Filaria was identified as one of the diseases to be eliminated globally. Global elimination of this disease by the year 2020 has been envisaged by World Health Organisation (WHO) and the Government of India is also signatory to the World Health Assembly Resolution in 1997 for its Global Elimination. The National Health Policy (2002) has envisaged elimination of lymphatic filariasis in India by 2015.
For controlling this disease, Govt. of India launched National Filaria Control Programme (NFCP) in 1955. The strategy for filariasis control in this programme has been vector control measures and treatment of individual patients reporting to the filaria clinics. The recommended dose for treatment of filariasis for interruption of transmission is Diethylcarbamazine citrate (DEC) tablets @ 6mg per kg body weight for 12 days to those persons who are detected as microfilaria positive. NFCP activities are implemented through 206 control units and 199 filaria clinics located in urban areas.
This year MDA is scheduled on 15th November and 13 states namely Andhra Pradesh, Assam, Chhattisgarh, Goa, Karnataka, Kerala, Madhya Pradesh, Maharashtra, West Bengal, Andaman & Nicobar Islands, Daman & Diu, Lakshadweep, and Dadra & N Haveli are launching this campaign of Mass Drug Administration (MDA). The remaining states have rescheduled due to local festivals and will be completing MDA before December 2007.
On the National Filaria Day, drug distribution is made by door-to-door campaign and some booths are set up at health facilities and town centers, etc. These tablets are supplied free. The drug, DEC, can also be obtained from filaria clinics and primary health centres (PHCs) in endemic States/UTs.
Lymphatic Filariasis (LF) is a disabling, disfiguring infection caused by parasitic worms. It is estimated that 100 and 20 million people are infected in around 83 countries throughout the tropics and sub-tropics. LF is major cause of disability, social stigmatization, phsyco-social and economic reductions in life opportunities and a major burden on health and hospital resources, especially on account of cost for surgical intervention. The disease is caused by worms and transmitted by mosquitoes. The infection is acquired in childhood and develops in man and woman of all ages. Its most frequent victims are rural and urban poor. It has been estimated that globally over a billion people are at risk. Although this disease is the most prevalent tropical disease, it is rarely fatal and thus in the developing countries it has been overshadowed by the killer diseases like HIV/AIDS, TB and Malaria.
The disease was recorded in India as early as in 6th century B.C. by the famous Indian physician, Susruta in his book ‘Susruta Samhita’. In 7th century A.D. Madhavakara described signs and symptoms of the disease in his treatise ‘Madhava Nidhana’ which hold good even today. In 1709, Clarke called elephantoid legs in Cochin as ‘Malabar legs’. The discovery of microfilariae (mf) in the peripheral blood was made first by Lewis in 1872 in Calcutta (Kolkata).
In India the disease is prevalent in 20 states and Union Territories namely Andhra Pradesh, Assam, Bihar, Chhatisgarh, Goa, Gujarat, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh, West Bengal, Puducherry, Andaman & Nicobar Islands, Daman & Diu, Lakshadweep, and Dadra & N Haveli and it has been estimated that about 500 million population of the country is living at the risk of filaria.
The strategy of lymphatic filariasis elimination is through:
· Annual Mass Drug Administration (MDA) of single dose of DEC (Diethylcarbamazine citrate) tablets for 5 years or more to the eligible population (except pregnant women, children below 2 years of age and seriously ill persons) to interrupt transmission of the disease and
· Home based management of lymphoedema cases and up-scaling of hydrocele operations in identified CHCs/ District hospitals /medical colleges.
In pursuit to achieve the goals, GoI launched nationwide MDA in 2004 in endemic areas as well as home based morbidity management, scaling up hydrocelectomies in CHCs and PHCs. The coverage of MDA has been reported to be 72.6%, 79.84% and 83.67% respectively in the year 2004, 2005 and 2006.
In addition to MDA, the another pillar for elimination of lymphatic filariasis is home based management of lymphoedema cases by simple washing and surgical intervention for hydrocele cases. Filaria patients with damaged lymphatic vessels often have more bacteria on the skin than usual. Good hygiene and treatment of entry lesions are important measures for managing lymphoedema. The patients should be encouraged to practise skin care and hygiene. The reduction in the frequency of the acute attacks is an indication that the patient’s condition is improving.
Our goal is to eliminate this disease completely from our country and make future generations live healthy and happy life, free from lymphatic filariasis.
KR/SK/MDA - 162
(Release ID :32649)