@article{103988,
  keywords = {Indonesia, Compliance, Mass drug administration, Lymphatic filariasis},
  author = {Wahyuni R and Ipa M and Hermawan A and Ernawan B and Faizah AN and Handayani NS and Dhewantara PW and Garjito TA},
  title = {Assessing factors influencing noncompliance with mass drug administration for lymphatic filariasis in urban and rural Indonesia},
  abstract = {<p><strong>Objective:</strong></p>

<p>To study assessed factors associated with mass drug administration (MDA) noncompliance for lymphatic filariasis in urban and rural Indonesian communities.</p>

<p><strong>Methods: </strong></p>

<p>A cross-sectional analysis was conducted using a subset of nationally representative data from the 2023 Indonesian Health Survey (Survei Kesehatan Indonesia, SKI). Participants were classified as residing in urban ( n =469 549) and rural ( n =407 982) and interviewed regarding anti-filarial drugs intake over the past 5 years. Logistic regression models were constructed to identify factors associated with MDA noncompliance.</p>

<p><strong>Results:</strong></p>

<p>A total of 877 531 individuals from 284 177 households across 514 districts in 38 provinces were included in the study. Among them, 136 526 (15.56%) took anti-filarial drugs in five years; of these, 27 113 (19.86%) never complied fully, revealing significant urban-rural disparities. In urban areas, noncompliance with MDA was associated with pre-working age group (a OR 1.58; 95% CI 1.21-2.07) and those with self-reported LF (a OR 1.47; 95% CI 1.13-1.91). Awareness of health facilities was protective against noncompliance (a OR 0.29; 95% CI 0.11-0.77). In contrast, rural noncompliance was associated with transportation cost barriers (a OR 1.55; 95% CI 1.21-1.99), children aged 2-5 years (a OR 1.43; 95% CI 1.08-1.87), mobile phone ownership (a OR 1.40; 95% CI 1.12-1.75), and self-reported LF (a OR 1.47; 95% CI 1.19-1.82).</p>

<p><strong>Conclusions:</strong></p>

<p>Distinct demographic, socioeconomic, and accessibility factors influence MDA noncompliance in Indonesia. Targeted behavioral interventions in urban areas and improved communication and access in rural regions are essential for LF elimination.</p>
},
  year = {2026},
  journal = {Asian Pacific Journal of Tropical Medicine},
  volume = {19},
  pages = {354 - 366},
  month = {08/2026},
  publisher = {Ovid Technologies (Wolters Kluwer Health)},
  issn = {1995-7645, 2352-4146},
  url = {https://www.ovid.com/jnls/aptm/pdf/10.4103/apjtm.apjtm_93_26~assessing-factors-influencing-noncompliance-with-mass-drug},
  doi = {10.4103/apjtm.apjtm_93_26},
  language = {ENG},
}