ABSTRACT
Background: Mass Drug Administration of a single dose of DEC was launched on June 5, 2004 by the Government of India. MDA coverage increased gradually from 72.42% in 2004 to 88.96% in 2014. However, compliance has remained relatively low in most of the endemic areas as in 9 endemic Districts in State of Chhattisgarh. In Chhattisgarh State, Lymphatic Filariasis affected 14,818 people in the year 2011 and 13921 in the year 2013 with demonstrated manifestation. Objectives: To assess the coverage and compliance along with factors affecting compliance regarding MDA implementation in Surguja and Surajpur District of Chhattisgarh. Methods: A cross-sectional descriptive study was conducted from July-September 2021 in two district of Chhattisgarh. The division of segments and selection of the households was done based on the WHO criteria of coverage evaluation survey field guide in which from 30 villages, 450 households were covered. Result: The overall coverage rate was 95.55% in Surguja and 89.16% in Surajpur District. The overall compliance was 89.3% with Coverage-Compliance gap of 4.12. The Effective Coverage Rate was 89.3% in 2243 eligible population of Surguja and Surajpur District. Coverage and Compliance was found more in females as compared to males but was found to be statistically not significant. Coverage and Compliance was found more in Surguja district as compared to Surajpur district. Conclusion: Training programme for drug distributors should emphasize more on how to address the fear of side effects among beneficiaries and other reasons of low compliance for the benefit of the MDA programme.
ABSTRACT
Lymphatic filariasis (LF) is a vector-borne neglected tropical disease, causing permanent disability. The disease is debilitating and widespread, leading to tremendous productivity and economic loss. The Government of India (GOI) prioritized the elimination of LF through the annual mass drug administration (MDA) programme in 2004 and continued with a single dose of diethylcarbamazine citrate (DEC), 6 mg/kg of body weight, plus albendazole annually over a period of 5-6 years. The GOI had set the target to achieve LF elimination by 2015 and now by 2030. The progress so far has been suboptimal. Much remains to be done as about 84 per cent of the total 328 endemic districts are still under MDA. The major challenge in implementing MDA is poor compliance. It is necessary to have a feasible alternative strategy addressing the above challenge to achieve the desired goal of LF elimination. At this juncture, a well-researched approach, i.e. the use of DEC-fortified salt, also advocated by the World Health Organization, as a unique form of MDA, is proposed. As per this strategy, a low dose of DEC (0.2% w/w) is added to the cooking salt at the manufacturing facility of iodized salt and consumed by the LF-endemic communities for about two years. Many examples of successful use of this strategy for LF elimination in small- and large-scale trials have been documented in India and several other endemic countries in the world. Implementing DEC–iodine-fortified salt is a safe, less expensive, more efficient and prompt approach for achieving the elimination of LF in India. Adverse effects are none or minor and self-limiting. The DEC-fortified salt strategy can easily piggyback on the existing countrywide deployment of iodized salt under the National Iodine Deficiency Disorders Control Programme (NIDDCP), which has achieved a great success in reducing iodine-deficiency disorders such as hypothyroidism. This existing robust programme can be leveraged to launch DEC-fortified salt for the community. If implemented appropriately, this strategy will ensure the complete cessation of LF transmission within two years from its introduction. If the said strategy is implemented in 2022, it is expected that India will be able to achieve the LF elimination by 2024, much before the global target of 2030.
