Acceptability of azithromycin for the control of trachoma in Northern Tanzania

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 99; no. 9; pp. 656 - 663
• Main Authors: Desmond, Nicola, Solomon, Anthony W., Massae, Patrick A., Lema, Ndeeshi, Anemona, Alessandra, Foster, Allen, Mabey, David C.W.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.09.2005; Royal Society of Tropical Medicine and Hygiene; Elsevier
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Attitude to Health; Azithromycin; Azithromycin - therapeutic use; Bacterial diseases; Bacterial diseases of the eye and orbit; Biological and medical sciences; Blindness - prevention & control; Chlamydia trachomatis; Drug acceptability; Female; General aspects; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Patient Acceptance of Health Care; Surveys and Questionnaires; Tanzania; Trachoma; Trachoma - complications; Trachoma - drug therapy; Trachoma - psychology; Africa; Tanzania; Trachoma; Chlamydia trachomatis; Drug acceptability; Azithromycin; Tanzania; Human; Acceptance; Chlamydiaceae; Conjunctiva disease; Macrolide; Infection; Eye disease; Antibiotic; Chemotherapy; Treatment; Mass campaign; Bacteriosis; Chlamydiales; Bacteria; Tropical medicine; Chlamydiosis; Antibacterial agent; Public health
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2005.03.006

Trachoma causes blindness; the prevention strategy includes mass antibiotic treatment. In a community in Northern Tanzania offered mass treatment with azithromycin for the control of trachoma, we used focus group discussions, individual interviews, questionnaires and direct observation to quantify, explore and contextualize reasons for acceptance or refusal of the drug. In the village studied, 76% of the population eligible to receive azithromycin were treated. Uptake was significantly higher among women (79% treated) than men (72%). Factors affecting acceptability included: local prevention norms (such as the belief that injections, rather than oral medicine, should be used for prevention); perceptions of drugs in general and azithromycin in particular; perceptions of the distribution team's expertise; witnessing adverse effects in others; and the timing, quality and quantity of information about azithromycin and its availability. Familiarity with trachoma as a blinding disease was significantly associated with uptake. Individuals who refused treatment seemed to be less altruistic than other respondents. Neither socio-economic status nor use of traditional healers was related to uptake. Pre-distribution community assessment and community education, advance notice of the distribution, standardized distribution guidelines and improved distributor training are recommended to maximize acceptance of azithromycin in future campaigns.