Determinants of Mass Drug Administration Uptake for Preventive Chemotherapy-Targeted Neglected Tropical Diseases in Ghana: A Systematic Review

Neglected tropical diseases (NTDs) targeted through preventive chemotherapy remain an important public health concern in Ghana, particularly among populations living in areas where environmental, socioeconomic, and health-system conditions facilitate transmission. Mass drug administration (MDA) is a major strategy for the control and elimination of several preventive chemotherapy-targeted NTDs, including lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases and trachoma. However, the effectiveness of MDA programmes depends substantially on adequate population uptake and sustained participation. Despite the availability of effective medicines and established national control programmes, suboptimal uptake may limit progress towards NTD control and elimination goals. This systematic review aims to identify and synthesise the determinants influencing uptake of MDA for preventive chemotherapy-targeted NTDs in Ghana. The review will examine factors operating at individual, interpersonal/community, health-system, programme implementation and policy or structural levels. Particular attention will be given to factors that facilitate or hinder MDA uptake, including knowledge and awareness, perceptions and beliefs, trust, community and social influences, access to medicines and services, characteristics of MDA delivery, health-system capacity, and broader contextual and structural conditions. The review will systematically identify, appraise, and synthesize relevant empirical evidence on determinants of MDA uptake among populations in Ghana. Eligible studies will be identified through systematic searches of relevant electronic databases and supplementary sources, followed by transparent study selection, data extraction, and methodological quality or risk-of-bias assessment using appropriate critical appraisal tools according to study design. The findings are expected to provide a comprehensive understanding of the multilevel determinants of MDA uptake in Ghana and to identify important barriers, facilitators and evidence gaps. The review will contribute to evidence-informed planning and implementation of NTD control and elimination programmes by identifying factors that may be addressed through community engagement, health education, programme implementation strategies, health-system strengthening, and policy interventions. The findings may also inform future implementation research and the design of contextually appropriate strategies to improve MDA uptake and support progress towards NTD control and elimination targets in Ghana.