Twifo Hemang Lower Denkyira District Pilots Moxidectin in Mass Drug Administration to Eliminate Onchocerciasis

The Twifo Hemang Lower Denkyira District has successfully conducted a Mass Drug Administration (MDA) exercise for onchocerciasis, marking a significant public health milestone with the introduction of Moxidectin, a newly piloted drug aimed at accelerating the elimination of the disease in endemic communities.

The exercise was spearheaded by the District Health Directorate under the Ghana Health Service, with support from national and partner institutions involved in the control of neglected tropical diseases (NTDs). Twifo Hemang Lower Denkyira District is among the selected districts in Ghana to pilot Moxidectin as part of a broader strategy to strengthen onchocerciasis elimination efforts.

District Officers engaging with partners and stakeholders

Onchocerciasis and the Rationale for Moxidectin

Onchocerciasis, commonly known as river blindness, is a parasitic disease transmitted through repeated bites of infected blackflies that breed near fast-flowing rivers. The disease causes severe itching, skin lesions, visual impairment, and in advanced cases, permanent blindness. It remains a public health concern in some rural and riverine communities.

For decades, Ivermectin has been the main drug used in mass treatment campaigns and has significantly reduced disease burden nationwide. However, in areas where transmission persists despite repeated rounds of treatment, there is a need for more effective tools. Moxidectin, a newer anti-parasitic medicine, has demonstrated a longer-lasting suppression of microfilariae compared to Ivermectin, making it a promising option for elimination-focused programmes.

Implementation of the Mass Drug Administration

The MDA exercise targeted eligible populations across selected onchocerciasis-endemic communities within the district. Trained health workers and community-based surveillance volunteers carried out house-to-house ensuring equitable access to the medication.

Before the commencement of drug distribution, extensive community sensitization and engagement activities were undertaken.

Community members were educated on the causes, symptoms, and prevention of onchocerciasis, as well as the benefits and safety of Moxidectin. These engagements helped address fears, dispel misinformation, and improve acceptance of the new drug.

Strict eligibility screening was conducted to ensure safe administration. Recipients were educated on how to take the drug and informed about possible mild side effects, reinforcing the importance of cooperation and transparency during the exercise.

District Health Information Officer engaging with some health workers

Management of Adverse Events and Free Treatment

A strong pharmacovigilance and adverse event monitoring system was integrated into the MDA. Health teams actively monitored recipients for Adverse Events Following Drug Administration (AEFI), which may include mild symptoms such as headache, dizziness, itching, or swelling.

Importantly, all individuals who experienced adverse events received prompt medical attention and treatment at no cost. Health facilities within the district were fully prepared to manage AEFIs, ensuring that affected individuals were assessed, treated, and followed up appropriately. This free treatment policy reassured community members and strengthened trust in the MDA process.

District health officials emphasized that the availability of free care for AEFIs is a core component of mass treatment programmes, reflecting the commitment of the Ghana Health Service to patient safety and community welfare.

District Director, Mr. Daniel Baah and DCO on the field monitoring the MDA exercise

Community Response and Data Management

Community response to the Moxidectin MDA was largely positive, with high levels of participation reported in many areas. Residents expressed appreciation for the proactive measures taken to protect them from the long-term complications of onchocerciasis.

The exercise also strengthened data collection and reporting systems, with detailed records captured to support evaluation of coverage, safety, and operational performance. These data will inform national decision-making on the potential scale-up of Moxidectin in other endemic districts.

Public Health Significance and the Way Forward

The successful implementation of the Moxidectin MDA in THLD represents an important step toward interrupting transmission and achieving elimination of onchocerciasis. By piloting innovative tools alongside proven strategies, the district is contributing valuable evidence to Ghana’s national NTD elimination agenda.

District health authorities have reaffirmed their commitment to sustaining high treatment coverage, strengthening surveillance, and maintaining strong community engagement. Residents have been encouraged to continue participating in future MDAs and to promptly report any side effects following drug administration.

As Ghana intensifies its efforts to eliminate neglected tropical diseases, the experience from Twifo Hemang Lower Denkyira District highlights the importance of innovation, community trust, and accessible healthcare, including free treatment for adverse events, in achieving lasting public health impact.