Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India
Identifieur interne : 000114 ( Pmc/Checkpoint ); précédent : 000113; suivant : 000115Reaching 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.
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
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Jesalpura</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat</wicri:regionArea><wicri:noRegion>Gujarat</wicri:noRegion></affiliation></author><author><name sortKey="Kurien, George" sort="Kurien, George" uniqKey="Kurien G" first="George" last="Kurien">George Kurien</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat</wicri:regionArea><wicri:noRegion>Gujarat</wicri:noRegion></affiliation></author><author><name sortKey="Kosambiya, Jayendra K" sort="Kosambiya, Jayendra K" uniqKey="Kosambiya J" first="Jayendra K." last="Kosambiya">Jayendra K. 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Jesalpura</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat</wicri:regionArea><wicri:noRegion>Gujarat</wicri:noRegion></affiliation></author><author><name sortKey="Kurien, George" sort="Kurien, George" uniqKey="Kurien G" first="George" last="Kurien">George Kurien</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat</wicri:regionArea><wicri:noRegion>Gujarat</wicri:noRegion></affiliation></author><author><name sortKey="Kosambiya, Jayendra K" sort="Kosambiya, Jayendra K" uniqKey="Kosambiya J" first="Jayendra K." last="Kosambiya">Jayendra K. Kosambiya</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Community Medicine, Government Medical College, Surat, Gujarat, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Community Medicine, Government Medical College, Surat, Gujarat</wicri:regionArea><wicri:noRegion>Gujarat</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS Neglected Tropical Diseases</title><idno type="ISSN">1935-2727</idno><idno type="eISSN">1935-2735</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lahariya, C" uniqKey="Lahariya C">C Lahariya</name></author><author><name sortKey="Tomar, Ss" uniqKey="Tomar S">SS Tomar</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Nujum, Zt" uniqKey="Nujum Z">ZT Nujum</name></author><author><name sortKey="Remadevi, S" uniqKey="Remadevi S">S Remadevi</name></author><author><name sortKey="Nirmala, C" uniqKey="Nirmala C">C Nirmala</name></author><author><name sortKey="Rajmohanan, K" uniqKey="Rajmohanan K">K Rajmohanan</name></author><author><name sortKey="Indu, P" uniqKey="Indu P">P Indu</name></author><author><name sortKey="Nair, Sm" uniqKey="Nair S">SM Nair</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Das, Pk" uniqKey="Das P">PK Das</name></author><author><name sortKey="Pani, Sp" uniqKey="Pani S">SP Pani</name></author><author><name sortKey="Krishnamorthy, K" uniqKey="Krishnamorthy K">K Krishnamorthy</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Babu, Bv" uniqKey="Babu B">BV Babu</name></author><author><name sortKey="Babu, Gr" uniqKey="Babu G">GR Babu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dhariwal Ac, Sp" uniqKey="Dhariwal Ac S">SP Dhariwal AC</name></author><author><name sortKey="Bhattacharjee, J" uniqKey="Bhattacharjee J">J Bhattacharjee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nandha, B" uniqKey="Nandha B">B Nandha</name></author><author><name sortKey="Sadanandane, C" uniqKey="Sadanandane C">C Sadanandane</name></author><author><name sortKey="Jambulingam, P" uniqKey="Jambulingam P">P Jambulingam</name></author><author><name sortKey="Das, P" uniqKey="Das P">P Das</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alexander, Nd" uniqKey="Alexander N">ND Alexander</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Shuford, Kv" uniqKey="Shuford K">KV Shuford</name></author><author><name sortKey="Turner, Hc" uniqKey="Turner H">HC Turner</name></author><author><name sortKey="Anderson, Rm" uniqKey="Anderson R">RM Anderson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kumar, P" uniqKey="Kumar P">P Kumar</name></author><author><name sortKey="Prajapati, P" uniqKey="Prajapati P">P Prajapati</name></author><author><name sortKey="Saxena, D" uniqKey="Saxena D">D Saxena</name></author><author><name sortKey="Kavishwar, Ab" uniqKey="Kavishwar A">AB Kavishwar</name></author><author><name sortKey="Kurian, G" uniqKey="Kurian G">G