Evaluation of mass drug administration for elimination of lymphatic filariasis in Goa, India
Keywords:Mass Drug Administration, Filaria, Diethyl carbamazine citrate, Coverage, Compliance
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.
Centre for Disease Control (CDC). Recommendations of the international task force for disease eradication. Morbidity and Mortality weekly Report. 1993;42:1-38.
Babu BV, Kar SK. Coverage, compliance and some operational issues of mass drug administration during the programme to eliminate lymphatic filariasis in Orissa, India. Tropical Med International Health. 2004;9(6):702-9.
Ottesen EA, Vijayasekaran V, Kumaraswami V, et al. A controlled trial of ivermectin and diethylcarbamazine in lymphatic filariasis. New England Journal of Medicine 1990, 322:1113-17.
Molyneux DH, Zagaria N. Lymphatic filariasis elimination: progress in global program development. Annals Tropical Med Parasitol. 2002;96:15s-40s.
Government of India. Operational guidelines on elimination of lymphatic filariasis. Directorate of National Vector Borne Disease Control Programme, Government of India, New Delhi, 2005.
Kumar P, Prajapati PB, Saxena D, Kavishkar AB, Kurian G. An evaluation of coverage and compliance of mass drug administration 2006 for elimination of lymphatic filariasis in endemic areas of Gujarat. Indian J Community Med 2008;33(1):38-42.
Nandha B, Sadanandane C, Jambulingam P, Das PK. Delivery strategy of mass annual single dose DEC administration to eliminate lymphatic filariasis in the urban areas of Pondicherry. Filaria J. 2007;6: 7.
Weerasooriya MV, Yahathugoda CT, Wickramasinghe D, Gunawardena KN, Dharmadasa RA, Vidanapathirana KK, et al. Social mobilization, drug coverage and compliance and adverse reactions in a mass drug administration (MDA) programme for the elimination of lymphatic filariasis in Sri Lanka. Filaria J. 2007;6:11.