A Mini Review On the Analytical Methods for Individual and Drug Combinations Administered in Mass Drug Administration for Lymphatic Filariasis

Abstract

Abstract: The NTDs (Neglected Tropical Diseases) are the group of diseases considered the diseases of the poor. Lymphatic Filariae (LF) is one of the category that is prevalent mostly in 47 countries and around 863 million people are under threat from this category of disease. A program named Global Programme to Eliminate Lymphatic Filariasis (GPELF) was initiated by WHO (World Health Organisation) in 1998, with the aim of eliminating LF by 2020. The main role of GPELF was to initiate measures to stop the spread of disease and to control the suffering caused by disease to the patients. For controlling the spread of disease, mass drug administration (MDA) was initiated where the drug or their combinations were administered annually or as and when required. This initiative was Alternating Mass Drug Administration Regimens to Eliminate Lymphatic Filariasis. The recommendations depended on the causative organism and co-endemicity of LF with other filarial diseases. The drug recommendations by WHO for MDA were; for areas with LF and loiasis, albendazole in a dose of 400 mg twice a year; for areas with onchocerciasis and LF, ivermectin in a dose of 200 mcg/kg along with albendazole 400 mg; for areas without onchocerciasis diethylcarbamazine citrate (DEC) in a dose of 6 mg/kg combined with albendazole in dose 400 mg. The three-drug combination was also recommended in some cases where onchocerciasis was not prevalent with LF. Many clinical trials also started for comparing one, two, and even three-drug combinations. A document to streamline the use of these drugs for LF was also issued by WHO in 2017 with the name Alternating mass drug administration regimens to eliminate lymphatic filariasis. The achievement with these regimens, till 2020 was that 80 percent of countries endemic to LF have achieved elimination of this disease. Further, to achieve better elimination in other countries a road map for 2020-2030 is now in being. The analytical methods for individual drugs as they are very old drugs were available and some of the methods for combination are also there mostly involving High- Performance Liquid Chromatography (HPLC) with different types of detecting combinations. These methods are given for detection in various clinical trials or used as an analytical method for the determination of drug(s) in dosage forms.