title: Towards elimination of lymphatic filariasis: social mobilization issues and challenges in mass drug administration with anti-filarial drugs in Tamil Nadu, South India.
abstract: India is a signatory to World Health Assembly resolution for elimination of lymphatic filariasis (LF) and National Health Policy has set the goal of LF elimination by 2015. Annual mass drug administration (MDA) is ongoing in endemic districts since 1996-97. Compliance rate is a crucial factor in achieving elimination and was assessed in three districts of Tamil Nadu for 10th and 11th treatment rounds (TRs). An in-depth study assessed the impact of social mobilization by drug distributors (DDs) in two areas from each of the three districts. Overall coverage and compliance for assessed TRs were 76.3 and 67.7% which is below the optimum level to achieve LF elimination. Modifiable determinants continue to be the reason for non-consumption even in the 11th TR and 20.8% were systematic non-compliers. In 76.4% of the cases, DDs failed to adhere to three mandatory visits as per the guidelines. Number of visits by DDs in relation to low and high MDA coverage areas showed a significant relationship (P ≤ 0.000). MDA is limited to drug distribution alone and efforts by DDs in preparing the community were inadequate. Probable means to meet the challenges in preparation of the community is discussed.
authors.affiliation: Vector Control Research Centre (Indian Council of Medical Research), Medical Complex, Indira Nagar Pondicherry 605 006, India. nandabasker@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Nandha
authors.forename: K
authors.initials: K
authors.lastname: Krishnamoorthy
authors.forename: P
authors.initials: P
authors.lastname: Jambulingam
mesh_terms: D015766:Albendazole / Q000008:administration & dosage / Q000600:supply & distribution / Q000627:therapeutic use; D000818:Animals; D003153:Community Health Services / Q000458:organization & administration*; D003150:Community Health Workers / Q000458:organization & administration; D003256:Community Participation; D004049:Diethylcarbamazine / Q000008:administration & dosage / Q000627:therapeutic use; D060740:Disease Eradication / Q000379:methods* / Q000592:standards; D004334:Drug Administration Schedule; D004605:Elephantiasis, Filarial / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D019353:Endemic Diseases / Q000517:prevention & control; D005369:Filaricides / Q000008:administration & dosage* / Q000600:supply & distribution / Q000627:therapeutic use; D014943:Global Health; D006291:Health Policy; D006792:House Calls; D006801:Humans; D007194:India / Q000453:epidemiology; D007559:Ivermectin / Q000008:administration & dosage / Q000600:supply & distribution / Q000627:therapeutic use; D055118:Medication Adherence / Q000523:psychology; D008842:Microfilariae / Q000187:drug effects / Q000254:growth & development; D009313:National Health Programs / Q000458:organization & administration; D011314:Preventive Health Services / Q000458:organization & administration*; D000078329:Workforce; D016903:Drug Monitoring
chemical_list: D005369:Filaricides; D007559:Ivermectin; D015766:Albendazole; D004049:Diethylcarbamazine