Significant gap between point participation and long‑term treatment adherence: an evaluation of ivermectin mass drug administration in the Kwanware‑Ottou persistent onchocerciasis transmission focus, Wenchi, Ghana
Summary
Onchocerciasis transmission persists in Ghana’s Kwanware Ottou area despite nearly 30 years of ivermectin mass drug administration (MDA). Using satellite imagery and community consultation, this study identified 19 settlements and assessed both recent and long-term treatment participation. Although 80% of people reported taking ivermectin in the last round, only about half had participated in at least 10 rounds – considered ‘effective participation’. Mobile groups and remote communities were most often missed. The study highlights that high single-round coverage can conceal major long-term participation gaps that impede elimination. The authors recommend monitoring both point coverage and effective participation in areas with inadequate coverage or ongoing transmission.