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Elimination of lymphatic filariasis
What is lymphatic filariasis (LF)?
GUIDELINES FOR DRUG
Lymphatic filariasis (LF) is a
parasitic disease, commonly
known as elephantiasis.
• It is caused by thread like worms
known as filarial parasite.
• The adult worms (male and
female) settle in lymph nodes and the female worm gives birth to millions of young ones known as microfilariae (mf).
Microfilaria in the blood of man
Directorate of National Vector
Disease Control Programme,
Directorate General of Health
Services, Ministry of Health and
Family Welfare, Government of
• Generally no symptoms are seen
Vector Control Research Centre,
initially, but the lymphatic system is
(Indian Council of Medical
• With no symptoms initially, the
persons with mf are not recognized and they continue to transmit the parasite to the community.
• The persons infected with the parasite
Why should every one take DEC and
may experience frequent acute
albendazole tablets during Mass
attacks of adenolymphangitis when
Drug Administration (MDA)?
they may have symptoms of fever,
pain and redness in the affected body
• People living in filaria endemic
areas, who look healthy, may be
• After 6 to 8 years of infection, clinical
carrying mf in their blood without
symptoms such as swollen legs or
any recognizable symptoms at the
enlarged lymph nodes/lymph vessels
or hydrocele may appear
• Finding the infected persons at this
• These chronic manifestations become
stage and giving them alone
irreversible as the lymphatic system
treatment is tedious.
has already been damaged.
• Both DEC and albendazole are
safe and even non-infected can
How is LF transmitted?
• DEC kills mf and albendazole
• Filarial parasite species in India lives
normally clears intestinal worms
only in man. The adult worm
which is an added benefit. When
produces microfilaria which circulates
both the drugs are given to-gether,
in the peripheral blood system of the
it has effect on adult worm and
infected people. When the mosquito
therefore the parasites will be
feeds on the infected person, it
destroyed preventing the infected
ingests the microfilaria.
person from developing disease
• When every individual in the
community takes drugs under MDA, microfilaria will be cleared and not present in the blood for the mosquitoes to transmit.
• MDA repeated annually over 5-6
years may interrupt transmission. This eventually leading to future
• The ingested microfilaria grows and
generation being free of this
within 12 days it reaches a stage
when it can infect another human
Who should take the drugs?
• When the mosquito with infective
stage larva bites another person, the
• Everybody in the community,
parasite enters and reaches the
except pregnant women, children
below two years of age and
persons who are very sick from
How to prevent infection?
• Administration of single dose of
When should people take DEC
antifilarial drugs to the entire
community (mass drug
administration), yearly once for 5-6
• DEC tablets should be taken once
in a year on the identified day of
Diethylcarbamazine (DEC) and
MDA (National Filaria Day).
albendazole are the drugs used for
mass drug administration
• The tablets should be taken after
• Protection from mosquito bites
food. If the tablets are taken on
empty stomach, it may cause
should list who should get the drugs
and then mobilize their participation.
Training will be provided to all the drug
How many tablets should one
distributors by the Medical Officer of the
PHC and VHN on MDA 15 days prior to
• The dose for different age groups is
Pre MDA activities:
Enumeration and motivation of the
community by making at least two visits
First visit: (Household enumeration)
• Visit every house in your assigned
area with in 15 days prior to the
• Identify yourself as an active
member of the community and
display your Identity card
Are there any side effects of drugs?
• DEC and albendazole are safe drugs,
which are in use for the last 50 years around the world.
• People, who look healthy but have
parasite in their blood, may experience some side (therapeutic) effects due to the killing of parasites following drug consumption
• One or combination of the following
• Enquire about the details of the
side effects may be experienced by a
household and record:
small proportion of population
especially microfilaria carriers:
o Name, age and gender of
the every member in the
• Inform the family members about
the MDA programme and clarify
o Rash and itching occasionally
These side effects are self limiting,
usually disappear or subside within a
Second visit: (Interpersonal contact)
day without any medication.
