Drug compliance, coverage key to eliminate lymphatic filariasis, say experts

  • | Tuesday | 19th June, 2018

This means that Maharashtra could well become the first Indian state to adopt the therapy and achieve the elimination of LF by 2020. If required, mopping activities will have to be carried to achieve the required level of coverage. “The monitoring will help us plug the programme gaps. “Further, IDA can sustain the gains achieved in reducing the infection level and prevent further transmission,” he said.Union health minister JP Nadda announced the inclusion of the WHO-recommended triple-drug therapy to eliminate lymphatic filariasis (LF) from the country at a meeting held in New Delhi on June 13.The new treatment regimen will be rolled-out in a phased manner in five districts — Nagpur in Maharashtra, Varanasi in Uttar Pradesh, Arwal in Bihar, Yadgir in Karnataka and Simdega in Jharkhand.However, monitoring drug coverage is going to be crucial. Pune: As the Centre gears up to roll out triple-drug therapy against lymphatic filariasis (LF) in five districts, including one in Maharashtra, experts have emphasized on monitoring medication compliance and coverage to eliminate the disease from the country.“We are close to the target year of LF elimination and we need strategies that can accelerate/hasten the process to achieve its elimination by 2020,” senior scientist NK Ganguly, former director general of the Indian Council of Medical Research (ICMR), told TOI.The triple-drug therapy or IDA (Ivermectin, diethylcarbamazine (DEC) and Albendazole) is more efficacious by clearing microfilariae by about 84%, Ganguly said, adding that two drugs in the existing mass drug administration regimen clear only 62% of microfilariae.

Pune: As the Centre gears up to roll out triple-drug therapy against lymphatic filariasis (LF) in five districts, including one in Maharashtra, experts have emphasized on monitoring medication compliance and coverage to eliminate the disease from the country.“We are close to the target year of LF elimination and we need strategies that can accelerate/hasten the process to achieve its elimination by 2020,” senior scientist NK Ganguly, former director general of the Indian Council of Medical Research (ICMR), told TOI.The triple-drug therapy or IDA (Ivermectin, diethylcarbamazine (DEC) and Albendazole) is more efficacious by clearing microfilariae by about 84%, Ganguly said, adding that two drugs in the existing mass drug administration regimen clear only 62% of microfilariae. “Further, IDA can sustain the gains achieved in reducing the infection level and prevent further transmission,” he said.Union health minister JP Nadda announced the inclusion of the WHO-recommended triple-drug therapy to eliminate lymphatic filariasis (LF) from the country at a meeting held in New Delhi on June 13.The new treatment regimen will be rolled-out in a phased manner in five districts — Nagpur in Maharashtra, Varanasi in Uttar Pradesh, Arwal in Bihar, Yadgir in Karnataka and Simdega in Jharkhand.However, monitoring drug coverage is going to be crucial. “The monitoring will help us plug the programme gaps. If required, mopping activities will have to be carried to achieve the required level of coverage. Monitoring of adverse events can be taken care of through the strong pharmacovigilance network of government of India,” Ganguly added.Directly observed treatment (DoT) strategy as used in tuberculosis control programme will be used in administering the new drug regimen or IDA because we need to administer the drug Ivermectin based on weight, he said.Besides, there is need to ensure monitoring and management of adverse events mechanisms which have been in place for many years during previous mass drug administration rounds.“This is an important aspect as the community confidence and compliance depends upon how well the programme manages the adverse events, which are minimal and restricted to body ache, vomiting, headache, dizziness, fever, rashes and itchiness,” Ganguly added.On June 15, the 10th meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF10) concluded in New Delhi in which Vikas Sheel joint secretary, union ministry of health and family welfare urged all partners to come out of silos and put in integrate efforts and implement the filariasis elimination agenda to meet the 2020 global lymphatic filariasis elimination target.PK Sen director, union government's National Vector Borne Disease Control Programme, said, “GAELF10 is the beginning of the endgame of Lymphatic Filariasis for all filariasis endemic countries in the world.”The Maharashtra chief minister’s office had sent a letter to the National Vector Borne Disease Control Programme expressing interest in rolling out IDA in the state’s endemic districts. This means that Maharashtra could well become the first Indian state to adopt the therapy and achieve the elimination of LF by 2020.

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