Coverage and evaluation survey of post-mass drug administration for lymphatic filariasis in four endemic districts of Uttar Pradesh: are we on the track?

Abstract

Background objectives: There is a persistent high microfilaria rate and variable reporting of coverage of Mass Drug Administration (MDA). The study aims to estimate the coverage, effective coverage, and compliance of drugs administered under MDA and to determine the predictors affecting the effective coverage.

Methods: A community-based cross-sectional study was conducted in Amethi, Lucknow, Raebareli and Sultanpur districts of Uttar Pradesh, India. The study participants were selected using multi-stage random sampling using Probability Proportional to Estimated Size (PPES). The coverage, effective coverage and compliance of drugs were presented as proportion. The multivariable logistic regression model was applied to identify the significant predictors for effective coverage.

Results: Of 4151 participants, 997 (24.0%), 340 (8.2%), 1158 (27.9%) and 1656 (39.9%) belonged to Amethi, Lucknow, Raebareli and Sultanpur districts respectively. The coverage ranged from 49.8% to 87.9% and effective coverage ranged from 51.8% to 73.2% across districts. The compliance was the poorest (70.7%) in Sultanpur. The source of information about MDA, the sex of the study participants and the area of residence emerged as predictors for effective coverage in the districts.

Interpretation conclusion: The effective coverage was poor with good drug complianceacross the districts. There is a need for a well-designed pre-MDA campaign addressing the fear of side effects of drugs and emphasising the presence of the community during the MDA round along with monitoring and evaluation of the round.