Evaluation of the lymphatic filariasis elimination program in Mkuranga district, Coast region

Abstract

Background Lymphatic filariasis is the leading mosquito transmitted parasitic disease responsible for morbidity in most developing tropical countries. The interruption of transmission through annual mass drug administration (MDA) and alleviation of suffering and morbidity through prevention and management of disease manifestations are two control strategies. The objective of MDA is to administer ant-filarial drugs once per year to all eligible individuals in the endemic area in order to reduce disease burden and interrupt transmission. The success of MDA depends on understanding of operational factors which contribute to transmission interruption outcome. Objective The main objective was to evaluate the impact of the Lymphatic filariasis elimination Programme in Mkuranga District. Material and Methods This descriptive cross sectional study was carried out in Mkuranga District during the period of April - May 2013. A total of 382 participants aged 5 years and above were involved in the study, of these 59 household leaders had an in depth interview. All 382 were diagnosed using ICT filariasis to ascertain W.bancrofti infection. Drug coverage and willingness to take the drugs in the coming round was also discerned. Parasitological diagnosis was done among CFA positive using the counting chamber. Additionally presence of Lymphoedema was physicallyassessed in all 382 participants. Results A total of 19 (5 %) out of 382 tested CFA positive,fifteen of these gave informed consent for night blood microfilaria testing whereby all tested negative. Prevalence of lymphoedema was found to be 0.8 % (3/382) and this finding was confirmed to the age group above 36 years whereby all tested CFA negative. Staging was done and all were staged 3 and 4.In the study population the MDA coverage for the year 2012 was 72.3 % (276/382).The acceptance to participate in the coming MDA was 96.9 % vi (370/382).Regarding household leader knowledge on the cause and transmission of LF it was found to be 33.9% low and 40.7% medium and 25.4% high. Conclusion There has been a marked reduction in circulating filarial antigen from pre MDA data, presence of microfilaria and lymphoedema after eight rounds of MDA is low. The knowledge regarding the intervention is relatively high however knowledge about the disease or causation remains low.