Lymphatic Filariasis Elimination in Kerala: A Success Story

National Filaria Control Programme has been running in the country since the year 1955 with the strategy of parasite detection, treatment and vector control mainly in urban areas. In the year 1997, the fiftieth World Health Assembly Resolution listed Lymphatic Filariasis (LF) for elimination by 2020 which now has been aligned with Sustainable Development Goal to be achieved by 2030. India also started its campaign to eliminate LF in 2004. The main strategy of the elimination programme is the Annual Mass Drug Administration (MDA) to progressively reduce and ultimately interrupt LF transmission. The other pillar of the strategy is morbidity management and disability prevention. Kerala state also started its LF elimination campaign in 11 endemic districts out of a total of 14 districts. The average population coverage during MDA in Kerala was reported to be more than 90% from 2004 to 2013, however, drug compliance during independent assessment was reported to be 40%-60% which improved in subsequent years due to a multipronged approach. The main reason of low consumption was the fear of side effects and the same was resolved through massive IEC activities highlighting its benefits compared to side effects, which are mostly self-limiting. The innovative strategic approach of extending the MDA period from 3 days to 3 weeks was undertaken to ensure that all the target population was covered. The results have been encouraging as compliance improved to above 65% and many districts have been validated for having achieved the elimination threshold through successfully clearing transmission assessment survey (TAS).