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BangladeshFilariasisEliminationProgramme

SummaryReportforCentreofNeglectedTropicalDiseases,Liverpool,UK

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IntroductionandRationaleIn Bangladesh, the disease is present all over the country with highest endemicity in

northernpartsofthecountry.

Outof147millionpeople,about20millionpeopleinthearea

has been suffering from the disease, most of which are children. The exact figures of

filariasisinBangladesharenotknown,butitisendemicin33districtsoutof64districtsas

reveledby

ICT

by

LQAS,

completed

in

2002

and

2004.

There

is

high

endemicity

of

filarisis

in

Nilphamari, Thakurgaon, Dinajpur, Rangpur, Panchagarh, Kurigram, Gaibandha, Chapai

Nawabganj, Rajshahi and Lalmonirhat. It is estimated that about 70 million are at risk of

infection, while 10 million havevarious formsofclinicaldeformityandanother10 million

aremicrofilaremics.

The introduction in recent years of yearly safe single dose regimens with DEC alone or in

combinationwithAlbendazoleforsuccessive46yearshasbeenanimportantbreakthrough

in filariasis elimination as a public health problem. The global strategy for elimination of

lymphatic filariasis is now principally based on annual single dose treatment of all the

eligible

members

of

at

risk

endemic

communities.

The

challenges

to

reach

adequate

treatment coverage and sustain drug delivery to all high risk communities are difficult to

achievebythehealthservicesalone.Theseservicesareoftenhavelittleinvolvementinthe

treatmentprogrammes.

ObjectivesGeneralObjectiveTo determine the mass drug administration coverage status and the nature of drug

reactionsinthestudyareawithaviewtoinformthefindingstotheconcernedauthorityto

takenecessarysteps.

SpecificObjectives1) TofindouttheMDAcoveragestatusamongsamplesofthestudyarea.2) To identify the nature of drug reactions with duration due to MDA among the

studysamples.

3) Tofindoutthecausesofnottakingtheantifilarialdrugsamongstudysamples.KeyVariables

1. Ageofhouseholdmembers2. Sexofthehouseholds3. Ingestionofdrugs4. Causesofnottakingdrugs5. Observedcoverage6. Actualcoverage7. Typeofdrugreactions8. Durationofdrugreaction

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MassDrugAdministration Year No.Districts Coverage

2001 1 93%

2002 4 87.32%

2003

6

81.9%

2004 9 Nodata

2005 12 81.9%

2006 13

MDAinLalmonirhatandNilphamaridistrict,2008NameofDistrict Upazila/Paurasava Total

population

Targetedpopulation

ReportedcoverageMDA*

Lalmonirhat LalmonirhatSadar 280,495 275,705 275,723Aditmari 236296 219,455 219,455

Kaliganj

260,006 243,456 243,456

Hatibandha 246,150 227,557 226,555

Patgram 230,342 211,912 211,870

Pourashava 58,795 56,562 55,923 Total 1,312,084 1,234,647 1,232,982Nilphamari NilphamariSadar&

Paurasava

436,296 406,000 406,000

Sayedpur 285,768 260,051 258,970

Dimla 290,569 275,945 275,984

Domar 249,336 230,213 229,030

Joldhaka

335,427 301,885 300,795Kishoreganj 270,327 248,422 248,222 Total 1,867,723 1,722,516 1,719,001

SummaryA total of 3,179,807 people were covered in the 7

th round of MDA in both districts,

Lalmonirhat and Nilphamari. The MDA was undertaken in both areas for a period of 10

consecutivedays.LalmonirhatDistrictThe survey findings of Lalmonirhat district showed that the observed coverage status of

massdrugadministrationwas87%andtheactualcoveragewas91.6%amongeligible.The

reportedcoveragebyCivilSurgeonwas93.96%.

NilphamariDistrictThefindingsinNilphamaridistrictshowedthattheobservedcoverageandactualcoverage

was85.5%and88.5%respectivelyamongeligiblepopulation.ThereportedcoveragebyCivil

Surgeonwas92.04%.