An accelerated plan for the elimination of lymphatic Filariasis was launched at the recent Global Alliance to Eliminate lymphatic Filariasis (GAElF) summit held in Delhi. This aims to eliminate the disease in India by 2020. This global initiative, on track for 20 years, has delivered treatments to more than 6.7 billion patients across 67 nations and cured 97 million cases.
What’s lymphatic Filariasis
lymphatic Filariasis (lF), commonly known as Elephantiasis, is a disease which causes excessive swelling in a person’s legs, arms, breasts or genitals. It causes pain, disability and disfigurement. It causes severe harm to the body and the immune system. Nematode worms form nests in the lymphatic system. It spreads mainly through carrier mosquitoes.
As per a report presented at the summit, India accounts for 40 per cent of the global burden of Filariasis. “The biggest challenge is stopping the transmission which happens when the microfilaria parasite is released into the blood of a person through a mosquito bite,” Dr Pranab Kumar Sen, director, National Vector-borne Diseases Control Programme, explains.
Treatment
Multi-drug administration (MDA) is needed for treating this disease. Diethylcarbamazine Citrate and Albendazole are used for prevention and treatment. “The two pillars of preventive therapy are through a single annual dose of MDA to interrupt the cycle of transmission and take care of Filariasis patients. Through this twin approach the disease has been eliminated in 100 districts in India. But in the rest of the 156 districts, lF eradication is yet to be achieved, probably because of low coverage and compliance among the public,” says Dr Promila Gupta, Director General of Health Services.
New Triple Drug Therapy
The new Triple Drug Therapy, also known as IDA (Ivermectin, Diethylcarbamazine and Albendazole) has been tested globally and shown a success rate of 96 per cent. In this therapy, Ivermectin has been introduced along with the old ones.
“The triple drug combination is better and even one round can bring down the lF parasite count to negligible levels. So, two rounds should be good enough to eliminate it. An extra dose doesn’t harm. We need to ensure high coverage which requires awareness and involvement of local district administrations in this programme,” Dr Soumya Swaminathan, WHO Deputy Director General of the programme, tells you.
Talking about the impact of IDA, Dr Sen says: “There was no drug to kill an adult worm. With those drugs, they stopped producing microfilaria for some years, but it would come back. There was false hope that it would eliminate the disease. Adding Ivermectin has solved the problem as it kills the adult worms too. Before putting IDA in all districts, it is being tested in Uttar Pradesh, Jharkhand, Maharastra, Karnataka and Bihar.”
In the accelerated plan, new initiatives are being launched to increase compliance of MDA intake and social mobilisation.
Challenges
The drugs can’t be given to children and pregnant women. Though the bridging for children is happening but pregnant women will have to wait until the child-birth.
While China and Korea were the first countries to eradicate the disease, GAElF honoured nations that successfully interrupted transmission of Filariasis. The awards were given by Union Health Minister Jagat Prakash Nadda to 11 out of 73 endemic countries, namely, Cambodia, Cook Islands, Maldives, Thailand, Sri lanka, Niue, Togo, Egypt, Tonga, Vanuatu and Marshall Islands.