Lymphatic Filariasis Elimination in Uttar Pradesh: Rationale of Revised Block Level Strategy for IDA Impact Assessment

S Kamal; Ramesh Chandra; Ashish Kumar; S M Singh; R K Singh; A N Pandey; Gujju  Gandhi; D N Shukla; Ritu Srivastava

S Kamal National Centre for Disease Control (NCDC), Patna.
Ramesh Chandra Regional Office of Health & Family Welfare (NCVBDC), Kendriya Bhawan, Aliganj, Lucknow.
Ashish Kumar Regional Office of Health & Family Welfare (NCVBDC), Kendriya Bhawan, Aliganj, Lucknow.
S M Singh Regional Office of Health & Family Welfare (NCVBDC), Kendriya Bhawan, Aliganj, Lucknow.
R K Singh Regional Office of Health & Family Welfare (NCVBDC), Kendriya Bhawan, Aliganj, Lucknow.
A N Pandey Directorate of National Centre for Vector Borne Disease Control, Delhi.
Gujju Gandhi Consultant Scientist, NEERI (CSIR), Nagpur.
D N Shukla District Vector-Borne Disease Control Officer, Lucknow.
Ritu Srivastava District Vector-Borne Disease Control Officer, Lucknow.

Keywords: MDA, IDA, Microfilaria, Lymphatic Filariasis, Night Blood Survey, DEC

Abstract

Lymphatic Filariasis (LF) is one of the various Vector Borne Diseases (VBD) slated for elimination by the Government of India. The target set for LF elimination is less than 1% microfilaraemia (MF) in a given area. Out of 51 districts of Eastern Uttar Pradesh, only Rampur has cleared up to TAS-3 level and is under post-Mass Drug Administration (MDA) surveillance. The state has implemented triple drug therapy (IDA) in MDA in 15 districts, of which districts Bareilly, Lucknow, and Rae Bareilly have observed only one round of IDA, while the remaining 12 districts have observed 2–3 IDA rounds in order to accelerate the number of MDA rounds, resulting in less than 5 rounds of effective coverage. These 12 districts had 237 implementation/ planning units (IUs) as per the revised strategy. Out of these, 165 IUs reported less than 1% MF rate, of which, 96 IUs belonging to nine districts cleared pre-TAS level, with a sample size of 300 tests of persons who were more than 20 years of age from each of the three sites (two from high-risk areas and one randomly selected). From 96 IUs, 40 evaluation units (EUs) with a population not exceeding 5 lakhs in each EU were selected, the IUs being geographically
in close proximity, but TAS-1 activities were conducted in 31 EUs belonging to eight districts (districts Chandauli, Kanpur Nagar, Lakhimpur Kheri, Mirzapur, Pratapgarh, Prayagraj-erstwhile Allahabad, Sitapur and Varanasi), performing 105 tests of persons more than 20 years of age from each of the 30 clusters of an EU, followed by night blood survey (NBS) of persons reflecting filarial antigen positivity though filarial test stripes (FTS). All 31 EUs reflected 2% filarial antigenemia and less than 1% microfilaraemia due to which all of these EUs cleared the TAS-1 stage. It was seen that this exhaustive activity could not reflect the due impact of IDA in circumstances when the sample size of the cluster was reduced in spite of the increase in the number of clusters and consequently the total sample size of the EU.

How to cite this article:
Kamal S, Chandra R, Kumar A, Singh S M,
Singh R K, Pandey A N, Gandhi G, Shukla D N,
Srivastava R. Lymphatic Filariasis Elimination in
Uttar Pradesh: Rationale of Revised Block Level
Strategy for IDA Impact Assessment. J Commun
Dis. 2024;56(2):62-69.

DOI: https://doi.org/ 10.24321/0019.5138.202433

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