ABSTRACT
En el año 2000, había más de 120 millones de personas infectadas por filarias en el mundo; unos 40 millones están desfiguradas e incapacitadas por la enfermedad. La infestación de los ganglios linfáticos por el parásito Wuchereira bancrofti, es la causa más frecuente del linfedema secundario. Se presenta un caso inusual de elefantiasis vulvar por filariasis. Se analizan las alternativas terapéuticas que incluyen el tratamiento farmacológico y quirúrgico, con el fin de considerar esta última como un tratamiento paliativo más que curativo tanto para el linfedema como para la cirugía reconstructiva(AU)
In 2000, there were more than 120 million people infected by filarias in the world; some 40 million are disfigured and disabled by the disease. Infestation of the lymph nodes by Wuchereira bancrofti parasite is the most frequent cause of secondary lymphoedema. An unusual case of vulvar elephantiasis due to filariasis is reprted in this paper. The therapeutic alternatives that include pharmacological and surgical treatment are analyzed, in order to consider the latter as a palliative rather than a curative treatment both for lymphedema and for reconstructive surgery(AU)
Subject(s)
Humans , Female , Vulva/abnormalities , Elephantiasis, Filarial/complicationsABSTRACT
Onchocerciasis and lymphatic filariasis (LF) are human filarial diseases belonging to the group of neglected tropical diseases, leading to permanent and long-term disability in infected individuals in the endemic countries such as Africa and India. Microfilaricidal drugs such as ivermectin and albendazole have been used as the standard therapy in filariasis, although their efficacy in eliminating the diseases is not fully established. Anti-Wolbachia therapy employs antibiotics and is a promising approach showing potent macrofilaricidal activity and also prevents embryogenesis. This has translated to clinical benefits resulting in successful eradication of microfilarial burden, thus averting the risk of adverse events from target species as well as those due to co-infection with loiasis. Doxycycline shows potential as an anti-Wolbachia treatment, leading to the death of adult parasitic worms. It is readily available, cheap and safe to use in adult non-pregnant patients. Besides doxycycline, several other potential antibiotics are also being investigated for the treatment of LF and onchocerciasis. This review aims to discuss and summarise recent developments in the use of anti-Wolbachia drugs to treat onchocerciasis and LF.
ABSTRACT
Background: Lymphatic filariasis is the second leading cause of disability worldwide accounting for more than 5 million disability adjusted life years annually. It has been a major public health problem in India which leads to irreversible chronic manifestations which are responsible for considerable economic loss and severe physical disability to the affected individuals. Mass drug administration (MDA) means administration of diethylcarbamazine and albendazole tablets to all people (excluding children <2 years, pregnant women, seriously ill persons) in endemic areas once in a year. The objective of the study was to assess coverage, compliance of MDA and awareness about lymphatic filariasis in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was conducted and total 120 households were surveyed in four randomly selected clusters of Tikamgarh district of Madhya Pradesh.Results: Out of total 743 persons 678 (91.25%) persons were eligible for MDA. Coverage rate was 86.57% and compliance rate was 74.27%. The main reason for non-compliance was not having the concerned disease (55.78%) followed by fear of side effect (22.31%). Only 40.83% among the surveyed families were aware about MDA and only 45.83% respondents had heard about lymphatic filariasis.Conclusions: There is coverage and compliance gap and awareness about the lymphatic filariasis and MDA program is limited. Drug compliance need to be improved and awareness need to be raised. MDA program should not be confined to tablet distribution only and due importance should be given to compliance rate.
ABSTRACT
Background: Lymphatic filariasis is a vector borne parasitic disease caused by lymphatic dwelling nematode parasite. It is one of the world's leading causes of permanent and long-term disability with an estimated 5.1 million disability adjusted life years (DALYs) are lost due to this disease. The National Health Policy 2002 aims at Elimination of Lymphatic filariasis by 2015 through Annual Mass Drug Administration (MDA) of single dose of DEC. Objective was to assess coverage and compliance of MDA Program and awareness about lymphatic filariasis in Chhatarpur district of Madhya Pradesh.Methods: Cross-sectional Study was conducted. Total 120 households were surveyed in four selected clusters of Chhatarpur district of MP.Results: Out of total 835 persons only 94.37% persons were eligible and 47 (5.62%) were not eligible for MDA for MDA. Coverage rate was 90.22% and compliance rate was 75.24%. The main reason for non-compliance was not having the concerned disease 34.38 % followed by fear of side effect (24.90%). Only 37.5% among the surveyed families were aware about MDA. Majority of respondent 21 (46.66%) acquired knowledge from health workers.Conclusions: The compliance of MDA program was low and the awareness about the lymphatic filariasis in the study population was limited in Chhatarpur district. Poor compliance of MDA is attributed to inadequate consumption of drugs due to poor awareness among eligible population. For elimination of lymphatic filariasis active involvement of community is very essential. It can be made possible through behavior change communication and health education of people.
