Lymphatic filariasis, also known as elephantiasis, remains one of the major public health problems in India. A vector-borne parasitic disease, it is an incredibly painful and disfiguring disease caused by mosquito bites.
India is a major contributor to the global burden, accounting for more than 40% of all lymphatic filariasis cases worldwide. According to the World Health Organization (WHO), the global benchmark estimate of other people affected by lymphatic filariasis is 25 million men with hydrocele and more than 15 million other people with lymphedema. At least 36 million other people continue to have these symptoms of chronic illness, he said.
Dr. NK Ganguly, former leader of the Indian Council of Medical Research (ICMR) told Financial Express. com that the disease encompasses asymptomatic, acute and chronic conditions.
“Other asymptomatic people have no outward symptoms of infection, but may experience internal damage to the lymphatic system, kidneys and immune system. Acute cases involve local inflammation of the skin, lymph nodes, and lymphatic vessels. Chronic cases come with lymphedema (swelling of the tissues) and hydrocele (swelling of the scrotum), which can cause disability,” Dr. Ganguly noted.
It also revealed that other asymptomatic people have no outward symptoms of infection, but may experience internal damage to the lymphatic system, kidneys, and immune system. Acute cases involve local inflammation of the skin, lymph nodes, and lymph vessels. Chronic situations come with lymphedema. (swelling of tissues) and hydrocele (swelling of the scrotum), which can lead to disability,” he added.
According to the WHO, painful and deeply disfiguring visual manifestations of the disease occur later in life and can lead to permanent disability. In addition, those patients not only have physical disabilities, but also suffer mental, social, and monetary losses that contribute to stigma. and poverty
The WHO shows that more than 882 million people in 44 countries around the world remain at risk of lymphatic filariasis and need preventive chemotherapy to prevent the spread of this parasitic infection.
According to the World Health Agency, lymphatic filariasis can be eliminated by preventing the spread of infection by preventive chemotherapy with drug combinations repeated each year.
According to Dr. Ganguly, the burden of lymphatic filariasis weighs heavily in India, accounting for 40% of all lymphatic filariasis cases worldwide. In addition, about 640 million people in India are at risk of contracting the disease lately.
“FL has been reported in 336 districts in 20 states/Union Territories in India. 90% of the FL burden in India falls on 8 tropical states, Uttar Pradesh, Bihar, Jharkhand, West Bengal, Chhattisgarh, Maharashtra, Odisha and Madhya Pradesh. ” he told Financial Express. com.
Apart from the burden of lymphatic filariasis, India faces several demanding situations in its fight against the disease.
“First, encouraging greater acceptance of the extensive pill regimen, especially among children, is a daunting task. The giant volume of medications required can be intimidating for patients, resulting in resistance or non-adherence. Second, the epidemiological variation of the disease presents its own set of difficulties. The sporadic nature of the disease, whether in terms of geographical distribution and affected population groups, complicates containment and elimination efforts. Third, a significant impediment is the lack of reliable and readily available diagnoses. Parasite is very important for any control effort, however, existing diagnostic strategies in many regions are not ideal,” Dr. Ganguly told Financial Express. com.
It should be noted that Lymphatic Filiaris causes long-term suffering and morbidity, as well as a social and economic burden. According to a 2002 ICMR study, the annual economic loss due to Lymphatic Filiaris is close to $1 billion for the country.
“To effectively eliminate lymphatic filariasis, we want to implement a comprehensive vector program, led by entomology experts, to detect and minimize disease-carrying vectors. In addition, more investment is essential to ensure that we can make our success in the most remote areas bigger. These concerted movements are the key to overcoming these demanding situations and achieving our purpose of getting rid of this disease,” he said.
According to Dr. Bhupendra Tripathi, National Leader, NTD Elimination, Bill Foundation
“Array. . This can obstruct efforts to slow transmission and control the disease. In addition, the social stigma attached to the physical symptoms of lymphatic filariasis may deter others from seeking care or treatment. However, it is important to note that the Indian government has made significant efforts in recent years to combat lymphatic filariasis,” Dr. Tripathi told Financial Express. com.
In January of this year, the Department of Health and Family Welfare launched a national crusade to combat lymphatic filariasis (FL). The country targets the disease until 2027 through a massive door-to-door drug delivery program.
Opening the National Symposium on India’s Roadmap to End Lymphatic Filariasis, Health Minister Mansukh Mandaviya said India is committed to eliminating the disease from the country.
