Progress towards elimination of lymphatic filariasis in two districts of Maharashtra: scenario of last five years.

Background: Filaria was identified as one of the diseases to be eliminated globally and its global elimination by the year 2020 has been envisaged by World Health Organization (WHO). A large coverage- compliance gap has been found in many MDA programmes in India. Togo is the first sub-Saharan country to have stopped MDAs after prevalence data suggested that LF transmission had been interrupted. The successful Togo program demonstrates that LF elimination can be achieved in countries with limited resources. This study was undertaken to assess the situation of MDA coverage and compliance in two districts of Maharashtra. Methods: This is a community- based cross sectional study carried out in four selected clusters each in Nagpur and Bhandara districts of Maharashtra. Stratified random sampling is adopted for selection of households. In each district, 120 households are surveyed for the purpose of MDA evaluation every year. The coverage calculated in this article is programme coverage. Results: The coverage found in the year 2011 in Nagpur district was 63%, after which it was consistently rising every year. Similarly in Bhandara district, the coverage found was 70% in the year 2010, after which there was a rise every year. But the actual consumption rate was far less when compared to the coverage reported by the drug distributor, or the medical officer (more than 90% compliance is reported every year). Commonest reason for not consuming the drug was fear of side effects of the drug, which they must have experienced in the previous years activity, or seen other persons having side effects. Conclusions: Gradual increase in compliance of drug consumption over the period of five years in both the districts shows good progress towards the path of elimination.