Lymphatic filariasis elimination programme in Andaman and Nicobar Islands, India: drug coverage and compliance post eight rounds of MDA

Abstract

Lymphatic filariasis (LF) is endemic in the Andaman and Nicobar islands, including the lone foci for a diurnally sub-periodic form of Wuchereria bancrofti in the Nancowry group of islands. A programme to eliminate LF was launched in 2004 by the Directorate of Health Services, Andaman and Nicobar Administration which involved a single annual mass drug administration (MDA) using diethylcarbamazine (DEC) with albendazole. So far, eight rounds of MDA have been implemented through the Public Health Care network. The pattern of antifilarial drug distribution and compliance achieved in the on-going LF elimination programme in these islands has been assessed. This is the first systematic effort undertaken in these remote islands to assess the coverage and compliance with the LF elimination programme. This study covered 900 households in each of the 3 districts. There were a largest number of side effects in the Nicobar district (6.4%). Non-consumption of drugs ranged from 18.6% (Nicobar) to 42% (North and Middle Andaman). A survey revealed that almost 95.3% of the respondents had heard about MDA from the drug distributors. Therefore, the distributors should be involved in programmes designed to educate the community at risk of acquiring filarial infection and the possible side effects of the drugs.

Diurnally subperiodic filariasis among the Nicobarese of Nicobar district - epidemiology, vector dynamics & prospects of elimination

“…A first systematic and independent effort was undertaken by the RMRC, Port Blair to assess the coverage and compliance post MDA-VIII in the ongoing LF elimination programme in these islands. A total of 2732 people were interviewed from the rural and urban areas of the three districts 34 . In this assessment, high drug coverage was observed in all three districts of the A & N Islands.…”

“…Distribution, compliance and effective drug coverage rates were higher in Nicobar district compared with the other two districts. About 10 per cent of the respondents were non-compliant and the major reasons were that the drug distributor had not visited the house and the fear of the side effects 34 . Compliance rate ranged between 91 per cent (Katchal) to 100 per cent (Chowra, and Teressa).…”

“…The overall effective drug coverage was 90.8 per cent, implying that 90.8 per cent of the population residing in the Nancowry group of islands had consumed the drug. Effective drug coverage in different islands ranged between 83.7 per cent (Katchal) to 100 per cent (Chowra and Teressa) 34 . This assessment indicates that maximum efforts have been accomplished to achieve these levels of distribution, compliance and effective drug coverage in the ongoing LF elimination programme.…”

A rare case of ovarian and pelvic filariasis

“…The signs and symptoms of the disease are related to lymphatic obstruction due to recurrent inflammation caused by filaria or by recurrent bacterial infections. 1 The incidence of the disease is more common in males than females (ratio 10:1). In females, the disease commonly affects the lymph nodes and breast lymphatics.…”

“…Currently, 120 million people are infected with this disease throughout the world and 1.3 billion people are at risk in more than 72 countries. 1 The most common causative organism is Wuchereria bancrofti followed by Brugia malayi and B. timori . The disease can be transmitted through any of the mosquito species, viz.…”