ArticleBMJ open2026
Promoting factors of adherence to annual mass drug administration for schistosomiasis among farmers in an endemic Southeast Asian setting: a cross-sectional study in Oriental Mindoro, Philippines.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMass drug administration (MDA) is essential for schistosomiasis elimination; however, evidence on factors promoting adherence in the Philippines is limited. This study aims to investigate these factors among high-risk farmers.
designA community-based cross-sectional study using a questionnaire survey and abdominal ultrasonography.
settingThis study was conducted in selected barangays in Victoria, Oriental Mindoro, Philippines where the highest prevalence was reported. PARTICIPANT: Eligible participants were farmers aged ≥18 years who had been directly engaged in paddy farming in Victoria for at least 5 years. Individuals unable to complete the questionnaire or provide informed consent were excluded. A total of 342 participants were enrolled in this study. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was adherence to annual MDA. Secondary outcome measures demographic characteristics, liver lesion images, schistosomiasis-related history and knowledge (12-item questionnaire).
resultsAmong 342 participants, 65.2% adhered to annual MDA. Ultrasonography findings potentially suggestive of schistosomiasis (Omae type 3) were observed in 37.7% overall (30.5% in non-adherent vs 51.3% in adherent participants). Self-reported history of schistosomiasis was reported by 51.0% (35.5% vs 51.3%). Family history was reported by 41.9% (55.5% vs 34.7%, p<0.001). Knowledge about schistosomiasis was high overall (79.1%) and higher among adherent participants (77.3% vs 82.4%, p<0.001). Variables with p<0.20 in bivariate analysis were included in a multiple logistic regression. Self-reported history showed the strongest association with MDA adherence (adjusted OR 3.608, 95% CI 1.940 to 6.711), whereas ultrasonography findings and family history were not significant.
conclusionA self-reported history of schistosomiasis was most strongly associated with MDA adherence, indicating that subjective awareness of infection is a key factor promoting participation. However, despite high overall knowledge levels, understanding of clinical manifestations remained limited. These findings highlight priority areas for targeted health education, particularly improving recognition of schistosomiasis symptoms, to strengthen participation in control programmes.
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