ABSTRACT
Cases of Lymphatic Filariasis (LF) have been notified since 1959 in the municipality of Paulista, yet it is still considered an LF-free area. The purpose of this study was to describe the situation of Paulista Health Department. The data were gathered via antigenic surveys carried out in the town, using POC-ICT-AD12 tests. A total of 1,000 individuals, aged 10 and over, were examined in the neighborhoods of Mirueira, Engenho Maranguape, Janga and Maranguape II (250 individuals in each district). Among the individuals evaluated, seven (0,7%) tested positive for antigens using CFA POC-ICT-AD12, 5 out of 250 (2.0%) in the Engenho Maranguape neighborhood and 2 out of 250 (0.8%) in Janga. In this group, one particular individual presented microfilaremia, quantified at 5 Mf/mL. These results suggest that the municipality of Paulista might be a "silent" source of LF continuous transmission, fact that could impact negatively on the goals of the GPELF program meant to provide certification of parasitic disease control and elimination by the year 2022
Subject(s)
Humans , Parasitic Diseases , Elephantiasis, Filarial , Microfilariae , EpitopesABSTRACT
Backgroundand Aims: Lymphatic filariasis (LF) is the most debilitating and disfiguring among all diseases. The National HealthPolicy (2002) had set the goal of elimination of LF in India by 2015. The concept of mass drug administration (MDA) is to approachevery individual in the target community and administer an annual single dose of antifilarial drugs (diethylcarbamazine andalbendazole).Objectives: The objectives of this study were (1) to find the coverage and compliance of MDA at Dakshina Kannada district and (2) toassess the knowledge of responsible adult respondent regarding elephantiasis/filariasis and MDA program.Materials and Methods: The present study was conducted to evaluate the coverage and compliance of MDA in Dakshina KannadaDistrict which was held on January 23, 2012. The evaluation was conducted for 1 week by a team of investigators. A total of 232 houseswere visited randomly in four clusters (1 in urban + 3 in rural area) covering of 982 beneficiaries between the age group of 2 and 60 yearsof age in pre-designed and semi-structured pro forma.Results: The coverage of MDA was 84%, and compliance among those who received the tablets was 80.24%. There was marginallybetter coverage in urban areas (89.27%) compared to rural area (82.41%), and compliance was better in rural areas (87.94%) comparedto urban area (63.18%). The coverage compliance gap which shows why people do not consume the tablet was 3.74%, and the effectivecoverage rate was 67.41%. The coverage was maximum, i.e., 91.3% in Kalladka (cluster 3) and minimum, i.e., 76.21% in Koila (cluster 2),whereas compliance was maximum, i.e., 90.73% in Koila (cluster 2) and minimum, i.e., 63.18% in Attavara (cluster 1).Conclusion: The coverage and compliance rate in Dakshina Kannada district were 84.01% and 80.24%, respectively, with effectivecoverage rate of 67.41%. Awareness regarding MDA program was poor
ABSTRACT
@#Filariasis continues to be one of the endemic problemsworldwide with 40% of the cases in India. We report a caseof lymphatic filariasis in a 32-year old female who presentedwith a non-tender swelling over left upper arm. Bloodsample showed no eosinophilia while the FNAC wasdiagnostic of W. bancrofti. Patient responded well with oraldiethylcarbamazine. High index of suspicion of filariasis isindicated when dealing with a swelling of unknown causeespecially in filariasis endemic areas.
