Pune: The Union government may have set a target to eliminate lymphatic filariasis (LF), also known as elephantiasis, from the country by 2017, but Maharashtra seems to be struggling to meet the goal.In the last five month, as many as 42 persons were found infected with microfilariae, the minute larva of filaria, mainly from six endemic districts. The detection has sparked concerns as eliminating microfilariae from the blood of infected individuals is of foremost importance in interrupting the transmission infection through mosquitoes.Incidentally, as many as 13 patients were found to be infected with microfilariae in Khadki area in April this year. The detection of these patients in a cluster in a particular area had alarmed the state health machinery, prompting officials to carry out mass surveillance.The officials collected blood smears of local residents apart from initiating anti-larval activity to destroy breeding of Culex mosquitoes, which are the primary vectors of the infectious disease in urban and semi-urban areas.The national health policy envisages elimination of LF by 2017. It has been defined as the cessation of lymphatic filariasis as a public health problem when the number of microfilaria carriers in the community is less than 1% and children born after initiation of elimination of lymphatic filariasis are free from circulating antigenaemia, that is presence of adult filarial worm in human body. However, in state's six endemic districts, the microfilariae rate continues to be over one per cent, which is a concern.Nevertheless, health officials seem to be optimistic about achieving the goal. "The 42 filaria cases recorded in the last five months were mainly from the state's six endemic districts — Thane, Nagpur, Nanded, Gadchiroli, Chandrapur and Gondia. We are detecting and putting on treatment every case so that there is no false projection," explained M S Diggikar, joint director (vector-borne diseases) of the state health department.Diggikar underlined that earlier there were 17 districts endemic to filariasis but the number has now reduced to six. "There are certain challenges but we have made significant progress in reducing the filariasis case burden, which is within less than one per cent rate in the other districts, which is an achievement," Diggikar stated.Regardless, health activists have expressed apprehension that filariasis elimination should not go the same way as leprosy eradication did. The global target for leprosy elimination, as set by the World Health Organisation (WHO), was achieved in 2000. This was when the elimination target shifted from global to national level.Around this time, a lacuna of targeting limited leprosy cases crept into the national leprosy eradication programme (NLEP). "That meant that once the stipulated numbers of leprosy cases were found, health workers would cease to probe other cases. This resulted in limited case detection and accumulation of leprosy cases over a period of time. This is a big reason why so many cases are being reported now. This should not happen with filariasis elimination," said Sanjeev Dabhade, a health activist.

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