People in 7 districts are receiving anti-elephant medicine

The Department of Epidemiology and Disease Control says all preparations for mass drug administration have been completed in seven districts where lymphatic filariasis disease, commonly known as elephantiasis, is endemic.

All healthy people above the age of two will be administered anti-elephantiasis during the two-week campaign, which starts on Sunday in six districts of the Tarai region – Jhapa, Dhanusha, Mahottari, Sarlahi, Rautahat and Kapilvastu – and the mountain district of Rasuwa .

“Healthy people above two years of age will be given diethylcarbamazine, albendazole and ivermectin,” said Dr Gokarna Dahal, head of the division’s vector control wing. “This could be the last year of the campaign as preparations have been made according to the strategy to reach all eligible populations.”

Lymphatic filariasis is a mosquito-borne parasitic disease caused by filarial worms transmitted by several species of mosquitoes, including Culex, Anopheles and Aedes.

After leprosy, it is the second major infectious disease to cause permanent and long-term disability in Nepal.

Doctors say that the disease can be contracted during childhood, and its visible manifestation may occur only in later life. The disease can lead to temporary or permanent disability, pain and social stigma.

The World Health Organization identifies the disease as a major public health problem, with increasing prevalence worldwide. Nepal is one of 73 countries where lymphatic filariasis is endemic.

Health workers and women health volunteers in the campaign districts will also visit every household to ensure that no one is deprived of anti-parasitic medicines.

Last year, anti-parasitic drugs were administered in 15 districts. According to Dahal, some districts – Morang, Bara, Lamjung, Parbat, Baglung, Banke, Dang and Kailali, which were previously endemic for elephantiasis – crossed the threshold in a preliminary transmission study, meaning they had halted the transmission rate of the disease.

The Ministry of Health conducts a transmission survey every two years. Such a study must be carried out three times in six years. When all studies show that the rate of transmission has stopped, the country will qualify for eradicated disease status.

The Ministry of Health and Population has started administering Ivermectin, an antiparasitic drug listed for the massive drug administration campaign, after diethylcarbamazine and albendazole failed to produce the desired results in some districts.

Dahal said two two-year mass drug administration campaigns would be enough to halt the transmission rate when ivermectin is used.

The government initiated a massive drug administration program in 2003 to eliminate lymphatic filariasis. Under the programme, healthy persons above the age of two years were given diethylcarbamazine and albendazole in 63 districts.

The Mass Drug Administration campaign has already been completed in 53 counties. An agency under the Ministry of Health has conducted transmission surveys in four districts.

So far, the disease has been eliminated in 70 out of 77 districts. In some districts the program has continued for the past fourteen years.

The government had committed to eliminating lymphatic filariasis as a public health problem by 2020. However, this goal could not be achieved due to low program coverage in some districts.

The Health Ministry had extended the deadline for eliminating lymphatic filariasis to 2028. Later, it was further postponed to 2030. Health officials said this year’s campaign could be the last as the government does not have the budget to carry out the campaign to continue further.

“Due to healthcare cuts, it will not be possible to continue the program next year,” said Dr Sangeeta Kaushal Mishra, director general of the Ministry of Health. “We would like to request all eligible people to take the elephantiasis drugs, which are safe and effective.”