ABSTRACT
Abstract INTRODUCTION: Lymphatic filariasis (LF) is a public health problem in Haiti. Thus, the emigration of Haitians to Brazil is worrisome because of the risk for LF re-emergence. METHODS: Blood samples of Haitian immigrants, aged ≥18 years, who emigrated to Manaus (Brazilian Amazon), were examined using thick blood smears, membrane blood filtration, and immunochromatography. RESULTS: Of the 244 immigrants evaluated, 1 (0.4%) tested positive for W. bancrofti; 11.5% reported as having received LF treatment in Haiti. CONCLUSIONS: The re-emergence of LF in Manaus is unlikely, due to its low prevalence and low density of microfilaremia among the assessed Haitian immigrants.
Subject(s)
Humans , Animals , Male , Female , Adolescent , Adult , Aged , Young Adult , Wuchereria bancrofti/immunology , Elephantiasis, Filarial/diagnosis , Antigens, Helminth/blood , Elephantiasis, Filarial/epidemiology , Brazil/epidemiology , Chromatography, Affinity , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/epidemiology , Emigrants and Immigrants , Haiti/ethnology , Middle AgedABSTRACT
OBJECTIVES: Korea was an endemic area for lymphatic filariasis (LF), caused by the nematode parasite Brugia malayi, until the 1970s. The World Health Organization recognized Korea as LF-free in June 2008. However, it is necessary to confirm that patients that have had LF in the past still test negative, to prevent the re-emergence of LF in Korea. METHODS: We followed up a total of 83 patients who had been diagnosed with LF between 2002 and 2010 in endemic LF areas. RESULTS: Fifty-two of the 83 subjects were negative for LF, whereas 31 subjects had re-located to a different city or province, were dead, or were unaccounted for. Most subjects with negative test results still exhibited edema in the legs or the arms, and some complained of redness and swelling in the legs or ankle joints. However, we found that these symptoms were due to diseases other than LF. CONCLUSION: In this follow-up study, we did not find any evidence indicating the potential re-emergence of LF in Korea.
Subject(s)
Humans , Ankle Joint , Arm , Brugia malayi , Edema , Elephantiasis, Filarial , Follow-Up Studies , Korea , Leg , Parasites , World Health OrganizationABSTRACT
ABSTRACT The aim of this study was to investigate the epidemiological characteristics, antigenic profile, perceptions, attitudes and practices of individuals who have been systematically non-compliant in mass drug administration (MDA) campaigns targeting lymphatic filariasis, in the municipality of Olinda, State of Pernambuco, Northeastern Brazil. A pretested questionnaire was used to obtain information on socioenvironmental demographics, perceptions of lymphatic filariasis and MDA, and reasons for systematic noncompliance with treatment. A rapid immunochromatographic test (ICT) was performed during the survey to screen for filariasis. It was found that the survey subjects knew about filariasis and MDA. Filariasis was identified as a disease (86.2%) and 74.4% associated it with the presence of swelling in the legs. About 80% knew about MDA, and the main source of information was healthcare workers (68.3%). For men the main reasons for systematic noncompliance with MDA were that “the individual had not received the medication” (p=0.03) and for women “the individual either feared experiencing adverse reactions”. According to the ICT, the prevalence of lymphatic filariasis was 2%. The most important causes of systematic noncompliance were not receiving the drug and fear of side-effects. For successful implementation of MDA programs, good planning, educational campaigns promoting the benefits of MDA, adoption of measures to minimize the impact of adverse effects and improvement of drug distribution logistics are needed.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Elephantiasis, Filarial/prevention & control , Filaricides/administration & dosage , Health Knowledge, Attitudes, Practice , Medication Adherence/statistics & numerical data , Drug Administration Schedule , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
In spite of the advances in drug development and research against human lymphatic filariasis following the WHO mandate to address the disease-associated socioeconomic burden, diethylcarbamazine (DEC, N, N-diethyl-4-methyl-1-piperazine carboxamide) is the only available antifilarial drug to date. The major obstacle for further development of antifilarial drugs is the lack of validation of candidate drugs in the experimental animal models. Both, green tea extract and a synthetic heterocyclic thiazolidine derivative (Im8; 2-chloro-N-(4-phenylthiazol-2-yl), showed efficacy of antifilarial action in our earlier in vitro study and hence, they were screened in the present study for their antifilarial potential in the BALB/c mouse filariasis model. Mice were treated with 25 mg/kg dose of either Im8 or green tea extract or DEC or only with their respective vehicles. The untreated mice served as controls. Following insertion of the micropore chamber laden with microfilariae (Mf) of Brugia malayi, the drug or vehicle was administered s.c. in mice at 12 h intervals as 4 doses. After 12 h of administration of the last dose, the micropore chambers were removed to determine the action of the treatments as the loss of Mf motility. The green tea extract showed a significant antifilarial action and Im8 showed relatively less but significant antifilarial action as compared to the respective vehicle controls. Both the green tea extract and Im8 showed higher activity than that was exerted by DEC. These results revealed a greater efficacy of green tea and thiazolidine derivative, Im8 as the novelantifilarial agents in the experimental mouse model of filariasis.
