Lymphatic Filariasis Elimination Program updates, Nepal

Lymphatic Filariasis Burden in Nepal

• • Endemic districts: 61
  • Average prevalence: 13%
  • Population at risk: 25 million
  • Causative agent: Wuchereria bancrofti
  • Transmission vector : Culex quinquefasciatus
  • Reported chronic conditions : > 30,000; majority are hydrocele

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Lymphatic Filariasis Elimination Program, Nepal
Goal

• To eliminate LF as a public health problem by 2020

Target

• To cover with MDA all LF endemic districts by 2014 and achieve <1% prevalence in all endemic districts by 2020

Strategy

• Interruption of transmission by MDA – Diethylcarbamazine (DEC) and Albendazole, yearly campaign for six years
• Morbidity management & Disability Prevention

LF Elimination Strategies & Steps

• Interruption of transmission by Mass Drug Administration (MDA) using two drugs regimen, Diethylcarbamazine (DEC) and Albendazole, once yearly for six years.
• Morbidity Management by self care and with support using intensive but simple, effective and local hygiene technique.

Monitoring and Evaluation During and After MDA

• Coverage is monitored at each MDA round to determine whether the goal of at least 65% coverage of the total population was met.
• After at least five rounds of effective MDA, the impact is evaluated at sentinel and spot-check sites.
• If all the eligibility criteria are met, a transmission assessment survey (TAS) is conducted before deciding to stop MDA.
• TAS is repeated twice during post-MDA surveillance phase.

Progress Towards LF Elimination: As of Dec 2018

• Mapping done: 2001,2005/2006, 2012
• Geographical Coverage: MDA started from 1 district in 2003 & Reached 100% in 2013,
• MDA stopped in 46 districts after TAS 1
• 2 districts are scheduled for TAS 1 in 2019
• TAS 2 succeeded in14 districts & TAS 3 succeeded in 5 districts
• Almost 110 million doses of MDA drugs administered.
• Post MDA surveillance and morbidity management ongoing.
• 12 districts completed MMDP mapping using Measure SMS Reporting and expanding rapidly.

Morbidity Management and Disability Prevention (MMDP) Status – 2018

• Free Hydrocele Surgery done – 7327 cases (Till 2018) and free surgeries ongoing in all endemic districts.
• Morbidity mapping completed in 12 districts and 9 more in plan for 2019 (9511 Cases)
• Successful Integration with LF and leprosy self care in 1 (Lalgadh) Hospital & in talk with few others.

Source of Info: EDCD Presentation 

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