Pattern of community compliance with spaced, single-dose, mass administrations of diethylcarbamazine or ivermectin, for the elimination of lymphatic filariasis from rural areas of southern India
Vanamail, P.; Ramaiah, K.D.; Subramanian, S.; Pani, S.P.; Yuvaraj, J.; Das, P.K.
Annals of Tropical Medicine and Parasitology 99(3): 237-242
2005
ISSN/ISBN: 0003-4983 PMID: 15829133 DOI: 10.1179/136485905x29666Document Number: 252189
Current programmes to eliminate lymphatic filariasis (LF) are largely based on annual mass administrations of single doses of antifilarial drugs. The level and pattern of compliance by the target population are important determinants of the success of such mass drug administration (MDA). Community compliance was therefore investigated during a study in Tamil Nadu, India of the effects of spaced MDA of diethylcarbamazine (DEC) or ivermectin (IVM) on Wuchereria bancrofti microfilaraemia and transmission. During six rounds of MDA (from 1994 to 2000), the frequency of compliance among populations living in 5 villages given DEC and in another 5 villages given IVM ranged from 55% to 77%. Analysis of the relevant cohort data indicated that about 30% of the villagers had complied with the treatment during all six rounds, but 3.5% of those in the DEC arm and 4.0% of those in the IVM arm showed non-compliance. Most of the villagers (>90%) had received treatment at least once, however, and >60% had each received treatment in at least four of the six rounds. Overall, there was a significant negative correlation (r=-0.78; P=0.008) between the size of the village, in terms of the number of villagers, and the mean frequency of compliance over the six rounds of MDA. The pattern of community compliance was 'semi-systematic'. In terms of the elimination of LF, a semi-systematic pattern of compliance was worse than random compliance, but better than systematic. The relevance of the levels and patterns of compliance to LF control or elimination is discussed.