ABSTRACT
RESUMO A filariose linfática põe em risco bilhões de pessoas em todo o mundo. Apesar disso, pouco se sabe sobre o impacto da morbidade crônica da doença, como o linfedema. A terapia complexa descongestiva apresenta-se como padrão ouro para tratar linfedemas, mas ainda não existem protocolos viáveis para implementação em países em desenvolvimento. O objetivo deste ensaio clínico foi avaliar a eficácia dessa técnica, com o uso de material alternativo, e comparar seus efeitos na qualidade de vida, funcionalidade e peso corporal. Os grupos intervenção e controle foram avaliados por meio de perimetria e cálculo do volume dos membros, do questionário de qualidade de vida Whoqol-bref, do teste de funcionalidade e mobilidade de membros inferiores Timed Up and Go e avaliação do peso corporal. O grupo intervenção recebeu a terapia complexa descongestiva duas vezes por semana, durante dez semanas, utilizando-se um material alternativo para o enfaixamento, confeccionado com tecido de cambraia, o que apresenta baixo custo em relação às faixas importadas. O grupo controle recebeu palestra com informações sobre a doença e orientações de cuidados e higiene dos membros. A amostra foi composta por trinta pacientes com idade média de 50,8±10 anos, sendo 52,9% mulheres. Na análise estatística foram utilizados os testes t de Student, Multivariate analysis of variance, teste de Wilcoxon e Kolmogorov-Smirnov. A significância adotada foi de 5% (p<0,05). Houve redução significativa do volume e perimetria do linfedema no grupo intervenção, e aumentou no grupo controle. A funcionalidade não apresentou melhora significativa na avaliação pelo teste Timed Up and Go. A qualidade de vida teve melhora significativa nos domínios físico e meio ambiente no grupo intervenção. O efeito do tratamento no peso corporal também foi significativo, apresentando redução no grupo controle e intergrupos. A terapia complexa descongestiva mostrou-se eficaz na redução e no controle do linfedema e impactou de maneira positiva, aumentando os valores numéricos dos aspectos físico e meio ambiente da qualidade de vida do grupo intervenção.
