Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India
Identifieur interne : 000244 ( Main/Exploration ); précédent : 000243; suivant : 000245Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India
Auteurs : Anjali Modi [Inde] ; Sukesha Gamit [Inde] ; Bharat S. Jesalpura [Inde] ; George Kurien [Inde] ; Jayendra K. Kosambiya [Inde]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2017.
Descripteurs français
- KwdFr :
- Albendazole (administration et posologie), Animaux, Association de médicaments, Diéthylcarbamazine (administration et posologie), Enquêtes et questionnaires, Filaricides (administration et posologie), Filariose lymphatique (), Filariose lymphatique (traitement médicamenteux), Filariose lymphatique (épidémiologie), Humains, Inde (épidémiologie), Maladies endémiques, Microfilaria, Recherche sur les services de santé, Surveillance sentinelle, Wuchereria bancrofti (), Éradication de maladie, Évaluation de programme.
- MESH :
- administration et posologie : Albendazole, Diéthylcarbamazine, Filaricides.
- traitement médicamenteux : Filariose lymphatique.
- épidémiologie : Filariose lymphatique, Inde.
- Animaux, Association de médicaments, Enquêtes et questionnaires, Filariose lymphatique, Humains, Maladies endémiques, Microfilaria, Recherche sur les services de santé, Surveillance sentinelle, Wuchereria bancrofti, Éradication de maladie, Évaluation de programme.
English descriptors
- KwdEn :
- Albendazole (administration & dosage), Animals, Diethylcarbamazine (administration & dosage), Disease Eradication, Drug Therapy, Combination, Elephantiasis, Filarial (drug therapy), Elephantiasis, Filarial (epidemiology), Elephantiasis, Filarial (prevention & control), Endemic Diseases, Filaricides (administration & dosage), Health Services Research, Humans, India (epidemiology), Microfilariae, Program Evaluation, Sentinel Surveillance, Surveys and Questionnaires, Wuchereria bancrofti (drug effects).
- MESH :
- chemical , administration & dosage : Albendazole, Diethylcarbamazine, Filaricides.
- drug effects : Wuchereria bancrofti.
- drug therapy : Elephantiasis, Filarial.
- epidemiology : Elephantiasis, Filarial, India.
- prevention & control : Elephantiasis, Filarial.
- Animals, Disease Eradication, Drug Therapy, Combination, Endemic Diseases, Health Services Research, Humans, Microfilariae, Program Evaluation, Sentinel Surveillance, Surveys and Questionnaires.
Abstract
Following the World Health Assembly resolution on Elimination of lymphatic filariasis (ELF) as a public health problem by the year 2020, a Global Program (GPELF) was launched in 1997 to help endemic countries to initiate national programs. The current strategy to interrupt transmission of LF, is administration of once-yearly, single-dose, two-drug regimen (Albendazole with Diethylcarbamazine (DEC) to be used in endemic areas with the goal of reaching 65% epidemiological coverage for 4–6 years. We report findings of independent assessment from year 2010 to 2015 for last six rounds, after initial five rounds of Mass Drug Administration (MDA) since 2005 for ELF in endemic area of Gujarat.
Independent assessment of MDA was performed to find coverage and compliance indicators, reasons for non-coverage and non-compliance in five Implementation Units (IUs). Pre, during and post MDA evaluations were done in three phases. The impact of MDA was measured by microfilaraemia survey. A total of eight sites, four random and four fixed sentinel sites were selected to calculate microfilaria rate (MF) per IUs per year. In years 2010 to 2015, we report results from 125,936 nocturnal blood smears and 17551 population in 120 selected clusters. Four clusters were selected per year in each of the five IUs for assessment of MDA round.
Post MDA survey showed drug coverage between 81%-88% and epidemiological coverage 77%-89% across years. Main reasons for non-coverage were drug administrator related (the team did not visit or missed people) while non-compliance was population related (fear of side effects, sickness, people forgot or absent). During MDA findings show that the directly observed consumption is considerably improved from 58% in 2010 to 82% in 2015. The knowledge about benefits of drug provided also increased from 59% to 90% over the years. The current MF rate is less than one in all IUs with an overall 68% percent decrease from baseline year 2005 to year 2015. The average MF rate of Gujarat is 0.44 for year 2015.
The findings show that achieving adequate epidemiological and drug coverage is possible by actual field level operation of the program in large endemic areas. The results and feedback from independent assessment, performed regularly, could guide the policymakers and program managers for mid-term corrections and to frame strategies to enhance program. Monitoring of coverage and impact indicator together informs decisions for reaching end-point of MDA. The impact indicator- microfilaria rate in all IUs of South Gujarat Region has reached and remained less than one percent signaling end-points of MDA. Post MDA stringent monitoring in form of TAS is recommended to keep vigil on maintenance of elimination achieved.
