Evaluation of mass drug administration for elimination of lymphatic filariasis in Goa, India.

Background: The most practical and feasible method of controlling lymphatic filariasis is the rapid reduction of microfilarial load in the community by annual mass drug administration (MDA) of a single dose of diethyl Carbamazine Citrate. The objective of the study aimed at the trends in coverage and compliance of Mass Drug Administration with Diethyl Carbamazine Citrate (DEC) for elimination of lymphatic filariasis in Goa. Methods: Cross-sectional population surveys were conducted after every yearly round of MDA with DEC for the years 2006, 2007, 2008 and 2010 as part of independent assessment of MDA. Four clusters were selected from each district, each cluster having 30 households. A pretested questionnaire was used to interview the study participants and the responses were recorded in pre-designed formats. The data was analysed using SPSS package. Coverage rate, compliance rate, coverage-compliance gap and effective coverage rate were calculated. Results: The total coverage ranged from a high of 95.55% in the year 2007 and a low of 84.94% in 2006. The total compliance rate fluctuated between a low of 64.68% in 2010 and a high of 93.47% in 2006. Total coverage–compliance gap ranged from a high of 35.31% in the year 2010 and a low of 6.52%. Overall coverage and compliance rates were consistently higher in rural areas compared to urban areas for all the years under study. Conclusion: Coverage, compliance, coverage-compliance gap and effective coverage rate were found to be consistently lower in urban areas compared to rural areas. For the state to reach elimination targets, the MDA strategy implementation would require thorough review and revamping. Action on this front would ensure that gains made in filarial elimination are sustained eventually leading to elimination of lymphatic filariasis in the state of Goa.