RESUMEN La filariasis linfática presenta riesgo para muchas personas en el mundo. Pero poco se sabe acerca del impacto de la morbilidad crónica de esta enfermedad, como es el linfedema. Y surge la terapia compleja descongestiva como la forma de tratarlo, pero todavía no hay protocolos que le posibilite su implementación en países en desarrollo. Este estudio clínico tiene el propósito de valorar la eficacia de esta técnica, con el empleo de material alternativo, y de comparar sus efectos en la calidad de vida, funcionalidad y peso corporal. Se evaluaron a los grupos intervención y control a través de medición y cálculo del volumen de los miembros, de cuestionario de calidad de vida Whoqol-Bref, de la prueba de funcionalidad y movilidad de los miembros inferiores Timed Up and Go y la evaluación del peso corporal. El grupo intervención hizo la terapia compleja descongestiva dos veces a la semana, durante diez semanas, y utilizó un material alternativo, el linón, para el vendaje, lo que mostró ser de bajo costo en comparación a otras vendas importadas. El grupo control vio una charla que exponía informaciones sobre la enfermedad y sobre los cuidados e higienización de los miembros. Treinta pacientes con promedio de edad de 50,8±10 años formaron la muestra, con un 52,9% de participantes mujeres. En el análisis estadístico se emplearon las pruebas t de Student, Multivariate analysis of variance, la prueba de Wilcoxon y Kolmogorov-Smirnov. El nivel de significación ha sido de 5% (p<0,05). Se observó una significativa reducción en el volumen y en la medición del linfedema en el grupo intervención, pero había aumentado en el grupo control. La funcionalidad no ha presentado mejora en la evaluación por la prueba Timed Up and Go. La calidad de vida ha presentado mejora en los dominios físico y medioambiente en el grupo intervención. El efecto del tratamiento en el peso corporal también ha sido significativo por presentar reducción en el grupo control e intergrupal. La terapia compleja descongestiva puede ser eficaz en la reducción y en el control del linfedema, además de aumentar positivamente los valores en los dominios físico y medioambiente de la calidad de vida del grupo intervención.
ABSTRACT Lymphatic filariasis puts billions of people around the world at risk. Despite this, little is known about the impact of chronic disease morbidity, such as lymphedema. The complex decongestant therapy is a gold standard for treating lymphedemas, but there are no viable protocols for implementation in developing countries. The objective of this clinical trial was to evaluate the efficacy of this technique with the use of alternative material and compare its effects on quality of life, functionality and body weight. The intervention and control groups were evaluated using perimetry and limb volume calculation, the Whoqol-bref quality of life questionnaire, the Functional and Mobility test of the lower limbs Timed Up and Go, and body weight assessment. The intervention group received the complex decongestant therapy twice a week for ten weeks, using an alternative material for the bandaging, made with cambric tissue, which presents low cost in relation to the imported bands. The control group received a lecture with information about the disease and care and hygiene guidelines of the members. The sample consisted of thirty patients with a mean age of 50.8 ± 10 years, 52.9% of whom were women. In the statistical analysis, Student's t test, Multivariate analysis of variance, Wilcoxon test and Kolmogorov-Smirnov test were used. The significance was 5% (p<0.05). There was a significant reduction in lymphedema volume and perimetry in the intervention group, and increased in the control group. The functionality did not show significant improvement in the evaluation by the Timed Up and Go test. The quality of life had significant improvement in the physical and environmental domains in the intervention group. The effect of treatment on body weight was also significant, presenting reduction in the control group and intergroups. Complex decongestant therapy was effective in reducing and controlling lymphedema and positively impacted, increasing the numerical values of the physical and environmental aspects of the quality of life of the intervention group.
ABSTRACT
We evaluated the activity of methanolic extracts of Melaleuca cajuputi flowers against the filarial worm Brugia pahangi and its bacterial endosymbiont Wolbachia. Anti-Wolbachia activity was measured in worms and in Aedes albopictus Aa23 cells by PCR, electron microscopy, and other biological assays. In particular, microfilarial release, worm motility, and viability were determined. M. cajuputi flower extracts were found to significantly reduce Wolbachia endosymbionts in Aa23 cells, Wolbachia surface protein, and microfilarial release, as well as the viability and motility of adult worms. Anti-Wolbachia activity was further confirmed by observation of degraded and phagocytized Wolbachia in worms treated with the flower extracts. The data provided in vitro and in vivo evidence that M. cajuputi flower extracts inhibit Wolbachia, an activity that may be exploited as an alternative strategy to treat human lymphatic filariasis.
