Global Programme to Eliminate Lymphatic Filariasis ... - libdoc.who.int

NEPAL113Endemicity statusEndemicNon-endemicUncertainAnnual Report on Lymphatic Filariasis 2003LF presents a health problem for the total populationof 25 million, of whom more than 22 million peopleare considered to be at risk. No national study of theprevalence and distribution of LF has been previouslyattempted, apart from a limited epidemiological surveyin semi-urban areas of the central regions of Nepal. Anevaluation of clinical manifestations of LF in sentinelsites shows a hydrocele and lymphoedema prevalence of11% and 9%, respectively.The administrative division designated as an IU is thedistrict. Mapping of LF was completed only in 43 of thetotal of 75 districts. Of 37 districts, it was revealed that33 were LF-endemic. The ICT estimated prevalence inendemic areas ranges from 1% to 39.8%. The remaining32 districts still need to be epidemiologically mapped.The first round of MDA using albendazole plus DECbegan in 2003 in one IU, Parsa district: 508 534 peoplewere targeted with a reported coverage of 81.2%.In 2003, 3200 drug distributors were trained and 160people participated in training in disability alleviation.The LF elimination programme is implemented by theministry of health. WHO provided financial support tocover the operational costs in the district of Parsa only.No financial and technical support was provided forother districts. GSK donates albendazole to cover the fullat-risk population. Future partnership initiatives are yetto be identified, such as with USAID.Chapter 3 Programme implementationTable 3.31 Goal: to eliminate LF from Nepal by 2008Objectives• To interrupt LF transmission• To prevent LF-associated disabilityStrategies• Treating the entire at-risk population with a single administration of twodrugs — albendazole plus DEC — given together once a year for five years• New, simple techniques that are easily carried out at home: regularwashing with soap and water, regular exercising of the limbs, and othersimple activities