Filariasis

 

Introduction

Highlights

The disease can be eliminated by yearly single dose of Tab.

Diethylcarbamazine & Tab. Albendazole for successive 4-6 years by Mass Drug Administration (MDA) as per WHO guideline

Objectives

To reduce and interrupt transmission of Lymphatic Filariasis by 2015 and prevent recurrence of new infections

To reduce and prevent disabiltiy associated with filariasis

Strategies

Social Mobilization - to build awareness, activities are planned according to local characteristics by local experts and backed up, where possible, by local political, religious and community leaders

To interrupt transmission using mass drug administration

Morbidity control including self help care for intensive local hygiene

Building and sustaining partnerships

Programme management by strengthening management and technical capacity

Door to door drug distribution strategy

Filariasis is a mosquito borne parasitic disease causing swelling of the limbs, urogenital organs, breast etc. with long-term disability. In Bangladesh it is present now in 23 endemic districts, mostly bordering India. About 20 million is already infected, most of which are incapacitated and another 30 million are at risk of infection.

The disease can be eliminated by yearly single dose of Tab.

Diethylcarbamazine & Tab. Albendazole for successive 4-6 years by Mass Drug Administration (MDA) as per WHO guideline. The morbidity can also be controlled by simple washing, hygiene, physiotherapy and surgery in case of hydrocele. Ministry of Health and Family Welfare is committed to eliminating filariasis by 2015 with global elimination of WHO commitment by 2020.

Mass Drug Administration (MDA) was started in Panchagar District in October 2001 covering 0.91 million population with 93% coverage. In 2002, 5.1 million were under MDA with 87.32% coverage. In 2003 another 17.2 million, in 2004, 25 million, in 2005, 50 million and in 2006 another 70 million population will be under MDA. Morbidity control activity will also continue

Status of the LF Elimination programme

Mapping has been partly completed resulting in 23 districts in Divisions being designated as endemic with Mf rates of up to 16%. The total endemic population is estimated to be 70 million.

In 2001 Bangladesh covered 896,000 people in Panchagar district with albendazole and DEC, achieving a coverage of 95.5%. The programme then scaled up and covered 4.9 million people in four districts in 2002, with a coverage of 93.6%. The reported coverage has been validated with independent assessments. The strategy for mass drug administration is door-to-door by health and family planning field staff and volunteers. Drugs are also administered in schools, mosques, cinemas, shopping complexes and bus stations, using volunteers, boy scouts and girl guides. The MDA is communicated to the population by an extensive social mobilisation programme using films, billboards, leaflets, audiocassettes, posters and banners.

Training for disability prevention programme was launched in Panchagar in 2001 and extended to Nilphamari district in 2002. A total of 43 doctors were trained in disability management techniques. In addition 60 doctors were trained in hydrocelectomy in January 2003. A Filaria hospital was constructed by an NGO in Nilphamari district with a grant from the JICA in 2002.

Goal: To eliminate Lymphatic Filariasis from Bangladesh by 2015

Outcomes 2003 2007

The LF Elimination programme aims to scale up to reach the full 70 million people living in endemic areas with albendazole and DEC mass drug administration by 2007.

YEAR

Nos. to be covered by MDA

Remarks

2001

1 million

896,000 people covered, coverage of 95.5%

2002

5 million

Actual achieved with 93.6% coverage

2003

17 million

Approved by the RPRG, tablets being shipped

2004

30 million

 

2005

50 million

 

2006

70* million

 

2007

70* million

 

* or to the total population at risk as ascertained after completion of mapping in 2005.

 

Partnerships

The Bangladesh Ministry of Health and Family Welfare initiated the LF elimination programme in 2001 with assistance from AUSAID and WHO and up scaled to cover 4 districts in 2002 with funding assistance from the Liverpool School of Tropical Medicine, and WHO, plus albendazole donated by GlaxoSmithKline. The supplies of DEC were provided by WHO through a grant from the Bill and Melinda Gates Foundation.