Url:
DOI: 10.1371/journal.pntd.0005476
PubMed: 28369129
PubMed Central: 5391126
Affiliations:
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Le document en format XML
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<author><name sortKey="Kosambiya, Jayendra K" sort="Kosambiya, Jayendra K" uniqKey="Kosambiya J" first="Jayendra K." last="Kosambiya">Jayendra K. Kosambiya</name>
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<term>Animals</term>
<term>Diethylcarbamazine (administration & dosage)</term>
<term>Disease Eradication</term>
<term>Drug Therapy, Combination</term>
<term>Elephantiasis, Filarial (drug therapy)</term>
<term>Elephantiasis, Filarial (epidemiology)</term>
<term>Elephantiasis, Filarial (prevention & control)</term>
<term>Endemic Diseases</term>
<term>Filaricides (administration & dosage)</term>
<term>Health Services Research</term>
<term>Humans</term>
<term>India (epidemiology)</term>
<term>Microfilariae</term>
<term>Program Evaluation</term>
<term>Sentinel Surveillance</term>
<term>Surveys and Questionnaires</term>
<term>Wuchereria bancrofti (drug effects)</term>
</keywords>
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<term>Animaux</term>
<term>Association de médicaments</term>
<term>Diéthylcarbamazine (administration et posologie)</term>
<term>Enquêtes et questionnaires</term>
<term>Filaricides (administration et posologie)</term>
<term>Filariose lymphatique ()</term>
<term>Filariose lymphatique (traitement médicamenteux)</term>
<term>Filariose lymphatique (épidémiologie)</term>
<term>Humains</term>
<term>Inde (épidémiologie)</term>
<term>Maladies endémiques</term>
<term>Microfilaria</term>
<term>Recherche sur les services de santé</term>
<term>Surveillance sentinelle</term>
<term>Wuchereria bancrofti ()</term>
<term>Éradication de maladie</term>
<term>Évaluation de programme</term>
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<term>Filaricides</term>
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<term>Diéthylcarbamazine</term>
<term>Filaricides</term>
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<term>Disease Eradication</term>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>Following the World Health Assembly resolution on Elimination of lymphatic filariasis (ELF) as a public health problem by the year 2020, a Global Program (GPELF) was launched in 1997 to help endemic countries to initiate national programs. The current strategy to interrupt transmission of LF, is administration of once-yearly, single-dose, two-drug regimen (Albendazole with Diethylcarbamazine (DEC) to be used in endemic areas with the goal of reaching 65% epidemiological coverage for 4–6 years. We report findings of independent assessment from year 2010 to 2015 for last six rounds, after initial five rounds of Mass Drug Administration (MDA) since 2005 for ELF in endemic area of Gujarat.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>Independent assessment of MDA was performed to find coverage and compliance indicators, reasons for non-coverage and non-compliance in five Implementation Units (IUs). Pre, during and post MDA evaluations were done in three phases. The impact of MDA was measured by microfilaraemia survey. A total of eight sites, four random and four fixed sentinel sites were selected to calculate microfilaria rate (MF) per IUs per year. In years 2010 to 2015, we report results from 125,936 nocturnal blood smears and 17551 population in 120 selected clusters. Four clusters were selected per year in each of the five IUs for assessment of MDA round.</p>
</sec>
<sec id="sec003"><title>Result</title>
<p>Post MDA survey showed drug coverage between 81%-88% and epidemiological coverage 77%-89% across years. Main reasons for non-coverage were drug administrator related (the team did not visit or missed people) while non-compliance was population related (fear of side effects, sickness, people forgot or absent). During MDA findings show that the directly observed consumption is considerably improved from 58% in 2010 to 82% in 2015. The knowledge about benefits of drug provided also increased from 59% to 90% over the years. The current MF rate is less than one in all IUs with an overall 68% percent decrease from baseline year 2005 to year 2015. The average MF rate of Gujarat is 0.44 for year 2015.</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>The findings show that achieving adequate epidemiological and drug coverage is possible by actual field level operation of the program in large endemic areas. The results and feedback from independent assessment, performed regularly, could guide the policymakers and program managers for mid-term corrections and to frame strategies to enhance program. Monitoring of coverage and impact indicator together informs decisions for reaching end-point of MDA. The impact indicator- microfilaria rate in all IUs of South Gujarat Region has reached and remained less than one percent signaling end-points of MDA. Post MDA stringent monitoring in form of TAS is recommended to keep vigil on maintenance of elimination achieved.</p>
</sec>
</div>
</front>
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<name sortKey="Gamit, Sukesha" sort="Gamit, Sukesha" uniqKey="Gamit S" first="Sukesha" last="Gamit">Sukesha Gamit</name>
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<name sortKey="Kosambiya, Jayendra K" sort="Kosambiya, Jayendra K" uniqKey="Kosambiya J" first="Jayendra K." last="Kosambiya">Jayendra K. Kosambiya</name>
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