Subject(s)
Adult , Humans , Aedes , Biological Assay , Brugia pahangi , Elephantiasis, Filarial , Flowers , In Vitro Techniques , Melaleuca , Methanol , Microscopy, Electron , Polymerase Chain Reaction , WolbachiaABSTRACT
There are two species of filarial parasites with sheathless microfilariae known to commonly cause parasitaemias in humans: Mansonella perstans and Mansonella ozzardi. In most contemporary accounts of the distribution of these parasites, neither is usually considered to occur anywhere in the Eastern Hemisphere. However, Sir Patrick Manson, who first described both parasite species, recorded the existence of sheathless sharp-tailed Mansonella ozzardi-like parasites occurring in the blood of natives from New Guinea in each and every version of his manual for tropical disease that he wrote before his death in 1922. Manson's reports were based on his own identifications and were made from at least two independent blood sample collections that were taken from the island. Pacific region Mansonella perstans parasitaemias were also later (in 1923) reported to occur in New Guinea and once before this (in 1905) in Fiji. Although Mansonella-parasitaemias are generally regarded as benign, they are thought to be of public health importance because they can affect the epidemiological monitoring of other filarial diseases. In this article, we reviewed the historic literature concerning Pacific-origin Mansonella-parasitaemias in an attempt to explain how, despite repeated reports of Pacific-region Mansonella-parasitaemias, by as early as the 1970s, the WHO had arrived at the present-day view that Wuchereria bancrofti is the only cause of filarial parasitaemias in Papua New Guinea. We have also evaluated the evidence supporting the contemporary existence of Pacific-area parasitaemia-causing Mansonella parasites and assessed the relevance such parasites could have for present-day lymphatic filariasis elimination efforts in the region.
ABSTRACT
Background: Lymphatic filariasis caused by nematode parasite is a public health problem in India. Filariasis in man manifests as acute and chronic lymphangitis, elephantiasis of genitalia arms, legs, hydrocele in males and lymphadenitis. The Government of India incorporated initial National Filaria Control Programme under the National Vector Born Disease Control Program (NVBDCP) with a goal of eliminating the disease as Public Health Problem by targeted date of year 2016. Aim: Aim of the study was to test the hypothesis that reducing “MICRO FILARAEMIA” in humans to <1% will stop transmission by mass administration of two drug for more than 5 Annual rounds with 65% coverage of total population. Materials and methods: The study was retrospective prospective analytical study from 2010 to 2014 (from coverage evaluation reports) of Medak dist. There is need to enhance community participation to cover more than 65% of total population for future 5 years. Results: The distribution of the drugs was carried to 68% of rural population and 18% of urban population. The effectiveness was only 57.7% of rural and 16% of urban population. The drug P. Samuel Rajkumar, Tukaram Kishanrao Pandve, G. Nagaiah, Sayyad Tajmul, Bansode Arun, NS Inamdar. An Operational Research on Annual Mass Drug Administration (MDA) For Elimination of Lymphatic Filariasis in Medak District, Telangana. IAIM, 2016; 3(7): 239-244. Page 240 compliance was 81% in rural and 87% in urban respectively. The coverage of the population for MDA by using DEC plus Albendazole tabs was 74.7% and 15.3% in rural and urban areas of Medak district respectively. But the actual effectiveness was observed 68% in rural and 15.3 % of urban population. However the drug compliance was found 91% of total population. 79.3% of respondents were aware of MDA trough banners / posters only. All other available Medias were found to be nonfunctional. Conclusion: MDA coverage was more in rural population in comparison with urban population. Major reasons for noncompliance having some underlying disease (40%), fear of side effects (18%) which can be overcome by intensification of IEC activities. In order to achieve the goal of elimination of lymphatic filariasis there is need to intensify IEC activates about modes of transmission and methods of prevention at community levels by all modes of communication so as increase the coverage with drugs.