• Make house to house visit
What should Drug Distributors do?
• Meet all the available members
• Explain to them:
The ultimate goal of the drug distributor is to administer drugs to the assigned
o The problem due to LF in the
area and socio-economic
population. Therefore the drug distributor
o Methods of prevention of LF
• Approach every individual in the
o Importance of MDA
o Possible side effects
• Select the correct dose of DEC
o Health and economic benefit of
based on the age of the person
Co-administer DEC with
Date and time of drug
• Ensure that the individual is
o Ensure that all family members
consuming the drugs in your
are available at the time of MDA
presence (supervised administration)
• Record the absentees and their
time of availability
• Advise to approach the Sub-
centre/PHC if any inconvenience is faced
• Make daily visits to your assigned
area for two days following MDA to cover the absentees
o Request them to eat and be
• If any case with side effects are
ready for drug consumption
come across, provide them with
Identify suitable time for contacting
and delivering drug
If any case requires hospital
Distribute IEC materials
admission, report to the VHN/rapid
• Consolidate your record on the
number of people covered daily
Checklist of items to be carried:
Data consolidation and reporting;
o Sufficient number of tablets
• Consolidate the data on :
For a population of 250
o The total population
Approximately 700 tablets of DEC
Number of people
administered with drugs
275 tablets of albendazole
o Number of people reported
with side effects
Type of side effects
o IEC materials such as hand
No. of people required
o Family register – updated
o Flash cards on elephantiasis to
o Number of tablets received
explain to the community
• Return the family register along
with drugs in balance to the VHN
Visit the house at the agreed time
Identify all the eligible individuals for
Tips for improving coverage & drug
• Also inform that the mass drug
compliance during MDA
administration with DEC and
albendazole alone will not cure the
• Ensure that messages on the date of
chronic complications such as
MDA are displayed through
lymphoedema and hydrocele.
posters/banners in your area and
• If there are patients in the family,
premises of public places.
they should be advised to
• The local community leaders should
approach the health care facilities
be informed and involved in MDA.
in your locality
• Explain to people about filariasis and
• Hydrocele can be surgically
how it spread and clear their doubts.
operated in the Government
• Inform people about the disabilities
Hospitals free of charge. Enlist the
caused by LF and its impact on
hydrocele cases and motivate
economic productivity and income.
them to avail the factiities.
• Educate people about its risk and
• Identify and involve individuals in
social stigma especially in case of
the village who will campaign for
MDA. Provide them with adequate
• Inform people about the importance of
prevention through consuming DEC
and albendazole tablets on the day of
OUR VISION : FUTURE GENERATION
FREE FROM FILARIASIS
• Inform people that they may not know
that they are infected from this disease and if they do not take DEC tablets, the manifestations may appear later in the form of swelling of legs/ enlargement of lymph nodes/lymph vessels or hydrocele.
• Explain that once swelling appears, it
is difficult or impossible to reverse. It may remain as a permanent disability causing social stigma, hampering the daily activities, quality of life and also be a financial burden.
• If the whole community takes DEC
tablets once a year for 5-6 years, the
microfilariae in the infected persons
HELP TO KEEP THIS SMILE ALIVE
will be killed and the disease progression will be halted. The spread of filariasis will be stopped as mosquitoes cannot pick up the infection and we can make the next generation free from filariasis.
• Explain also that unless everybody
takes the drug, the disease will continue to spread.
• Killing of microfilariae by the drugs
may cause some the side effects among a small proportion of people
• Tablets should not be taken on empty
E DEL LAMBRUSCO 20/21 - 27/28 dell'Amministrazione insieme e senza paura sono Fabio Franceschini, Vostro nuovo Sindaco dal 26 maggio scorso. Partiamo con qualche dato personale. Portate pazienza ma non tutti mi conoscono bene e prometto che questa sarà la prima e ultima volta che vi assillerò con sciocchezze personali. Dunque, sono nato il 17 marzo 1963 a Modena, dal 1994 sono sposato con Mariella ed ho
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