Mass Drug Administration Coverage Evaluation Survey For Lymphatic Filariasis In Bagalkot And Gulbarga Districts

Author: Prakash Kurubarahalli Patel

Indian Journal Of Community Medicine 2012; 37(2):101-6.

INTRODUCTION

Lymphatic filariasis is endemic in 83 countries, with more than 1 billion

people at risk of infection.

Estimated 5.1 million DALY loss.

Global programme to eliminate LF through MDA started in 1999.

Govt. of India began a nationwide MDA campaign in 2004

MDA with single dose of DEC and albendazole was used for elimination in

all endemic districts.

AIMS & OBJECTIVES

Assess coverage of MDA against LF in Bagalkot and Gulbarga

districts of Karnataka state.

STUDY DESIGN

Multi stage Cluster sampling

1 urban cluster 3 rural cluster (3 PHC)

1 sub center

1 village (50 houses)

By

Random

sampling

150 Households in each cluster, & totally 1,228 individuals were surveyed.

House to house survey was conducted , Performa filled via personal interview

MATERIALS & METHODOLOGY

Place of study: Bagalkot and Gulbarga in Karnataka state.

Type of Study : Cross-sectional study.

Study period: 22-2-2010 to 27-2-2010 (5 days)

Inclusion criteria:

All the eligible population who belong to the MDA campaign area.

Exclusion Criteria:

Pregnant and lactating women

Children below two years of age and

Seriously ill persons.

Investigator : Was trained informally in the regional office for health and

family welfare, Bangalore in all aspects of coverage survey.

Drug distributors

Health workers

Anganwadi workers

Accredited social health activist and

Student volunteers

Training

A formal training program was organized to all the staff (PHC

medical officers and health workers)

A training manual was distributed to the participants

Ethical issues: As it is a non-interventional & non-invasive study,

no ethical issues were involved.

Outcome measures: MDA coverage rate, Compliance rate

Analysis and statistical methods

The data were, computed in Microsoft Excel & analyzed

using the statistical program SPSS-10.

Chi-square test was used to indicate the difference in

proportions.

P value <0.05 was considered as significant.

RESULTS

•Total study population was 1228 individuals from 8 clusters (1 urban + 3

rural )

TABLE I: Socio- demographic characteristics of the respondents

Variables Bagalkot district (n=616)

Percentage

Gulbarga district n=612

Percentage

Age: 15- 59 yrs 62.7% 63.9%

Sex ratio (M:F) 49.5: 50.5 46.9:53.1

Education

Illiterate

primary

31.7%

29.5%

36.1%

26.3

Occupation

Students

House wives

Unskilled person

33.6%

28.2%

18.3%

37.1%

17.2%

29.2%

DISTRIBUTION OF STUDY POPULATION BASED ON CONSUMPTION OF TABLETS

TABLETS

CONSUMED

BAGALKOT DISTRICT

(N=597)

percent

GULBARGA DISTRICT

(N=595)

Percent

DEC+ Albendazole 78.6% 38.8%

DEC only 1.6% 0.0%

DEC incomplete

dosage

1.0% 12.4%

Albendazole only 0.0% 0.0%

No tablets 18.8% 48.8%

TABLE:II

TABLE: III : Reason for not consuming tablets

REASON FOR NON-

CONSUMPTION

BAGALKOT DISTRICT

N=147

Percent

GULBARGA DISTRICT

N=381

Percent

ODD RATIO- CI

Did nor receive tab 27.9 15.2 -

Not present at home 18.4 10 -

Drug given at home but

no information

9.5 3.7 -

Too small to take drugs 8.8 3.7 -

Too many tablets 6.1 0 -

Fear of side effects 5.4

4.1

51.2 18.2(8.6-38.1)

Forgot to take 4.1 1.6 -

Fear to give drugs to

children's

3.4 4.7 1.4(0.5-3.8)

Other reasons 3.5 5.5 1.6(0.6-4.4)

Exclusion criteria 12.9 4.4 -

Table 4: Distribution of study subjects according to compliance (DEC+albendazole)

CONCLUSION

The MDA coverage and compliance should be given at most

importance.

Effective drug delivery strategies needed to improve the

compliance

Even with 54-75% treatment coverage, can reduce LF

transmission very appreciably.

Better treatment coverage and a few more rounds of MDA

may achieve total interruption of transmission.

The study was conducted after 3 months of MDA campaign (recall

bias)

The Survey assessed only the coverage aspect and not the entire

MDA implementation programme.

Exclusion criteria was not followed properly by drug distributers.

Interviewer was informally trained (Measurement bias)

Short time span for the study.

LIMITATIONS

LF endemic areas in India.

LF prophylaxis

Cluster sampling methods.

Cross sectional study.

LEARNING

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