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Operational issues of lymphatic filariasis elimination program and community acceptance of mass drug administration.

Abstract

Introduction: Lymphatic Filariasis (LF) is a Neglected Tropical Disease (NTD). Mass Drug Administration (MDA) is the recommended preventive chemotherapy by the World Health Organization (WHO) to stop the spread of infection. But proper execution of the program is yet to be confirmed. Methods: This cross-sectional study was conducted in Rangpur district among the permanent residents and health officers. Concurrent mixed method approach was taken for data collection. Purposively 204 respondents were selected for quantitative data. Qualitative data were collected through focus group discussions of the residents of that area and in-depth interviews were taken from the health officers as key informants. Results: Among all the respondents, 98.5% was found to be aware of LF, 83.4% was found to be aware of MDA whereas only about 55% of the respondents found to have ingested drugs given during last MDA round. Majority came to know about LF through neighbor/friends or seeing a patient, and Mass Drug Distributors were source of information for MDA in majority of sampled population. Majority related purpose of MDA with antihelminthic drug distribution and vitamin supplementation, along with prevention of LF. Among those who were aware of MDA, 15.7% knew about the correct dose of their age group. Urban area was recorded lower rates of drug ingestion than rural area. At the health system and policy level, lack of workforce, poor planning-promotionadvocacy, delay in supply and processes, inappropriate strategy and poor community participation were prominent at various stages of program implementation. Addition of fixed-site drug distribution in urban area, intensified health education and advocacy programs, more community participation of local governments and more allocation of workforce is essential for better program implementation. Conclusion: Baseline survey and community participation with proper monitoring were essential for the best outcome of the LF elimination program.

More information

Type
Journal Article
Author
Saha S
Miah KA
Alam A
Haque HS
Sultana S
Haque N
Pasha MK
Das T