School Based Filaria Transmission Assessment Survey at Purba Medinipur District, West Bengal; India in 2014
Abstract
Lymphatic Filariasis is one of the neglected tropical diseases of world. India was set a target to eliminate lymphatic filarial within the year 2015 by administering Mass Drugs Administration (MDA) with diethyl carbamazine and albendazole for five consecutive years. MDA coverage was more than 80% - 92% of different MDA rounds in Purba Medinipur district. Impact of MDA programme was assessed by searching microfilaria through night blood survey. Prevalence of microfilaria was 2.4% to zero in all sentinel sites. Finally transmission assessment survey (TAS) as per WHO guidelines - 2011 of microfilaria was conducted on September and October’ 2014 among student of class I and II for making decision to stop or continue MDA. This district was sub-divided into three evaluation units (EUs), named Evaluation Unit-I, Evaluation Unit-II and Evaluation Unit-III to implement TAS programme. Sample Survey Builder (SSB) tool was used for sampling. Cluster survey was conducted with critical cut off value 20 in each EU. Immuno-chromatographic test (ICT) card was used to detect microfilaria among school students of class I and II (6 - 7 years age). All students of class-I and II of selected school were tested with ICT card, no sampling interval. Among the total enrolled school student of class-I and II, 3.67% were tested for microfilaria with ICT card. Among them, 51.3% were boys and 47.3% were girls. Out of total 5108 children surveyed only three (0.06%) was found positive for filarial antigen. All three cases had migratory history to filaria endemic areas and remain with relatives for >11 months. As proportion of positive cases did not cross the critical cut off value. So these three Evaluation Units were qualified to stop further MDA.
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Introduction
Lymphatic Filariasis is commonly known as “Elephantiasis” - a disfiguring disease; usually infection occurs in childhood and visible manifestation develops at later life. 1 It was estimated that 120 million people of tropical and sub-tropical region were infected with lymphatic Filariasis (LF). Among them, 25 million men had genital swelling (Hydrocele) and 15 million women had lymphaedema legs (Elephantiasis), approximately 66% of total Filariasis cases were accounted from South East Asian Country and 33% were from African country. 2
India is a Filaria endemic country. Out of 600 districts in India, 250 districts of 15 States and five Union territories are Filaria endemic. 3 Around 650 million population are at risk of developing Filariasis. 4 In 2002, India set a target to eliminate filaria by 2015. 5 This goal will be achieved with strategies: (a) Annual single dose Mass Drug Administration (MDA) with Di-ethyl Carbamazine (DEC) and Albendazole tablets to all eligible population of the endemic districts for at least five consecutive years and (b) Alleviation of morbidity by promoting home-base care of lymphaedema cases and up-scaling hospital based hydrocele operation. 6
Conclusion
In this present study Filaria positivity rate was found 0.06% i.e. out of total 5108 students test for filaria only 3 were positive. And all these positive students had migratory history from filaria endemic (Odisha State) areas and resided there along with their relatives for > 11 months. They did not take DEC tablets during MDA programme. So, there was no indigenous source of filarial transmission. With the view of this fact MDA may be stopped in district Purba Medinipur (West Bengal) India.