Community-Based Delivery of Onchocerciasis Preventive Chemotherapy in Taraba State: Coverage and Compliance Patterns

Community-directed treatment with ivermectin has been the global strategy for onchocerciasis control for over three decades, yet sub-optimal coverage and compliance continue to delay programme goals in hyperendemic communities of Northeast Nigeria. This study assessed coverage and compliance patterns for community-directed ivermectin treatment in onchocerciasis-endemic communities of Taraba State. A cross-sectional survey was conducted in 18 communities across three local government areas following the most recent treatment round. Structured questionnaires were administered to 360 adults. Community-directed distributor performance was assessed through supervisor checklists. Treatment coverage was 58.3 percent, below the national target of 65 percent. Non-swallowers accounted for 12.1 percent of the eligible population reached, predominantly citing fear of side effects. Community-directed distributors reported inadequate pre-campaign sensitisation as the primary operational gap. Communities with female community-directed distributors showed significantly higher female participation rates. The study highlights the need for differentiated implementation strategies that address gender-specific barriers and recommends investment in community-directed distributor training and community engagement before each treatment round in Taraba State. Keywords: onchocerciasis, ivermectin, community-directed treatment, coverage, Taraba State.