Triple-drug therapy for lymphatic filariasis

Context: A pilot project to administer triple drug therapy with the long term aim of eradicating lymphatic filariasis was recently launched in Nagpur, Maharashtra. Nagpur is one of the five districts in the country and only one in Maharashtra where this triple drug therapy campaign is being launched.

Triple drug therapy:

• The World Health Organization (WHO) is recommending three drug treatment to accelerate the global elimination of lymphatic filariasis.
• The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole. It is being recommended annually in settings where its use is expected to have the greatest impact.
• The third drug being used in this therapy will help control adult worms of lymphatic filariasis. Micro filariasis, which is produced by adult worms, is the cause of swollen leg. Previously the adult worms were sterilized by drugs and remained inactive for a year. Now that period will increase to two years.
• The plan is to administer these drugs for two consecutive years. The life of the adult worm is hardly four years, so it would die a natural death without causing any harm to the person.

Need for and significance of the therapy:

Lymphatic filariasis poses a grave threat to India. Over 40% of worldwide cases are found in India. Since 2004, two drug therapy for lymphatic filariasis has been in place but the addition of the third drug now will give a boost to the overall campaign.

India has missed earlier deadlines to eradicate the disease by 2015 and 2017. The global deadline now is 2020and the three drug approach may help the country get there.

Lymphatic filariasis:

Caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

The parasites are transmitted by four main types of mosquitoes: Culex, Mansonia, Anopheles and Aedes.

Sources: the hindu.