Coverage of mass drug administration (MDA) and operational issues in elimination of lymphatic filariasis in selected districts of Jharkhand, India

Background: Despite annual rounds of mass drug administration (MDA) being carried out every year since 2004 to break the transmission of lymphatic filariasis, India has not achieved elimination status in many areas of country. This study was conducted to determine the operational issues in the implementation of MDA for elimination of lymphatic filariasis in selected districts of Jharkhand. Methods: Two districts of Jharkhand state were selected for present cross-sectional study. Multi-staged cluster sampling was adopted to select study participants. Data were collected with use of prescribed questionnaire of National Vector Borne Disease Control Programme (NVBDCP) from the study participants. Data related to socio-demographic details, coverage and compliance of MDA and operational issues were collected. Results: Findings of independent assessment show that percentage of MDA coverage and compliance for Hazaribag district was 96.02% and 88.90%, respectively. On the other hand, percentage of MDA coverage and compliance was found to be only 67.06% and 48.44% in Chatra district. Overall drug consumption was significantly associated with age group (p-value = 0.045), educational status (p-value = <0.0001) and socio-economic status (p-value <0.0001) of eligible population. Most common reason for not swallowing the drugs was found to be absence of family members at the time of MDA rounds followed by no visit of house by drug distributors. Conclusions: Coverage and compliance of MDA was better in Hazaribag district as compared to Chatra district. In order to increase compliance, socio-demographic factors must also be addressed apart from other operational issues.