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
Lymphatic Filariasis Elimination Program, Nepal
- To eliminate LF as a public health problem by 2020
- To cover with MDA all LF endemic districts by 2014 and achieve <1% prevalence in all endemic districts by 2020
- 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