The Epidemiology and Disease Control Division says all preparations for a mass drug administration drive have been completed in seven districts where the lymphatic filariasis disease, known more commonly as elephantiasis, is endemic.

All healthy people above two years of age will be administered anti-elephantiasis in the two-week-long campaign, which is set to kick off on Sunday in six districts of the Tarai region—Jhapa, Dhanusha, Mahottari, Sarlahi, Rautahat, and Kapilvastu—and the mountain district of Rasuwa.

“Healthy people above two years will be given diethylcarbamazine, albendazole and Ivermectin,” said Dr Gokarna Dahal, chief of the Vector Control Section at the division. “This could be the last year of the campaign, as preparations have been made as per the strategy to cover all eligible populations.”

Lymphatic filariasis is a mosquito-borne parasitic disease caused by filarial worms transmitted by different species of mosquitoes, including Culex, Anopheles, and Aedes.

It is the second major infectious disease after leprosy that causes permanent and long-term disability in Nepal.

Doctors say the disease may be acquired during childhood and its visible manifestation may occur only later in life. The disease can lead to temporary or permanent disability, pain, and social stigma.

The World Health Organisation identifies the disease as a major public health problem, with an increasing prevalence worldwide. Nepal is one of the 73 countries where lymphatic filariasis is endemic.

Health workers, as well as female community health volunteers in the campaign districts, will also visit every household to make sure that no one is deprived of antiparasitic drugs.

Last year, antiparasitic drugs were administered in 15 districts. According to Dahal, some districts—Morang, Bara, Lamjung, Parbat, Baglung, Banke, Dang and Kailali, which were endemic to elephantiasis earlier—passed the threshold in a preliminary transmission survey, meaning they had halted the disease’s transmission rate.

The health ministry carries out a transmission survey every two years. Such a survey needs to be performed three times in six years. When all surveys show a halt in the transmission rate, the country will be eligible for the status of having eliminated the disease.

The Ministry of Health and Population has started administering Ivermectin, an antiparasitic that has been listed for the mass drug administration campaign, after diethylcarbamazine and albendazole failed to yield desired results in some districts.

Dahal said that two two-year mass drug administration campaigns would be sufficient to stop the transmission rate when Ivermectin is used.

The government started a mass drug administration programme to eliminate lymphatic filariasis in 2003. Under the programme, healthy persons above two years of age in 63 districts were given diethylcarbamazine and albendazole.

The Mass Drug Administration campaign has already been completed in 53 districts. An agency under the Health Ministry has been carrying out transmission surveys in four districts.

So far, the disease has been eliminated from 70 out of 77 districts. In some districts, the programme has continued for the last 14 years.

The government had committed to eliminating lymphatic filariasis as a public health problem by 2020. However, the target could not be achieved due to low programme coverage in some districts.

The Health Ministry had extended the deadline to eliminate lymphatic filariasis to 2028. Later, it was postponed further to 2030. Health officials said that this year's campaign could be the last, as the government does not have the budget to continue the campaign further.

“Due to budget cuts in healthcare, it will not be possible to continue the programme next year,” said Dr Sangeeta Kaushal Mishra, director general at the Department of Health Services. “We would like to request all eligible people to take the anti-elephantiasis medicines, which are safe and effective.”