Once a contributor, Tamil Nadu is now closer to eliminating lymphatic ‚lariasis
From being one of the nine States that contributed to 95% of the total burden of lymphatic lariasis in India some two to three decades ago, Tamil Nadu is now closer to achieving elimination of the disease.
Doctors of the Directorate of Public Health (DPH) and Preventive Medicine and Institute of Community Medicine, Madras Medical College (MMC), in an article Tamil Nadu at the brink of eliminating lymphatic lariasis, have said that Tamil Nadu “stands as the only State in the country to successfully accomplish all requisite Mass Drug Administration (MDA) rounds and attain a microlaria (Mf ) rate of below one per cent”.
“By elimination, we mean that the disease has reached a threshold when it is no longer a public health issue. This is a big milestone. Lymphatic lariasis is a neglected tropical disease, and if not attended to properly, it can lead to lifelong disability. While reducing deaths due to lariasis is on one side, we should also reduce the stigma associated with the disease, as it has a huge impact on the person and the family,” said T. S. Selvavinayagam, Director of Public Health and Preventive Medicine. He, along with P. Vadivelan and D. Barani Kumar of the DPH, and
Sudharshini Subramaniam of the Institute of Community Medicine, MMC, authored the article. It was published in the Tamil Nadu Journal of Public Health and Medical Research.
According to the authors, Tamil Nadu was the pioneer State in the country to launch the MDA programme in Cuddalore district in 1996 as a pilot project, even before the declaration by World Health Organisation Assembly for Elimination of Lymphatic Filariasis. Based on its success, the programme was extended to 25 other endemic districts in Tamil Nadu, from 1998.
“We needed to do things systematically. This was a long-drawn process, and we needed everyone’s contribution, including eorts from the sta, the public and local bodies that took measures for vector control,” Dr. Selvavinayagam added. To begin with, the drug regimen that was adopted for MDA in Tamil Nadu was diethylcarbamazine citrate (DEC) six mg/ kg of body weight. Since 2001, 400 mg albendazole was added. MDA was implemented in all 26 districts from 2007 to 2012, achieving a coverage of over 65% in all these rounds.
Transmission Assessment Surveys (TAS) carried out in 2014, 2016 and 2018 showed a Mf rate of 0.18%, 0.21% and 0.10% respectively. The MDA with DEC was stopped from 2015, but surveillance measures continued.
A testing and treating strategy was implemented among high-risk populations, such as migrants. The directorate carried out entomological data collection by identifying sentinel and random sites each year. Tamil Nadu is now in the stage of the verication process for which the dossier is being prepared. The document will be submitted to the appropriate authority for certication of lymphatic lariasis elimination status, the authors said.