Kurian</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Babu, Bv" uniqKey="Babu B">BV Babu</name></author><author><name sortKey="Nayak, An" uniqKey="Nayak A">AN Nayak</name></author><author><name sortKey="Dhal, K" uniqKey="Dhal K">K Dhal</name></author><author><name sortKey="Acharya, As" uniqKey="Acharya A">AS Acharya</name></author><author><name sortKey="Jangid, Pk" uniqKey="Jangid P">PK Jangid</name></author><author><name sortKey="Mallick, G" uniqKey="Mallick G">G Mallick</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mahalakshmy, T" uniqKey="Mahalakshmy T">T Mahalakshmy</name></author><author><name sortKey="Kalaiselvan, G" uniqKey="Kalaiselvan G">G Kalaiselvan</name></author><author><name sortKey="Parmar, J" uniqKey="Parmar J">J Parmar</name></author><author><name sortKey="Dongre, A" uniqKey="Dongre A">A Dongre</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ramaiah, Kd" uniqKey="Ramaiah K">KD Ramaiah</name></author><author><name sortKey="Vanamail, P" uniqKey="Vanamail P">P Vanamail</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vaishnav, Kg" uniqKey="Vaishnav K">KG Vaishnav</name></author><author><name sortKey="Desai, Hs" uniqKey="Desai H">HS Desai</name></author><author><name sortKey="Srivastava, Pk" uniqKey="Srivastava P">PK Srivastava</name></author><author><name sortKey="Joshi, Pt" uniqKey="Joshi P">PT Joshi</name></author><author><name sortKey="Kurian, G" uniqKey="Kurian G">G Kurian</name></author><author><name sortKey="Thakor, Hg" uniqKey="Thakor H">HG Thakor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Geldsetzer, P" uniqKey="Geldsetzer P">P Geldsetzer</name></author><author><name sortKey="Fink, G" uniqKey="Fink G">G Fink</name></author><author><name sortKey="Vaikath, M" uniqKey="Vaikath M">M Vaikath</name></author><author><name sortKey="B Rnighausen, T" uniqKey="B Rnighausen T">T Bärnighausen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krentel, A" uniqKey="Krentel A">A Krentel</name></author><author><name sortKey="Fischer, P" uniqKey="Fischer P">P Fischer</name></author><author><name sortKey="Weil, G" uniqKey="Weil G">G Weil</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, A M" uniqKey="Khan A">A.M. Khan</name></author><author><name sortKey="D, P" uniqKey="D P">P D</name></author><author><name sortKey="Sarmah, C K" uniqKey="Sarmah C">C.K. Sarmah</name></author><author><name sortKey="Baruah, N K" uniqKey="Baruah N">N.K. Baruah</name></author><author><name sortKey="Das, S" uniqKey="Das S">S. Das</name></author><author><name sortKey="Pathak, A K" uniqKey="Pathak A">A.K. Pathak</name></author><author><name sortKey="Sarmah, P" uniqKey="Sarmah P">P. Sarmah</name></author><author><name sortKey="Mahanta, J" uniqKey="Mahanta J">J Mahanta</name></author><author><name sortKey="Me, H" uniqKey="Me H">H ME</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Babu, B V" uniqKey="Babu B">B V Babu</name></author><author><name sortKey="K, Ks" uniqKey="K K">KS K</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Richards, Fo" uniqKey="Richards F">FO Richards</name></author><author><name sortKey="Eigege, A" uniqKey="Eigege A">A Eigege</name></author><author><name sortKey="Miri, Es" uniqKey="Miri E">ES Miri</name></author><author><name sortKey="Kal, A" uniqKey="Kal A">A Kal</name></author><author><name sortKey="Umaru, J" uniqKey="Umaru J">J Umaru</name></author><author><name sortKey="Pam, D" uniqKey="Pam D">D Pam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Derua, Ya" uniqKey="Derua Y">YA Derua</name></author><author><name sortKey="Magesa, Sm" uniqKey="Magesa S">SM Magesa</name></author><author><name sortKey="Pedersen, Em" uniqKey="Pedersen E">EM Pedersen</name></author><author><name sortKey="Stensgaard, As" uniqKey="Stensgaard A">AS Stensgaard</name></author><author><name sortKey="Malecela, Mn" uniqKey="Malecela M">MN Malecela</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS Negl Trop Dis</journal-id><journal-id journal-id-type="iso-abbrev">PLoS Negl Trop Dis</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosntds</journal-id><journal-title-group><journal-title>PLoS Neglected Tropical Diseases</journal-title></journal-title-group><issn pub-type="ppub">1935-2727</issn><issn pub-type="epub">1935-2735</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28369129</article-id><article-id