Predictors of Acceptance and Barriers to the Uptake of Mass Drug Administration Program for Eliminating Trachoma in Taura District, Jigawa State Nigeria: A Mixed Methods Study

Aim: To identify predictors and barriers to antibiotics acceptance during mass drug administration (MDA) for trachoma in Taura Local Government Area of Jigawa state Nigeria, which is one of the trachoma-endemic districts with repeated reports of low coverage rates.

Methods: A mixed-method cross-sectional survey was carried out. A survey questionnaire on attitude, belief, and practice associated with the acceptance of MDA for trachoma was administered to a cross- section of 1502 persons from 202 randomly selected households of 30 clusters. In addition, four key informant interviews (KII) and three Focus Group Discussions (FGD) were conducted to explore barriers to the acceptance of antibiotics during mass treatment. Quantitative data were analyzed using STATA version 14.0, while the qualitative data were analyzed using thematic framework.

Results: Predictors of antibiotics acceptance were older age [adjusted odds ratio (AOR) = 1.84], higher educational qualification (AOR = 2.64), perception of being at risk of disease, perception of additional benefits of the drug, and household participation in the previous MDA. Major reasons for non-acceptance were previous personal experience of side effects (32%), fear of side effects (23%), and participants’ belief that they were not suffering from any illness (16%). Major barriers were low felt need, effect of rumor, fears of side effects, and unsuitable timing of distribution. Provider-related barriers were poor motivation of community drug distributors (CDDs) and lack of pre-distribution awareness campaigns.

Conclusion: If MDA programs are to succeed, consideration must be made for a pre-distribution community awareness campaign, on-the-spot consumption strategy, appropriate timing, and motivation of CDDs.