02727nas a2200277   4500000000100000008004100001260005500042653001400097653001500111653002900126653002500155100001400180700001000194700001500204700001400219700001400233700001700247700001800264700001500282245013200297856012400429300001400553490000700567520185000574022002502424       2026                            d  c08/2026bOvid Technologies (Wolters Kluwer Health)10aIndonesia10aCompliance10aMass drug administration10aLymphatic filariasis1 aWahyuni R1 aIpa M1 aHermawan A1 aErnawan B1 aFaizah AN1 aHandayani NS1 aDhewantara PW1 aGarjito TA00aAssessing factors influencing noncompliance with mass drug administration for lymphatic filariasis in urban and rural Indonesia  uhttps://www.ovid.com/jnls/aptm/pdf/10.4103/apjtm.apjtm_93_26~assessing-factors-influencing-noncompliance-with-mass-drug  a354 - 3660 v193 a<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>
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