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Lymphatic filariasis (LF), a neglected tropical disease is targeted for elimination globally by 2020. National Health Policy of India set the goal by 2017 and annual single-dose mass drug administration (MDA) with anti-filarial drugs is in operation in endemic districts since 2004. Performance and effectiveness of MDA was diverse across the nation and prevalence of infection continues above threshold level in 50% of endemic districts which requires alternative strategies. National programme aims at achieving >65% consumption for transmission control. Post 10 rounds of MDA in an endemic district of Kerala state, a three-arm study identified determinants in gap in outreach and consumption, based on which context-dependent intervention using social group work and networking (SGWN) was implemented and impact assessed. A spill over effect with overall increase in coverage and consumption rates irrespective of arms apparently is due to inclusive improvement in MDA programme whereas, significant relative improvement in intervention arm reflects effectiveness of SGWN strategy. Though reduction in microfilaria prevalence in all arms was observed, it was significant between intervention and comparison arm. This study highlights need for context-dependent communication strategy to improve MDA for accelerating LF elimination by the targeted 2020.

Globally mosquito-borne lymphatic filariasis (LF) is targeted for elimination by 2020. Towards this goal, the scope of community-based vector control as a supplementary strategy to mass drug administration (MDA) was assessed through an intensive education campaign and evaluated using pre- and post-educational surveys in an intervention and comparison village in Tamil Nadu, South India. Environmental and entomological indicators for breeding sites and mosquito density were examined before and after the intervention. Significant ("P" less than 0.05) increase in knowledge was observed in intervention area with regard to transmission and control of LF. Relative change between intervention and comparison villages before and after intervention was also significant ("z" = greater than 1.96). Multiple mosquito control and personal protection methods were in use during the post-intervention assessment and was evident from the significantly ("P" less than 0.05) higher average score. Breeding sources declined significantly ("P" less than 0.05) in the intervention village with a significant relative change ("z" = 4.32). Significant reduction in per man-hour indoor resting density of mosquitoes was observed in the intervention area compared to baseline. The per capita cost for reducing 87% of the mosquito density was $0.32 indicating the effectiveness of community-based approach. The usefulness of this strategy in the elimination of LF is discussed.

Community compliance is crucial for the success of mass treatment using cooking salt fortified with diethylcarbamazine citrate (DEC) for the elimination of lymphatic filariasis (LF). We describe the role and effectiveness of school-based health education for social mobilization to promote the use of DEC salt, in an endemic district in India. Health education through classroom sessions was the main motivational strategy used. Community members were targeted to receive the message through children. The impact of this approach was assessed among students and community members using an interviewer-administered questionnaire and analysis of salt samples for DEC content from households. Significant improvement in awareness on LF among students and community respondents was observed. School health education (SHE) could promote the use of DEC salt by 19% points more in households with children in schools covered under health education campaign [campaign school (CS)] compared with others. Significantly higher proportion (72.7%) of samples from households with children in CS had detectable DEC, indicating the impact of the intervention on enhancing the use of DEC salt by the community. The results exemplify that SHE is a potential tool for improving and sustaining compliance, thus serving as part of a public health strategy to eliminate LF using DEC salt. [ABSTRACT FROM AUTHOR]

Background: The recommended strategy for elimination of Lymphatic filariasis is single-dose, once-yearly mass treatment with anti-filarial drugs and the program is in operation on a national level in India. Rate of coverage and consumption is the most crucial factor in the success of Mass Drug Administration (MDA) program. In spite of massive efforts, the program demonstrated suboptimal coverage and consumption in urban areas than rural. The involvement of Anganwadi workers (AWWs) of the Integrated Child Development Scheme (ICDS) as communicators and drug distributors was attempted to enhance the coverage and consumption in urban areas and the results presented here. Methods: An annual single dose MDA program was launched under the auspices of Freedom From Filariasis (FFF) program in Pondicherry, India, in the year 1997 and continued for five years. A questionnaire survey was carried out following all the treatment rounds (TRs) for assessing coverage of distribution and consumption Five percent of randomly selected households constituted the sample. All the members available in the selected household at the time of interview formed the respondent of the study. Results: The coverage of drug distribution during the TRs varied from 74.3 to 95.4 percent and consumption rate from 52.9 to 78.8. Among the respondents, 71% were aware of the MDA program and the source of information for 62.8% of them was through personal communication by the AWW. It was observed that 33.2% of the respondents who accepted the drug did so based on the trust on the AWW as a government representative. The main reason for non-consumption in all TRs was fear of side reaction (25.4 - 42.2%). Conclusion: The delivery-strategy of health information and Diethylcarbamazine (DEC) drug to the urban community using the AWWs could achieve relatively higher coverage and consumption than reported in other urban areas. In order to achieve the optimum level, it is imperative to equip the AWWs with current knowledge and skills, and design innovative Information, Education and Communication (IEC) campaign to target the less compliant groups. The beneficial effect of this delivery strategy may be used in similar urban settings to achieve the elimination of LF. [ABSTRACT FROM AUTHOR]