Community-based education strengthens campaign for elimination of lymphatic filariasis

Nearly 1.3 billion people worldwide live at risk of infection with the parasite that causes lymphatic filariasis. Infected individuals may develop long-term complications, such as grossly swollen limbs from lymphedema. Elimination of this disease of poverty requires giving drugs at least once per year to people who are at risk; of that population, 80% or more need to continue receiving medication on an annual basis for 5 or more years to stop transmission.

The authors evaluated a community-based education campaign, noted deficiencies, and designed interventions to correct them. An evaluation of the revised education program, covering over 8,000 people in ninety villages, showed markedly improved drug compliance and, for the first time, showed that lymphedema management programs, which teach leg care to patients with swollen legs, may also increase compliance with lymphatic filariasis mass drug administration programs. The increase was greatest in areas that had implemented U.S. Agency for International Development-supported programs to teach people how to care for legs swollen from infection.

This evaluation was confined to rural areas in Orissa State, so the findings do not necessarily apply to urban areas or areas outside the state. Nonetheless, lymphatic filariasis elimination programs facing difficulties in achieving the necessary level of drug compliance should consider evaluating their education campaigns using similar methods and integrating lymphedema management with lymphatic filariasis elimination efforts, the authors say.