Table 3.
Individual-level correlates of non-treatment amongst adults in DeWorm3 intervention clusters
| Benin (n = 165,058, 15 + years of age) | India (n = 298,237, 20 + years of age) | Malawi (n = 153,970, 20 + years of age) | ||||
|---|---|---|---|---|---|---|
| Predictors | aOR (95% CI) | P-value | aOR (95% CI) | P-value | aOR (95% CI) | P-value |
| MDA rounda | ||||||
| MDA1 | 1.0 | 1.0 | 1.0 | |||
| MDA2 | 0.95 (0.85, 1.05) | 0.282 | 1.26 (1.12, 1.42) | < 0.001 | 1.18 (1.10, 1.26) | < 0.001 |
| MDA3 | 0.44 (0.36, 0.53) | < 0.001 | 0.54 (0.44, 0.67) | < 0.001 | 0.52 (0.47, 0.58) | < 0.001 |
| MDA4 | 0.88 (0.67, 1.15) | 0.335 | 0.71 (0.52, 0.97) | 0.032 | 0.52 (0.46, 0.59) | < 0.001 |
| MDA5 | 1.02 (0.71, 1.45) | 0.927 | 1.69 (1.11, 2.57) | 0.014 | 0.26 (0.22, 0.31) | < 0.001 |
| MDA6 | 0.60 (0.39, 0.94) | 0.025 | 0.78 (0.46, 1.31) | 0.351 | 0.35 (0.29, 0.43) | < 0.001 |
| Individual factors | ||||||
| Age | ||||||
| 15–19 years | 1.78 (1.63, 1.95) | < 0.001 | – | – | ||
| 20–29 years | 2.44 (2.26, 2.64) | < 0.001 | 1.74 (1.62, 1.88) | < 0.001 | 4.25 (3.93, 4.59) | < 0.001 |
| 30–39 years | 1.92 (1.77, 2.08) | < 0.001 | 1.19 (1.11, 1.28) | < 0.001 | 2.52 (2.33, 2.74) | < 0.001 |
| 40–49 years | 1.44 (1.32, 1.57) | < 0.001 | 0.77 (0.71, 0.83) | < 0.001 | 1.45 (1.32, 1.58) | < 0.001 |
| 50 + years | 1.0 | 1.0 | 1.0 | |||
| Sex | ||||||
| Female | 0.83 (0.79, 0.88) | < 0.001 | 1.03 (0.98, 1.08) | 0.251 | 0.22 (0.21, 0.24) | < 0.001 |
| Male | 1.0 | 1.0 | 1.0 | |||
| Migratory status | ||||||
| Migratoryb | 3.99 (3.73, 4.27) | < 0.001 | 5.12 (4.79, 5.46) | < 0.001 | 6.34 (5.93, 6.79) | < 0.001 |
| Non-migratory | 1.0 | 1.0 | 1.0 | |||
| Marital status | ||||||
| Unmarried | 1.0 | 1.0 | 1.0 | |||
| Married | 0.79 (0.75, 0.84) | < 0.001 | 0.62 (0.59, 0.66) | < 0.001 | 0.96 (0.90, 1.01) | 0.136 |
| Married (polygamous) c | 0.71 (0.60, 0.83) | < 0.001 | NAc | 1.21 (1.10, 1.33) | < 0.001 | |
| Marital status unknown | 2.59 (2.07, 3.23) | < 0.001 | 3.68 (1.77, 7.68) | 0.001 | 2.43 (1.73, 3.40) | < 0.001 |
| Education level | ||||||
| No primary education | 1.0 | 1.0 | 1.0 | |||
| Any primary or middle school education | 1.05 (0.99, 1.11) | 0.091 | 0.92 (0.86, 0.98) | 0.007 | 1.14 (1.08, 1.20) | < 0.001 |
| Any secondary or higher secondary education | 0.98 (0.92, 1.04) | 0.442 | 1.30 (1.21, 1.40) | < 0.001 | 1.35 (1.23, 1.49) | < 0.001 |
| Any higher/tertiary education | 1.19 (1.10, 1.29) | < 0.001 | 1.77 (1.62, 1.94) | < 0.001 | 3.06 (1.90, 4.91) | < 0.001 |
| Other education level | 1.28 (0.95, 1.72) | 0.103 | 2.07 (1.20, 3.56) | 0.009 | 1.29 (0.94, 1.78) | 0.117 |
| Education level unknown | 1.20 (0.94, 1.52) | 0.139 | 3.14 (1.57, 6.26) | 0.001 | 2.69 (2.30, 3.14) | < 0.001 |
| Household factors | ||||||
| Wealth quintile | ||||||
| Lowest quintile | 1.0 | 1.0 | 1.0 | |||
| Low quintile | 1.07 (0.99, 1.16) | 0.101 | 0.80 (0.74, 0.88) | < 0.001 | 0.98 (0.90, 1.07) | 0.639 |
| Medium quintile | 0.89 (0.83, 0.97) | 0.007 | 0.79 (0.72, 0.86) | < 0.001 | 0.91 (0.84, 1.00) | 0.043 |
| High quintile | 0.89 (0.82, 0.96) | 0.004 | 0.73 (0.66, 0.79) | < 0.001 | 0.95 (0.87, 1.03) | 0.237 |
| Highest quintile | 0.80 (0.74, 0.87) | < 0.001 | 0.79 (0.72, 0.87) | < 0.001 | 0.95 (0.87, 1.03) | 0.230 |
| Household language | ||||||
| Minority language | 1.48 (1.38, 1.60) | < 0.001 | 1.49 (1.30, 1.70) | < 0.001 | 1.49 (1.27, 1.74) | < 0.001 |
| Majority languaged | 1.0 | 1.0 | 1.0 | |||
| Household religion | ||||||
| Minority religion | 0.96 (0.91, 1.01) | 0.148 | 1.12 (0.98, 1.28) | 0.085 | 0.96 (0.84, 1.11) | 0.607 |
| Majority religione | 1.0 | 1.0 | 1.0 | |||
| Household population density (1000 population per half km) | 0.96 (0.94, 0.98) | < 0.001 | 1.02 (1.00, 1.04) | 0.015 | 1.01 (0.98, 1.04) | 0.523 |
Factors associated with non-treatment were assessed using a mixed effects model with random intercepts for cluster and individual and random slopes to account for individual trends over six rounds of MDA. The final adjusted model includes mutual adjustment for all a priori specified variables. Factors found to be significant at the 0.05 level in the fully adjusted modell are indicated in bold
aOR adjusted odds ratio, CI 95% confidence interval, MDA mass drug administration, N/A not applicable
aMDA5 was interrupted by COVID-19 lockdown orders in India
bDefined as living in the household < 6 months of the year in the previous year
cNot assessed in India
dMajority language is defined as Pedah, Sahoue, Watchi, Mina, Adja, and Xwla in Benin, Tamil in India, and Chiyao in Malawi
eMajority religion is defined as Christianity in Benin, Hinduism in India and Islam in Malawi