Impact of mass drug administration for elimination of lymphatic filariasis in Nepal.
Lymphatic filariasis (LF) is a neglected tropical disease transmitted by mosquitoes. Nepal has implemented a national effort to eliminate LF by 2020 through mass drug administration (MDA) using diethylcarbamazine (DEC) and albendazole (ALB). We assessed the impact of MDAs on LF in selected districts...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-07-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC5536438?pdf=render |
| _version_ | 1828398151327809536 |
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| author | Chet Raj Ojha Basant Joshi Khagendra Prakash Kc Shyam Prakash Dumre Keshav Kumar Yogi Bandana Bhatta Tulasi Adhikari Kathryn Crowley Babu Ram Marasini |
| author_facet | Chet Raj Ojha Basant Joshi Khagendra Prakash Kc Shyam Prakash Dumre Keshav Kumar Yogi Bandana Bhatta Tulasi Adhikari Kathryn Crowley Babu Ram Marasini |
| author_sort | Chet Raj Ojha |
| collection | DOAJ |
| description | Lymphatic filariasis (LF) is a neglected tropical disease transmitted by mosquitoes. Nepal has implemented a national effort to eliminate LF by 2020 through mass drug administration (MDA) using diethylcarbamazine (DEC) and albendazole (ALB). We assessed the impact of MDAs on LF in selected districts of Nepal after the recommended six MDA rounds had been completed.Baseline surveys were conducted in seven districts and mapping data were used as baseline in the other three districts before starting MDA in 2009. LF antigen (Ag) prevalence ranged from 1.06% to 20% among districts included in the baseline and mapping study. The number of people who received DEC and ALB were recorded during each MDA round and population-based cluster surveys were conducted at least once in each district during the life of the program. The reported MDA coverage in five districts was consistently at least 65%. Two districts achieved the targeted coverage in four out of five rounds and the rest three districts achieved the target only in the first round. A pre-transmission assessment survey (pre-TAS) was conducted in one sentinel site and at least one spot check site in each of the districts after five MDA rounds. In pre-TAS, all the sites of five districts (Pyuthan, Arghakhanchi, Kaski, Bhaktapur, and Kathmandu) and all but one spot check site of Lalitpur district had LF Ag < 2% (ranging from 0.0% to 1.99%). Transmission assessment survey (TAS) was conducted in six evaluation units (EUs) consisting of six districts qualified on pre-TAS. Though MDA coverage of 65% was not achieved in three districts (Kathmandu, Lalitpur and Bhaktapur), Nepal government in consultation with World Health Organization (WHO) decided to conduct TAS. All six EUs achieved the LF Ag threshold required to stop MDA in TAS, despite the low reported MDA coverage in those three districts.Although Nepal has achieved significant progress towards LF elimination, five rounds of MDA were not sufficient to disrupt the transmission cycle in all districts, probably because of high baseline prevalence. |
| first_indexed | 2024-12-10T08:57:10Z |
| format | Article |
| id | doaj.art-63212427b193448fa7bd7a033f42021d |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-10T08:57:10Z |
| publishDate | 2017-07-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-63212427b193448fa7bd7a033f42021d2022-12-22T01:55:23ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352017-07-01117e000578810.1371/journal.pntd.0005788Impact of mass drug administration for elimination of lymphatic filariasis in Nepal.Chet Raj OjhaBasant JoshiKhagendra Prakash KcShyam Prakash DumreKeshav Kumar YogiBandana BhattaTulasi AdhikariKathryn CrowleyBabu Ram MarasiniLymphatic filariasis (LF) is a neglected tropical disease transmitted by mosquitoes. Nepal has implemented a national effort to eliminate LF by 2020 through mass drug administration (MDA) using diethylcarbamazine (DEC) and albendazole (ALB). We assessed the impact of MDAs on LF in selected districts of Nepal after the recommended six MDA rounds had been completed.Baseline surveys were conducted in seven districts and mapping data were used as baseline in the other three districts before starting MDA in 2009. LF antigen (Ag) prevalence ranged from 1.06% to 20% among districts included in the baseline and mapping study. The number of people who received DEC and ALB were recorded during each MDA round and population-based cluster surveys were conducted at least once in each district during the life of the program. The reported MDA coverage in five districts was consistently at least 65%. Two districts achieved the targeted coverage in four out of five rounds and the rest three districts achieved the target only in the first round. A pre-transmission assessment survey (pre-TAS) was conducted in one sentinel site and at least one spot check site in each of the districts after five MDA rounds. In pre-TAS, all the sites of five districts (Pyuthan, Arghakhanchi, Kaski, Bhaktapur, and Kathmandu) and all but one spot check site of Lalitpur district had LF Ag < 2% (ranging from 0.0% to 1.99%). Transmission assessment survey (TAS) was conducted in six evaluation units (EUs) consisting of six districts qualified on pre-TAS. Though MDA coverage of 65% was not achieved in three districts (Kathmandu, Lalitpur and Bhaktapur), Nepal government in consultation with World Health Organization (WHO) decided to conduct TAS. All six EUs achieved the LF Ag threshold required to stop MDA in TAS, despite the low reported MDA coverage in those three districts.Although Nepal has achieved significant progress towards LF elimination, five rounds of MDA were not sufficient to disrupt the transmission cycle in all districts, probably because of high baseline prevalence.http://europepmc.org/articles/PMC5536438?pdf=render |
| spellingShingle | Chet Raj Ojha Basant Joshi Khagendra Prakash Kc Shyam Prakash Dumre Keshav Kumar Yogi Bandana Bhatta Tulasi Adhikari Kathryn Crowley Babu Ram Marasini Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. PLoS Neglected Tropical Diseases |
| title | Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. |
| title_full | Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. |
| title_fullStr | Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. |
| title_full_unstemmed | Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. |
| title_short | Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. |
| title_sort | impact of mass drug administration for elimination of lymphatic filariasis in nepal |
| url | http://europepmc.org/articles/PMC5536438?pdf=render |
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