Overcoming myths in the community to implement successful public health interventions: The Haiti neglected tropical disease program

Lymphatic filariasis (LF) is endemic throughout Haiti with a prevalence rate of 34%. The Ministry of Health and Population leads the Haiti Neglected Tropical Disease (NTD) Control Program and is working to eliminate LF from Haiti by 2020. Transmitted by mosquitoes, LF can cause severe disfigurement with swelling of the limbs, breasts, and genitals. There are myths about what causes this swelling. In Haiti, LF patients believed the disease was a curse and visited voodoo priests to seek treatment. The program employed two strategies to combat this problem. Intense community sensitization prior to mass drug distribution (MDA) and post-MDA coverage surveys to explore the reasons for non-compliance during MDA were implemented. During sensitization, community volunteers teach the population about the disease and the purpose of MDA. In 2000, program coverage rates were 78% on average. Community volunteers provide education to the population annually about NTDs and MDA and as a result, coverage rates have risen to 90% in 2012. Specific strategies are developed to address non-compliance like use of local leaders to support the program and encourage the population to participate in MDA. For MDA to lead to elimination of disease, it must be conducted consistently with good coverage. In order to prevent or control a disease, the population affected needs to have a good understanding of the cause, symptoms, and treatment. Addressing popular misconceptions early and consistently will increase program uptake and outcomes