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Community Directed Ivermectin Treatment Coverage in Burundi: A Spatio-Temporal Analysis for 2030 World Health Organization Road Map


Background: Integrated national programme for the control of neglected tropical diseases and blindness aims to achieve a paradigm shift from control of morbidity to interruption of transmission and ultimately elimination.

Objective: The aim of this study was to understand onchocerciasis epidemiology and control strategies in the context of Burundi. Specifically, the study sought to understand the coverage of Ivermectin treatment in onchocerciasis endemic zones, to assess the impact of African Programme for Onchocerciasis Control (APOC) approach on treatment coverage and forecast the therapeutic coverage to 2030 horizon in Burundi.  

Methods:  We  used  retrospective  data  collected  from  2005  to  2019  in  four  onchocerciasis  endemic  provinces  in  Burundi. For mapping and ivermectin coverage rates comparison, we respectively used a spatial analysis and welch testing  methods.  After,  we  forecasted  the  therapeutic  coverage  using  the  Autoregressive  Integrated  Moving  Average  (ARIMA) model, a statistical analysis model which uses time series data to predict future trends. All analysis were done using Quantum Geographic Information System (QGIS) and the R 3.5.3 software.

Results: During study period, a mean population of 1,536, 392 (95% CI: 1,114 ,870 -1,932 ,403) has been targeted by ivermectin treatment in all the four provinces. The ivermectin coverage rate was 77.8% (95% CI: 67.8% to 81.6%). Specifically,  ivermectin  coverage  rates  were  76.4%,  76.6%  and  78.7%  in  Rutana,  Bururi  and  Cibitoke  -  Bubanza  respectively.  After  six  years  of  massive  drug  administration  under  World  Health  Organization  community  guidelines  launched in 2011, the coverage rates were, except the 2016 year, above 80%. Forecasts for 2030 showed that the coverage rate for treatment could increase.

Conclusion: This study showed that the ivermectin coverage rate significantly increased during the community-directed treatment approach period. The coverage rate should remain over 80% until 2030 in endemic regions, a strategy which should contribute to decrease the onchocerciasis prevalence and lead to onchocerciasis elimination.

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Journal Article
Iradukunda A
Gaturagi C
Habonima A
Manirakiza M
Bucumi V
Nimpa D
Odjidja EN