Mass drug administration programme against lymphatic filariasis-an evaluation of coverage and compliance in a northern Karnataka district, India

Abstract

Background and objectivesLymphatic Filariasis, also known as elephantiasis, is a neglected tropical disease causing chronic damage to the lymphatic system. The disease, due to its peculiar morphological manifestations and disfigurations, is associated with severe social stigma and results in severe economic and mental stress for the affected. India's National Health Policy (2002) was aiming at the elimination of Lymphatic Filariasis in the country by 2015 which was extended to 2017. Preventive chemotherapy using yearly one dose of DEC and albendazole through mass drug administration is the key strategy adopted for this. This study aims at assessing the coverage, compliance, and causes for noncompliance towards MDA in Bagalkot district and assessing the rates of directly observed treatment, the source of information on MDA and incidence of side effects related to MDA Programme. MethodsA cross-sectional study was done in four randomly selected clusters in endemic Talukas of Bagalkot district of Karnataka. A total of 240 households with 1110 beneficiaries were evaluated during the study. The information was collected by directly interviewing one responsible adult member from each house using a structured proforma. The data obtained was then entered to Microsoft Excel 2013 spreadsheet and analyzed using SPSS version 22. ResultsAmong the 1110 persons evaluated the coverage was found to be 93.9% and effective coverage rate (compliance) was 83.2%. The coverage compliance gap was 10.7%. The most common reason quoted by the beneficiaries for not consuming the tablet was lack of faith in the tablets. The incidence of adverse drug reactions was 14.68%. ConclusionThe effective coverage rate of MDA programme in Bagalkot was well below the national target of 85%, recommended by the government of India. The major reason for the high coverage-compliance gap was the failure of effective IEC activities. Intensive IEC activities are needed for educating the beneficiaries against the misconceptions of filariasis and MDA programme.