Filariasis - Mass Drugs Administration (MDA) Programme in Fiji

What is Filariasis?

Lymphatic Filariasis, commonly known as elephantiasis, is a painful and disfiguring tropical diseases caused by thread-like worms (filariae) that live in the human lymphatic system. It is one of the leading causes of disability in the world.

About Symtoms

There are acute and chronic manifestations of lymphatic filariasis. Acute episodes of local inflammation involving skin, lymph nodes and lymphatic vessels often accompany the chronic lymphoedema or elephantiasis. Some of these are caused by the body’s immune response to the parasite, but most are the result of bacterial infection of skin where normal defenses have been partially lost due to underlying lymphatic damage. In endemic communities, some 10-50% of men suffer from genital damage, especially hydrocoele (fluid-filled balloon-like enlargement of the sacs around the testes) and elephantiasis of the penis and scrotum. Elephantiasis of the entire leg, the entire arm, the vulva, or the breast-swelling up to several times normal size – can affect up to 10% of men and women. The worst symptoms of the chronic disease generally appear in adults and in men more often than in women.

The new strategy By breaking the cycle of infection between mosquitoes and humans, the medicines given as part of the programme will spare the next generation from elephantiasis, hydrocoele and other grotesque manifestations of Lymphatic Filariasis Filarialsis is burden Lymphatic Filariasis is a major social economic burden. Lymphatic Filariasis causes elephantiasis, an abnormal enlargement of the arms, legs, breasts and the genitals (scrotum and vulva). It causes enormous suffering and disability to those affected, preventing them from leading a normal life. Its clinical signs result not only in physical but also in psychological damage.

How is it transmitted?

Lymphatic Filariasis is transmitted from person to person by mosquitoes.

The thread-like adult worms live in the body’s lymph nodes and lymph vessels, and female worms release millions of baby worms (microfilariae), into the bloodstream. These can be picked up by a biting mosquito and transmitted to other people when the mosquito bites again.

Mass Drug Administration

2002 is the first year for Mass Drug Administration for Fiji.

All persons in Fiji except infants under 2 years old, pregnant women, severe sick people will be given the 2 drugs. The responsible health workers and village MDA volunteers will visit house to house and register family members and give tablets. All community members take medication once a year. MDA continues for 2 months from October to November for 5 years until the parasite dies out. After that the disease should be totally eliminated from Fiji. The MDA should be priority in the National Plan of Action and during the campaign all health workers, community leaders will be involved.

This is the only way we can be sure that the disease will be eliminated.

About Filariasis tablets

How do you Take the tablets?

Why use two drugs?

If DEC is given in combination with Albendazole, effectiveness is greatly increased and transmission can be dramatically interrupted.

Are there any side effects from the medicine?

DEC and Albendazole are safe and well-tolerated drugs. There are sometimes mild adverse reactions which you may expect if you are infected with filariasis. These may include headache, body ache, fever, dizziness, decreased appetite, itching and vomiting. Adverse reactions are good signs of the worms being killed by the drugs.

The additional benefit of Mass Drug Administration

An additional benefit of these drugs is their added effect against other intestinal parasites, such as hookworms, which are common in our children here in Fiji.

Where can I get the filasiasis tablets?

Fundamentally nurses, health workers will visit house to house and give tablets. For workers, drugs distribution booths are set up at Health facilities and towncentres, etc.

Suva area: You can get the tablets at Suva Health Office (located on the bottom floor of LICI Building, Butt St. Suva) during normal working hours.

History of the disease in Fiji

In the 1950’s filariasis control efforts were using vector control. Treatment pf filariasis began countrywide during 1969 to 1975 after which all treated areas showed decreased microfilariae rates to 1% or less. Another campaign was carried out in selected demonstration areas in 1984-1991.

Fiji carried out the blood surveys for microfilariae in between 1991 to 1995. In this survey, the positive microfilarial rate changed from as low as 0.22% to as high as 19.74%. The most recent blood surveys (using ICT test kits) carried out in 1997 & 2000-2001. According to the results of them, the positive microfilarial rate was 16.6%.

Fiji statistics

1.) Mean infection rate: 5.1% (1991-1995 blood surveys - 16.6% (2001 ICT survey))

2.) Clinical disease: 1%

3.) At risk populations: Total: 153,094 (18%)

Central: 102,603 (33.9%), Western: 20,879 (6.4%), Northern: 22,290 (14.3%), Eastern:  7,322 (15.8%)

Fijians > Indians

Males > Females (2:1)

Target of the project

Filariasis elimination from the Fiji islands by the year 2010.

Strategy and tactics

- To reassess the prevalence of filariasis antigenaemia in the population of the Fiji Islands.

- To eliminate the risk of filarial infection from the population by interrupting transmission through Mass Drug Administration and vector control.

 Family Health Youth Sexual Health   Workshops Reproductive Health Care  ENT Clinics  Alerts Filiarisis Dengue