Factors associated with low-uptake of ivermectin in Mahenge, an area with high prevalence of onchocerciasis and epilepsy in Tanzania: A qualitative perspective

Introduction Despite over 20 years of community-directed treatment with ivermectin (CDTI) in Mahenge area Tanzania, the prevalence onchocerciasis has remained high (over 40% children 6-10 using antibody testing and 49% skinsnips adults). The one highest epilepsy, exceeding 3.5% some rural villages. Methods Between June July 2019, four villages qualitative methods, we assessed factors potentially associated persistence Onchocerca volvulus transmission. Results Eleven focus group discussions were organized persons epilepsy their caretakers, community resource persons, drug distributors (CDDs), two in-depth interviews district programme coordinators neglected tropical diseases (NTD). Factors considered being responsible for transmission included not taking during CDTI fear adverse reactions such as itching, swelling misconception that causes infertility. Challenges coverage included, long walking distance by CDDs to deliver drugs households, away farming, low awareness disease including association between limited supervision NTD coordinators. Conclusion Ivermectin uptake should be optimised continuous advocacy about importance prevent onchocerciasisassociated morbidity improving CDTI.