Mass drug administration coverage evaluation for lymphatic filariasis in selected endemic districts of Jharkhand, India.

Background: This study aimed to evaluate mass drug administration (MDA) coverage for lymphatic filariasis (LF) in selected endemic districts of Jharkhand, India, and to identify household-level determinants of drug consumption.

Methods: A cross-sectional coverage evaluation survey was conducted in the Deoghar, Giridih and Godda districts of Jharkhand in 2023 within 6 wk of the completion of the MDA campaign. The survey included 9039 individuals from 1680 households across 56 randomly selected clusters (three urban, eight tribal and 45 rural).

Results: Approximately 78.5% of households reported that at least one member consumed MDA drugs, with 54.5% reaching 'complete epidemiological drug coverage'. Factors positively associated with achieving 'complete epidemiological drug coverage' included higher education levels (adjusted OR [AOR] 1.02), awareness of LF (AOR 2.32), prior communication about MDA (AOR 1.38) and previous MDA participation (AOR 4.42). By contrast, larger family sizes were associated with a lower likelihood of achieving complete coverage (AOR 0.78). Adverse events were experienced by 14.9% of participants, primarily when MDA drugs were consumed on an empty stomach. Key reasons for non-compliance included perceived absence of disease (25.5%), fear of side effects (22.4%) and absence during the campaign (20.9%).

Conclusions: MDA coverage was suboptimal, with only one-half of households achieving 'complete epidemiological drug coverage'. Enhancing MDA coverage and compliance requires intensified Information, Education, and Communication efforts, especially among marginalized communities, both during campaigns and all year round.