pub-id-type="pmc">5391126</article-id><article-id pub-id-type="doi">10.1371/journal.pntd.0005476</article-id><article-id pub-id-type="publisher-id">PNTD-D-16-01246</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pharmaceutics</subject><subj-group><subject>Drug Therapy</subject><subj-group><subject>Drug Administration</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Parasitic Diseases</subject><subj-group><subject>Helminth Infections</subject><subj-group><subject>Filariasis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pharmaceutics</subject><subj-group><subject>Drug Delivery</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject><subj-group><subject>Geographical Locations</subject><subj-group><subject>Asia</subject><subj-group><subject>India</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Parasitic Diseases</subject><subj-group><subject>Helminth Infections</subject><subj-group><subject>Filariasis</subject><subj-group><subject>Lymphatic Filariasis</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Tropical Diseases</subject><subj-group><subject>Neglected Tropical Diseases</subject><subj-group><subject>Lymphatic Filariasis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Public and Occupational Health</subject></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Anatomy</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Blood</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Anatomy</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Blood</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Physiology</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Blood</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Physiology</subject><subj-group><subject>Body Fluids</subject><subj-group><subject>Blood</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pharmacology</subject><subj-group><subject>Drug Information</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India</article-title><alt-title alt-title-type="running-head">Mass drug administration- way to filariasis elimination</alt-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0002-2058-0722</contrib-id><name><surname>Modi</surname><given-names>Anjali</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="corresp" rid="cor001">*</xref></contrib><contrib contrib-type="author"><name><surname>Gamit</surname><given-names>Sukesha</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jesalpura</surname><given-names>Bharat S.</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref><xref ref-type="author-notes" rid="econtrib001"><sup>‡</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kurien</surname><given-names>George</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kosambiya</surname><given-names>Jayendra K.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="author-notes" rid="econtrib001"><sup>‡</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>Department of Community Medicine, Government Medical College, Surat, Gujarat, India</addr-line></aff><aff id="aff002"><label>2</label><addr-line>National Vector Borne Disease Control Department (NVBDCP), Health and Family Welfare Department, Government of Gujarat, Gandhinagar, Gujarat, India</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Barry</surname><given-names>Alyssa E.</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Walter and Eliza Hall Institute, AUSTRALIA</addr-line></aff><author-notes><fn fn-type="COI-statement" id="coi001"><p>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p><list list-type="simple"><list-item><p><bold>Conceptualization:</bold> BSJ GK AM SG JKK.</p></list-item><list-item><p><bold>Data curation:</bold> GK AM SG BSJ JKK.</p></list-item><list-item><p><bold>Formal analysis:</bold> AM SG GK.</p></list-item><list-item><p><bold>Investigation:</bold> AM SG.</p></list-item><list-item><p><bold>Methodology:</bold> BSJ GK AM SG.</p></list-item><list-item><p><bold>Project administration:</bold> AM SG GK JKK BSJ.</p></list-item><list-item><p><bold>Resources:</bold> BSJ GK JKK AM SG.</p></list-item><list-item><p><bold>Software:</bold> AM SG GK.</p></list-item><list-item><p><bold>Supervision:</bold> BSJ GK JKK AM SG.</p></list-item><list-item><p><bold>Validation:</bold> AM SG JKK GK BSJ.</p></list-item><list-item><p><bold>Visualization:</bold> AM.