Predictors of compliance in mass drug administration for the treatment and prevention of lymphatic filariasis in Leogane, Haiti

The global strategy for the elimination of lymphatic filariasis (LF) is based on annual mass drug administration (MDA) to interrupt transmission. Noncompliance with MDA represents a serious programmatic obstacle for the LF program because systematically noncompliant individuals may serve as a reservoir for the parasite and permit recrudescence of infection. Using a survey questionnaire concerning practices, beliefs, and attitudes towards MDA, we assessed differences between noncompliant individuals and compliant individuals in Leogane, Haiti (n = 367) after four years of treatment. A logistic regression model showed the odds of being noncompliant were significantly increased for women (odds ratio = 2.74, 95% confidence interval = 1.12-6.70), as well as for people who lacked knowledge about both LF and programs to eliminate infection. Public health programs should be designed to target people who are at risk for systematic noncompliance.