{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T19:36:59Z","timestamp":1770925019903,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013958","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["OPP1190754"],"award-info":[{"award-number":["OPP1190754"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite over two decades of Community-Directed Treatment with Ivermectin (CDTI), onchocerciasis transmission persists in localized pockets in Ghana, particularly in the Kwanware-Ottou community within the Wenchi Health District. This study trialled a scalable approach to identifying context-specific barriers and solutions for improving CDTI effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/principal findings<\/jats:title>\n                    <jats:p>A mixed-methods approach was employed, including Geographical Information System mapping, community consultation, census and treatment coverage evaluation, and qualitative assessments. These informed the participatory development of an Action Plan, which was implemented and evaluated across three sub-districts. Key challenges identified and addressed included poor data quality, high population mobility, remote settlements with accessibility issues, limited awareness, and inadequate number and deployment of community drug distributors. As a result, therapeutic coverage increased from 70.8% to 88.2. Seven out of eight communities with pre-intervention coverage below the recommended 65% threshold not only achieved but exceeded this target. Ultimately, all communities met the coverage goal. The intervention also improved data accuracy and quality, community engagement, and adherence to directly observed treatment, while addressing systemic gaps in CDTI delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/significance<\/jats:title>\n                    <jats:p>This study demonstrates that a coordinated, locally adapted stimulus package can significantly enhance CDTI performance in areas of persistent onchocerciasis transmission. The approach presents a scalable model for similar endemic settings and aligns with the World Health Organization\u2019s 2021\u20132030 Roadmap for the elimination of Neglected Tropical Diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013958","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T18:48:02Z","timestamp":1770317282000},"page":"e0013958","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reaching the last mile with ivermectin mass drug administration against onchocerciasis: The case of Kwanware-Ottou persistent transmission focus in the Wenchi health district of Ghana"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7472-4608","authenticated-orcid":true,"given":"Rogers","family":"Nditanchou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinola Stephen","family":"Oluwole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sapana","family":"Basnet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Chailloux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Saare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Agyemang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Adelaide","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike Yaw","family":"Osei-Atweneboana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Selby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Opare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Hamill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Nelson Siewe","family":"Fodjo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronique","family":"Verhoeven","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Colebunders","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"issue":"4","key":"pntd.0013958.ref001","first-page":"297","article-title":"Onchocerciasis (river blindness)","volume":"72","author":"LH Borup","year":"2003","journal-title":"Cutis"},{"key":"pntd.0013958.ref002","volume-title":"Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021\u20132030","author":"WHO","year":"2020"},{"key":"pntd.0013958.ref003","doi-asserted-by":"crossref","unstructured":"Traore MO, Sarr MD, Badji A, Bissan Y, Diawara L, Doumbia K. 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