Are we nearly there yet? Coverage and compliance of mass drug administration for lymphatic filariasis elimination.
Alexander, Neal DE;
(2015)
Are we nearly there yet? Coverage and compliance of mass drug administration for lymphatic filariasis elimination.
Transactions of the Royal Society of Tropical Medicine and Hygiene, 109 (3).
pp. 173-174.
ISSN 0035-9203
DOI: https://doi.org/10.1093/trstmh/tru204
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Lymphatic filariasis has been targeted for elimination by 2020, and a threshold of 65% coverage of mass drug administration (MDA) has been adopted by the Global Programme to Eliminate Lymphatic Filariasis (GPELF). A recent review by Babu and Babu of 36 studies of MDA for lymphatic filariasis in India found that coverage, defined as receipt of tablets, ranged from 48.8 to 98.8%, while compliance, defined as actual ingestion of tablets, was 22% lower on average. Moreover, the denominator for these coverage figures is the eligible, rather than total, population. By contrast, the 65% threshold, in the original modelling study, refers to ingestion of tablets in the total population. This corresponds to GPELF's use of 'epidemiological drug coverage' as a trigger for the Transmission Assessment Surveys (TAS), which indicate whether to proceed to post-MDA surveillance. The existence of less strict definitions of 'coverage' should not lead to premature TAS that could impair MDA's sustainability.