ABSTRACT
There are two species of filarial parasites with sheathless microfilariae known to commonly cause parasitaemias in humans: Mansonella perstans and Mansonella ozzardi. In most contemporary accounts of the distribution of these parasites, neither is usually considered to occur anywhere in the Eastern Hemisphere. However, Sir Patrick Manson, who first described both parasite species, recorded the existence of sheathless sharp-tailed Mansonella ozzardi-like parasites occurring in the blood of natives from New Guinea in each and every version of his manual for tropical disease that he wrote before his death in 1922. Manson's reports were based on his own identifications and were made from at least two independent blood sample collections that were taken from the island. Pacific region Mansonella perstans parasitaemias were also later (in 1923) reported to occur in New Guinea and once before this (in 1905) in Fiji. Although Mansonella-parasitaemias are generally regarded as benign, they are thought to be of public health importance because they can affect the epidemiological monitoring of other filarial diseases. In this article, we reviewed the historic literature concerning Pacific-origin Mansonella-parasitaemias in an attempt to explain how, despite repeated reports of Pacific-region Mansonella-parasitaemias, by as early as the 1970s, the WHO had arrived at the present-day view that Wuchereria bancrofti is the only cause of filarial parasitaemias in Papua New Guinea. We have also evaluated the evidence supporting the contemporary existence of Pacific-area parasitaemia-causing Mansonella parasites and assessed the relevance such parasites could have for present-day lymphatic filariasis elimination efforts in the region.
ABSTRACT
Background: Lymphatic filariasis (LF) is a mosquito-borne parasitic infection that occurs in many countries in the Globe including India. Single dose once yearly mass administration of Diethylcarbamazine citrate (DEC) 6 mg/Kg and Albendazole 400 mg to all inhabitants of filariasis endemic areas excluding children <2 years, pregnant women and seriously ill patients is the recommended strategy for elimination of LF. The mass drug administration (MDA) campaigns are carried out by the Health Departments through door to door distribution of DEC and Albendazole tablets by drug distributing teams. The objective of this study was to evaluate the coverage, compliance, effective coverage and coverage compliance gap of MDA campaigns in Gulbarga and Yadgiri districts during the 10th and 11th MDA campaigns respectively. Methods: Cross sectional population based house to house visit. Outcomes were assessed as actual coverage, compliance and effective coverage in percentages and proportions. Results: 320 households from 8 clusters in 2 districts were covered. Among the 1653 eligible population the coverage rate is 93.42% in Gulbarga and 74.12% in Yadgiri district with inter cluster variation. The compliance rate is 86.35% in Gulbarga and 75.78% in Yadgiri district. The effective coverage rate is 80.67% in Gulbarga district and 56.17% in Yadgiri district. The coverage compliance gap is 13.65% in Gulbarga district and 24.22% in Yadgiri district. Conclusions: The effective coverage in both Gulbarga and Yadgiri districts is below the target (<85%) which is essential for progression towards elimination of LF. Side effects after drug consumption were minimal.
ABSTRACT
In India diurnally subperiodic filariasis (DspWB) is prevalent only in the Nicobar district of Andaman and Nicobar Islands. Studies undertaken at different points of time indicate that this form of filariasis is restricted to a small region in Nancowry group of islands where it is transmitted by mosquito Downsiomyia nivea, a day biting mosquito. Studies on prevalence, distribution, and assessment of endemicity status, vector incrimination, bioecology, host seeking behaviour, population dynamics of the vector, transmission dynamics and clinical epidemiology indicate the prevalence and persistence of this infection in the Nancowry group of islands with perennial transmission. There was no control programme in these islands, until the National programme to eliminate filariasis was launched in 2004. Eight rounds of annual mass drug administration (MDA) with diethyl carbamazine (DEC) + albendazole have been completed. Despite this, microfilaria prevalence remains at above one per cent, the level identified for initiating transmission assessment survey to decide on continuation of MDA further. This necessitates adjunct measures to the ongoing MDA programme in these islands. The vector control options could be an adjunct measure, but the vector is a forest dweller with a unique bio-ecology, therefore, not a technically feasible option. Use of DEC fortified salt for six months to one year could hasten the process of elimination. Although administration of DEC-fortified salt is simple, rapid, safe, and cost-effective, challenges are to be tackled for evolving operationally realistic strategy. Such a strategy requires commitment of all sections of the society, a distribution mechanism that ensures the use of DEC-fortified salt in the Nancowry islands. Here we discuss the plan of action to serve the indigenous communities and operationalizing DEC fortified salt strategy through an inter-sectoral approach involving multiple stakeholders.