</p></list-item><list-item><p><bold>Writing – original draft:</bold> AM.</p></list-item><list-item><p><bold>Writing – review & editing:</bold> AM SG JKK BSJ GK.</p></list-item></list></p></fn><fn fn-type="other" id="econtrib001"><p>‡ These authors are joint senior authors on this work.</p></fn><corresp id="cor001">* E-mail: <email>dranjalimodi@gmail.com</email></corresp></author-notes><pub-date pub-type="epub"><day>3</day><month>4</month><year>2017</year></pub-date><pub-date pub-type="collection"><month>4</month><year>2017</year></pub-date><volume>11</volume><issue>4</issue><elocation-id>e0005476</elocation-id><history><date date-type="received"><day>27</day><month>7</month><year>2016</year></date><date date-type="accepted"><day>10</day><month>3</month><year>2017</year></date></history><permissions><copyright-statement>© 2017 Modi et al</copyright-statement><copyright-year>2017</copyright-year><copyright-holder>Modi et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="pntd.0005476.pdf"></self-uri><abstract><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></abstract><abstract abstract-type="summary"><title>Author summary</title><p>The Global Program to Eliminate Lymphatic Filariasis (GPELF) is one of the largest public health intervention till date based on mass drug administration (MDA). MDA interrupts transmission by clearing larval parasites from blood so that they are unavailable for mosquitoes. The current communication describes independent assessment of annual MDA of diethylcarbamazine and albendazol in endemic area of Gujarat state, India during years 2010–2015. The process indicators coverage and compliance rates and impact indicator microfilaraemia were studied following WHO guidelines. We report results from 125,936 nocturnal blood smears and 17,551 population in 120 clusters. Post MDA survey shows high coverage and compliance above 85%. Both drug and epidemiological drug coverage were above recommended average of 80% and 65% respectively. Directly observed consumption improved from 58% in 2010 to 82% in 2015. The reports were shared with program managers and drug administrators to inform development of specific strategies to enhance the program. Microfilaraemia decreased by 68% from baseline year 2005 to 2015. Findings demonstrate implementing MDA gives sustainable results in large populations. After ten rounds MDA, LF transmission is interrupted and microfilaraemia decreased to <1%. Now, Gujarat State is ready for post-MDA surveillance and Transmission Assessment Survey (TAS).</p></abstract><funding-group><funding-statement>The Health and Family Welfare Department, Government of Gujarat helped in study design and funded the field visits for data collection. They also provided funding for data analysis and report preparation under the National Vectorborne Disease Control Program (NVBDCP). The funder had no role in data collection and analysis, decision to publish, or preparation of manuscript.</funding-statement></funding-group><counts><fig-count count="2"></fig-count><table-count count="5"></table-count><page-count count="14"></page-count></counts><custom-meta-group><custom-meta><meta-name>PLOS Publication Stage</meta-name><meta-value>vor-update-to-uncorrected-proof</meta-value></custom-meta><custom-meta><meta-name>Publication Update</meta-name><meta-value>2017-04-13</meta-value></custom-meta><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>All relevant data are within the paper and its Supporting Information files.</p></notes></front></pmc><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Modi, Anjali" sort="Modi, Anjali" uniqKey="Modi A" first="Anjali" last="Modi">Anjali Modi</name></noRegion><name sortKey="Gamit, Sukesha" sort="Gamit, Sukesha" uniqKey="Gamit S" first="Sukesha" last="Gamit">Sukesha Gamit</name><name sortKey="Jesalpura, Bharat S" sort="Jesalpura, Bharat S" uniqKey="Jesalpura B" first="Bharat S." last="Jesalpura">Bharat S. Jesalpura</name><name sortKey="Kosambiya, Jayendra K" sort="Kosambiya, Jayendra K" uniqKey="Kosambiya J" first="Jayendra K." last="Kosambiya">Jayendra K. Kosambiya</name><name sortKey="Kurien, George" sort="Kurien, George" uniqKey="Kurien G" first="George" last="Kurien">George Kurien</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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