A programme to eliminate lymphatic filariasis in Tamil Nadu state, India: compliance with annual single-dose DEC mass treatment and some related operational aspects

This paper reports on DEC distribution and compliance with treatment in a l arge-scale annual single-dose mass treatment programme to eliminate lymphat ic filariasis in the south Indian state of Tamil Nadu. 76.9% of households (82.5% in rural areas and 58.0% in urban areas) were aware of drug distribu tion fur control of filariasis. DEC was given to 70% (= distribution rate) (range 0-92%) of the population and 53.5% (range 12-89 %) complied with tre atment. The distribution rate was more than 75% in 74% of the villages and compliance was in the range of 51-75% in 76% of the villages. About 5% of t he treated population reported side-effects. Distribution and compliance we re higher in rural than urban areas and similar between males and females. Qualitative data showed that some socio-economic factors, logistic and drug -related problems and people's poor knowledge and perceived benefits of tre atment placed a role in a proportion of the population not receiving or tak ing the drug. The Tamil Nadu programme showed that large-scale repeated ann ual DEC mass treatment is feasible and that existing health services are ca pable of delivering the drug to ail communities. While even poor to moderat e compliance rates can reduce the vector transmission of infection to some extent, improved drug distribution and compliance with treatment are necess ary to consolidate the gains of earlier rounds of treatment and achieve the goal of filariasis elimination within a reasonable time frame.