West S},
  title = {Community mass treatment with azithromycin for trachoma: Factors associated with change in participation of children from the first to the second round.},
  abstract = {<p><strong>BACKGROUND: </strong>Mass drug administration (MDA) with azithromycin is an important part of trachoma control programs. Maintaining high participation among children is challenging.</p>

<p><strong>AIM: </strong>We assessed factors identifying households with a child who changed participation from the first MDA to the second MDA compared to households where all children participated at both MDAs.</p>

<p><strong>METHODS: </strong>Two case-control comparisons were conducted in 11 Tanzanian communities, which underwent MDA in 2008 and 2009. The first case group (n=165) was a random sample of households with a child who changed from a 2008 non-participant to a 2009 participant (delayed participant). The second case group (n=165) was a random sample of households with a child who went from a 2008 participant to a 2009 non-participant (change to non-participant). Controls (n=330) were a random sample of households where all children participated in both rounds. Risk factors were assessed using questionnaires asked of children's guardians. Logistic models with a random-intercept were used to estimate odds ratios and 95% confidence intervals.</p>

<p><strong>RESULTS: </strong>Households with delayed participation were more likely to be in communities with fewer treatment days (OR=2.98, 95% CI=1.80-4.92) and assigned to Community Treatment Assistants (CTA) with a wide area to cover (OR=1.88, 95% CI=1.09-3.23). Households with change to non-participation were more likely to live further from the distribution site (OR=3.17, 95% CI=1.19-8.46), have the guardian born outside the village with short-term residency (OR=2.64, 95% CI=1.32-5.31), and be assigned to a male CTA (OR=1.75, 95% CI=1.08-2.83).</p>

<p><strong>CONCLUSIONS: </strong>Factors related to program accessibility were associated with delayed participation and maintaining participation.</p>
},
  year = {2015},
  journal = {Clinical epidemiology and global health},
  volume = {3},
  pages = {37-43},
  issn = {2452-0918},
  url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599782/pdf/nihms501849.pdf},
  doi = {10.1016/j.cegh.2013.06.001},
  language = {eng},
}