A New Outlook in Lymphatic Filariasis Elimination in India

In India, human lymphatic filariasis (LF) is the most common vector-borne disease after malaria. It is a roundworm nematode parasitic helminthiases group of diseases under Filarioidea type of infection. The parasites are found in the lymphatic system, damage the system leading to deformities of body organs. Of the eight human filarial parasites, Wuchereria bancrofti, Brugia malayi and B. timori are involved with the lymphatic system. Globally W. bancrofti is the most predominant species sharing 90% of the burden. In India, W. bancrofti and B. malayi are present. The revised control strategy was aimed at a single-dose mass drug administration (MDA) and home-based morbidity management. The Elimination of LF (ELF) was initiated in 2004 in 202 districts which were expanded later in 256 districts after a pilot study in LF endemic districts initiated in 1997. The initial start of ELF campaign was with a single drug, i.e. diethylcarbamazine (DEC), but later in 2007, a combination of two drugs DEC and albendazole (ALB) were given through MDA. Now a third drug ivermectin (IVM) has been added to accelerate the elimination process by 2020 which is the global goal of elimination under Global Programme to Eliminate Lymphatic Filariasis (GPELF).