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. 2022 Mar 15;106(5_Suppl):29-38.
doi: 10.4269/ajtmh.21-0964. Print 2022 May 11.

Introduction of Triple-Drug Therapy for Accelerating Lymphatic Filariasis Elimination in India: Lessons Learned

Bhupendra Tripathi  1 , Nupur Roy  2 , Neeraj Dhingra  2
Affiliations

Introduction of Triple-Drug Therapy for Accelerating Lymphatic Filariasis Elimination in India: Lessons Learned

Bhupendra Tripathi et al. Am J Trop Med Hyg. .

Abstract

There are 670 million people at risk of contracting lymphatic filariasis (LF) in India, which bears 40% of the global burden of the disease. The National Program to Eliminate LF was launched in 2004 first with a single-drug therapy-diethylcarbamazine (DEC), followed by a two-drug therapy-DEC + albendazole (DA). In 2017, following successful drug trials, World Health Organization endorsed a new triple-drug therapy to fight LF using ivermectin with DEC and albendazole (IDA). 1 In June 2018, India made new commitments to accelerate their program to eliminate LF and initiated the new IDA protocol in five districts in the country. This article looks at the experience of India in the roll out of the new drug protocol and shares their preparations, successes, challenges, and lessons learned.

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Figures

Figure 1.
Figure 1.
Lymphatic filariasis endemic districts of India, 2021. Source: National Vector Borne Diseases Control Program, Ministry of Health and Family Welfare, Government of India https://nvbdcp.gov.in/.
Figure 2.
Figure 2.
World Health Organization (WHO) field monitoring data. Source: WHO India Country Office LF MDA field monitoring data.
Figure 3.
Figure 3.
National lymphatic filariasis (LF) symposium 2018.
Figure 4.
Figure 4.
Comparison of ivermectin with DEC and albendazole (IDA) round 1 vs. IDA round 2 World Health Organization (WHO) coverage monitoring data.
Figure 5.
Figure 5.
Use of dose poles for ivermectin with DEC and albendazole (IDA) administration.
Figure 6.
Figure 6.
New logo for the program. Note: The bold line below the design says “Filaria Free Campaign” with the tagline: “Safe drug, assurance for better health.”
Figure 7.
Figure 7.
Improvement in coverage over time, Uttar Pradesh, India. Source: WHO India Country Office LF MDA field monitoring data.
Figure 8.
Figure 8.
Comparative data over 3 years for program reach and drug consumption. Source: Social Mobilization field study by Project Concern International.
See this image and copyright information in PMC

References

    1. World Health Organization , 2017. Guideline: Alternative Mass Drug Administrations to Eliminate Lymphatic Filariasis. Geneva, Switzerland: WHO. Available at: http://apps.who.int/iris/bitstream/handle/10665/259381/9789241550161-eng.... Accessed August 16, 2021. - PubMed
    1. Raghavan NGS , 1957. Epidemiology of filariasis in India. Bull Wld Hlth Org 16: 553–579. - PMC - PubMed
    1. National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India , 2018. Accelerated Plan for the Elimination of Lymphatic Filariasis. Available at: https://nvbdcp.gov.in/WriteReadData/l892s/1031567531528881007.pdf, page 8. Accessed August 8, 2021.
    1. World Health Organization , 2020. Global programme to eliminate lymphatic filariasis: progress report, 2019. Wkly Epidemiol Rec 43: 513. Available at: https://apps.who.int/iris/bitstream/handle/10665/336185/WER9543-eng-fre.pdf. Accessed July 8, 2021.
    1. Weil GJ et al. 2019. The safety of double- and triple-drug community mass drug administration for lymphatic filariasis: a multicenter, open-label, cluster-randomized study. PLoS Med 16: e1002839. Accessed August 16, 2021. - PMC - PubMed

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