The strategy of filaria control has been given as follows :

1.detection and treatment of microfilaria carriers and
2.recurrent anti mosaquito measures.

Anti larval measures and detection cum treatment of micro filaria carriers are the two methods adopted to control filaria transmission in the selected areas where the programme is implemented. The larvicide under use include temephos, Fenthion and MLO. The selection of breeding places for treatment with a particular larvicide is done judiciously. Detection and treatment of microfilaria carriers will be carried out in the existing control units by establishing Filaria Clinics at the rate of one per 50,000 population.

Recurrent anti-larval measures at weekly intervals.

Environmental methods including source reduction by filling ditches, pits, low lying areas, deweeding, desilting, etc.

Biological control of mosquito breeding through larvivorous fish.

Anti-parasitic measures through ‘detection’ and ‘treatment’ of microfilaria carriers and disease person with DEC by Filaria Clinics in towns covered under the programme.

Revised Strategy

Annual Mass Drug Administration with single dose of DEC was taken up as a pilot project covering 41 million population in 1996-97 and extended to 74 million population. This strategy was to be continued for 5 years or more to the population excluding children below two years, pregnant women and seriously ill persons in affected areas to interrupt transmission of disease

STRATEGY FOR Elimination of lymphatic filariasis

MASS DRUG ADMINISTRATION (MDA) :

The strategy for achieving the goal of elimination is by Annual Mass Drug Administration of DEC for 5 years or more to the population excluding children below two years, pregnant women and seriously ill persons in affected areas to interrupt transmission of disease.

Home based management of cases who already have the disease and hydrocelectomy operations in identified CHCs and hospitals.

Annual Mass Drug Administration with single dose of DEC was taken up as a pilot project covering 14 endemic districts of Maharashtra State viz. Solapur, Chandrapur, Gadchiroli, Nagpur, Bhandara, Wardha, Godia, Yeotmal, Amaravati, Jalgaon, Nandurbar, Thane, Sindhudurga, & Nanded. during Jun 2004. 1.58 Crore selected population was covered under MDA in 2004 and extended to 2.68 Crore population in 18 districts for the year 2005. Four newly added districts for the campaign are Ratnagiri, Latur, Osmanabad, & Akola. This strategy is to be continued for 5 years or more to the population excluding children below two years, pregnant women and seriously ill persons in affected areas to interrupt transmission of disease.

Objectives of MDA :

(i) To review the progress of activities of single dose DEC mass administration in the selected districts.

(ii) To make independent assessment of the programme implementation with respect to process and outcome indicators.

(iii) To recommend mid-course corrections and suggest necessary steps for further course of action.

The Basic Principle of Revised Strategy for the Single Dose Mass DEC Administration:

(i) Interruption of disease transmission and

(ii) Treatment of problems associated with lymphoedema (disability prevention and control)

Parasite control with DEC is often relatively cheap when compared with vector control. The drug is safe and effective for human lymphatic filariasis. There is basic difference between individual and community treatment of filariasis. In the first case, it is usually the patient who is in need of help and therefore he or she is more likely to comply with the treatment. In a community, on the other hand, only a small proportion of the population is suffering from acute clinical filariasis at any one time and therefore a few people feel the need for help.

During a large-scale treatment programme, the key to success is the ability of the peripheral (village/subcentre) level team involved in MDA to communicate effectively with the community. Once the mutual confidence is built-up, the communication with people becomes easy and the treatment objectives and nature of possible reactions would be explained to them. The success of the strategy also depends on the speed of control measures put forth in order to prevent parasite becoming re-established within a stipulated period of time.

In filariasis, the life cycle of the parasite is relatively long. In contrast to malaria parasite, it does not multiply in the mosquito vector. The infective larvae transmitted by mosquito do not multiply in the human host. Prolonged exposure is required to develop patent infection in man. The incubation interval is one year or more. Therefore, the parasite never causes epidemics.