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Improved Assessment of Mass Drug Administration and Health District Management Performance to Eliminate Lymphatic Filariasis

MarotoCamino, Carmen, Hernandez-Pastor, Pilar, Awaca, Naomi, Safari, Lebon, Hemingway, Janet ORCID:, Massangaie, Marilia, Whitson, Donald, Jeffery, Caroline ORCID: and Valadez, Joseph ORCID: (2019) 'Improved Assessment of Mass Drug Administration and Health District Management Performance to Eliminate Lymphatic Filariasis'. PLoS Neglected Tropical Diseases, Vol 13, Issue 7, e0007337.

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Lymphatic filariasis (LF) elimination as a public health problem requires the interruption of transmission by administration of preventive mass drug administration (MDA) to the eligible population living in endemic districts. Suboptimal MDA coverage leads to persistent parasite transmission with consequential infection, disease and disability,
and the need for continuing MDA rounds, requiring considerable investment. Routine coverage reports must be verified in each MDA implementation unit (IU) due to incorrect denominators and numerators used to calculate coverage estimates with administrative data. IU are usually the health districts. Coverage is verified so IU teams
can evaluate their outreach and take appropriate action to improve performance.
Mozambique and the Democratic Republic of Congo (DRC) have conducted MDA campaigns for LF since 2009 and 2014, respectively. To verify district reports and assess the achievement of the minimum 80% coverage of eligible people (or 65% of the total population), both countries conducted rapid probability surveys using Lot Quality Assurance Sampling (LQAS)(n=1102) in 2015 and 2016 in 58 IU in 49 districts.
The surveys identified IU with suboptimal coverage, reasons for not residents did not take the medication, place where the medication was received, information sources, and knowledge about diseases prevented by the MDA.
LQAS identified four inadequately covered IU triggering district team performance reviews with provincial and national teams and district retreatment. Provincial estimates using probability samples (weighted by populations sizes) were 10 and 17 percentage points lower than reported coverage in DRC and Mozambique. The
surveys identified: absence from home during annual MDA rounds as the main reason for low performance and provided valuable information about pre-campaign and campaign activities resulting in improved strategies and continued progress towards elimination of LF and co-endemic Neglected Tropical Diseases.

Item Type: Article
Subjects: WA Public Health > WA 105 Epidemiology
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
Repository link:
Item titleItem URI
LQAS and administrative data from Mozambique and DRC used to improve assessment of MDA to eliminate lymphatic filariasis
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Stacy Murtagh
Date Deposited: 16 Jul 2019 09:43
Last Modified: 06 Sep 2019 11:29


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