Mass drug administration for elimination of lymphatic filariasis: Study on coverage and barriers to implementation

Abstract

Lymphatic filariasis (LF) is a debilitating vector-borne disease causing significant morbidity and disability worldwide. Mass drug administration (MDA) is a cost-effective and proven method to combat the disease. Conducted biannually, MDA is pivotal for LF elimination in India. However, there remain challenges and barriers to its implementation. The aim of the study was to adress the gap in understanding operational and behavioral barriers to MDA compliance through monitoring and evaluation of MDA in the postadministration phase of the September 2024 round in high-burden districts. A cross-sectional descriptive study was conducted from September 3–7, 2024, in two high-burden districts, Kanpur Nagar and Kanpur Dehat, in the endemic state of Uttar Pradesh. Systematic random sampling was used to select four villages, and the eligible populations in 200 households were surveyed using standardized forms. The study highlighted high drug coverage but suboptimal compliance due to fear of side effects, misconceptions, and operational challenges such as poor timing and inadequate IEC activities. Community awareness, trust in drug distributors, and the presence of healthcare workers directly influenced participation. Innovations like real-time drug administration and peer involvement improved outcomes, whereas data recording lapses, logistical issues, and refusal rates continue to hinder the effectiveness of efforts. Effective MDA implementation demands enhanced community engagement, consistent IEC efforts, and improved logistical coordination. Addressing myths and side effect fears through culturally tailored messaging and bridging supervision gaps through routine monitoring with validated tools and reliable data tracking is crucial. Empowering frontline workers and involving beneficiaries in outreach can significantly boost participation.