In February of this year, the central government introduced a national crusade by the Mass Drug Administration (MDA) aimed at ending transmission of the disease through door-to-door management of antifilarial drugs, in 10 states affected by cables.
In the same month, the crusade was introduced in 10 endemic districts of Odisha. These include Balasore, Bhadrak, Bolangir, Cuttack, Kalahandi, Kandhamal, Khurda, Nayagarh, Nuapada and Rayagada.
As a component of the campaign, the government is administering FL drugs to 640 million at-risk people in 930 blocks in 90 affected districts in 10 states. districts to take certain medicines through 13,606,948 beneficiaries.
“India has stepped up its efforts to combat lymphatic filariasis, a vector-borne disease caused by Culex mosquitoes, which causes disability long before the global goals of protecting communities from disability and social and economic insecurity. The Indian government has already presented five new-advanced strategy for the elimination of lymphatic filariasis,” the ministry said in a statement.
Removal of five-pronged lymphatic filariasis includes:
“Array. . From the beginning, the government has put in place policies to combat this disease. One of the significant achievements for elimination took place in 2018, the launch of the Accelerated Lymphatic Filariasis Elimination Plan (APELF). The plan committed to introducing new methods of intervention and improving MAID implementation and monitoring, a comprehensive strategy of broad participation, and evaluation and monitoring methods. Since then, the government has been constantly under pressure over the need for a holistic strategy to combat the disease. This increased outreach effort also supported through the project’s orientation organization with the approval of more resources for block-level network mobilization,” Dr. Tripathi told Financial Express. com.
Dr. Tripathi also revealed that the government has also done a task in expanding drug treatment involving the management of ivermectin with DEC and albendazole (ADI) through ivermectin purchases nationwide.
“Earlier this year, Dr. Mansukh Mandaviya, India’s Minister of Health and Family Welfare and Union Chemicals and Fertilizers, made a strong commitment. He declared a determined effort to eliminate lymphatic filariasis in India until 2027, 3 years before the world one. objective. This can be achieved through the project mode roadmap that the government has established by engaging multiple partners, sectors and specific initiatives,” he told Financial Express. com.
One of the most demanding situations facing the program is the point of awareness that other people have about the disease, he revealed.
“For example, the government, in this mission-mode approach, made the decision to carry out two rounds of mass drug control on February 10 and August 10. In those days, the government distributes medicines at low prices to other people living in endemic districts. . However, despite this, drug consumption levels are very low. Civil society organizations like Rotary, etc. have been incredibly helpful in fostering greater adoption at the network level, but much remains to be done. It’s very important, if we’re going to prevent the transmission of this disease, that all Americans take these drugs. . . People with a higher load of microfilariae would possibly feast on more itching, but this quickly goes away. )MDA rounds or cabin layovers are underway to set up medication administration for taking medication,” Dr. Tripathi told Financial Express. com.
According to Dr. Tripathi, another challenge lies in disease detection.
“Since detection of parasite carriers is only imaginable through nighttime blood checks (a practice known as nocturnal blood surveying), the availability of knowledge is incomplete. Nighttime blood surveys are expensive, time-consuming, and have little acceptance in the community. If they are done at the wrong time, they can sometimes give misleading results. Along with this, personal corporations and government investments are needed to acquire high-capacity filariasis control strips (FTS) as well, he told Financial Express. com.
Dr. Tripathi also revealed that climate replacement has implications in the spread of mosquito-borne diseases, such as lymphatic filariasis. diseases and not just FL,” he said.
In addition, the occurrence of more common and intense excessive weather events, such as floods and droughts, disrupts mosquito breeding sites and hampers mosquito population efforts, which can lead to outbreaks of lymphatic filariasis, Dr. Tripathi noted.
“In addition, changes in precipitation patterns, influenced by updating climate, could increase the availability of suitable breeding sites for mosquitoes, posing demanding situations to control FL transmission in some areas. Overall, the weather update is exacerbating the threat and complexity of FL transmission, which require comprehensive methods to combat the disease, which are in place,” he told Financial Express. com.
According to Dr. Gangguly, following a phased approach, the Massive Drug Administration (MDA) crusade was introduced in February this year and focused on 91 districts in 10 states of India. The current phase of the MDA crusade is scheduled to begin on August 10.
“During this phase, the focus will be on 89 districts in 8 states. The main objectives of this phase are to ensure effective adherence to medication management and to build policies among the target population. To achieve those goals, activities undertaken to promote awareness of lymphatic filariasis and inspire drug use among people, especially those living in vulnerable areas,” Dr. Ganguly told Financial Express. com.