Lymphatic Filariasis (LF) is a mosquito-borne disease caused by nematode parasites viz., Wuchereria bancrofti, Brugia malayi and B. timori with its common manifestations like lymphoedema, hydrocele and elephantiasis which are associated with social stigma besides patient’s suffering from frequent attacks of high fever and pain. LF has been targeted for elimination as per resolution of World Health Assembly in 1997. Global programme to Eliminate Lymphatic Filariasis (GPELF) formulated in 2000 to achieve the LF elimination goal by 2020 was pushed by WHO recommendation for the twin-pillar strategy of preventive chemotherapy and morbidity management. The commitments of pharmaceutical industries for free donation of drugs towards achieving elimination strengthened further. India being the largest endemic country with about 600 million at risk population across 256 district, launched the national campaign to eliminate Lymphatic Filariasis in year 2004. Initially the annual Mass Drug Administration (MDA) was undertaken with Diethylcarbamazine citrate (DEC) alone but was replaced with co-administration of DEC and Albendazole during 2007 and now since 2019, triple drug combination of Ivermectin, DEC and Albendazole is being scaled up to accelerate the programme activities. Home based lymphoedema management by simple washing and drying; and surgical intervention for those affected with hydrocele was also augmented.
Indian programme scaled up to reach about 600 million population. Drug administration coverage ranged between 40 to 85 per cent due to which better performing units met the target of microfilaria prevalence below 1% and also successfully cleared Transmission Assessment Survey (TAS) initiated in 2013. Approximately 200 million population has successfully been made free from risk of LF but the last mile challenges are more crucial to realize the goal. These are mainly operational to sustain effective drug consumption above 65%, assessing current status of LF endemicity in non-endemic districts, liquidating active foci and intensifying Disability alleviation and morbidity management (MMDP).
