37.4.5  Prevention and control of lymphatic filariasis

Lymphatic filariasis is one of the few communicable diseases that the WHO believes could be eradicated (totally removed from all populations in the world, never to return) with the currently available prevention and control measures. These are:

• Integrated vector control (IVC) measures to reduce the mosquito population, including indoor residual spraying, use of insecticide treated bed nets (ITNs), and environmental management such as drainage and filling of breeding sites for the mosquitoes.
• Community-directed mass drug administration (MDA). The WHO recommends a two-drug regimen of albendazole and diethylcarbamazine (or ivermectin in areas where onchocerciasis is also endemic), which is administered to the entire at-risk population once every year for four to six years. These drugs are prescribed by staff at health centres.
• Personal protective clothing to reduce exposure of skin to mosquito bites, and use of ITNs.
• Rapid case detection and referral to prevent cases from spreading.
• Education in the community about the causes and modes of transmission of lymphatic filariasis, and ways to protect themselves from mosquito bites. Encouraging acceptance of the mass drug administration programme is an important health education message that you can deliver if your community is affected. You also have a key role in educating patients about how to prevent and alleviate disabilities and pain due to lymphatic filariasis, as described in the final part of this study session.