Mass Drug Administration (MDA) for Lymphatic Filariasis Elimination in Uttar Pradesh, India: Issues, Gaps & Challenges

Abstract

Uttar Pradesh is the largest state of India and is comprised of 75 revenue districts. 51 districts of eastern Uttar Pradesh are endemic for LF and are under Elimination of Lymphatic Filariasis (ELF). In order to ensure elimination of the disease from the people, the mass drug administration (MDA) is being observed in these 51 districts since 2004 by ensuring administration of drug Di-ethyl Carbamazine Citrate (DEC) alone once in a year according to the age excluding children <2years, pregnant women and seriously ill persons. Thereafter, 400 mg albendazole to >2 years age group was added with DEC since 2008. When both the drugs are administered together, the effect is on the adult worm too and therefore the parasite will be destroyed preventing the infected person from developing clinical manifestation. NVBDCP guidelines envisages that administration of drug to the 65% of the total population or 85% of the targeted population for five consecutive years will bring down the microfilarimia to <1% among the population, ultimately leading to the elimination of the disease after conducting Transmission Assessment Survey (TAS) thrice at an interval of two years among the virgin/protected group of children i.e. 6-7 years. The Transmission Assessment Survey (TAS) is conducted after ensuring <1% microfilariamia in 10 additional sites selected randomly.

The state could subject only one district Rampur under post MDA surveillance, which cleared TAS-1 & TAS-2. The other districts subjected for TAS during 2016, 2017, 2018 & 2019 but could not qualify for conducting TAS in additional m.f. survey as microfilariamia during 2016, 2017, & 2018 was found >1% and during 2019, the antigenemia was found >2% in 13 districts. The possible gaps, issues and challenges at various levels of the programme implementation have been discussed in the present paper, the rectification of which may lead the state for achieving the goal of elimination of the disease.

How to cite this article:
Kamal S, Chandra R, Singh SM, Kumar A, Mittra KK, Roy N. Mass Drug Administration (MDA) for Lymphatic Filariasis Elimination in Uttar Pradesh, India: Issues, Gaps & Challenges. J Commun Dis 2020; 52(3): 62-73.

DOI: https://doi.org/10.24321/0019.5138.202033