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Nepal’s campaign to treat elephantiasis

In February Nepal commenced an annual campaign against lymphatic filariasis, better known as elephantiasis. The campaign commenced in 56 of the country’s 75 districts, including the Kathmandu Valley. Elephantiasis has been eradicated in five of the 61 districts where the disease was prevalent since Nepal began the campaign in 2003.

The 3-4 day campaign was administered by the Epidemiology and Disease Control Division within the Department of Health Services (DOHS) deploying female community health volunteers as well as other health workers through District Public Health Offices, reported The Himalayan Times (February 18, 2013). The program is part of the government’s plan to eradicate the disease by 2018.

All except pregnant women, children below the age of two, and ailing citizens (with high blood pressure, tuberculosis, kidney ailments, heart diseases, and other major ailments) will receive the preventative anti-elephantiasis medicine, Diethylcarbamazine (DEC) and Albendazole tablets in the targeted districts. In Kathmandu Valley 1.5 million of the population of 1.7 million will receive the medicines. The medicines are typically taken three times a day for three weeks, and should be taken every year for six years, said DOHS.

The DOHS reported 28,135 cases of people suffering elephantiasis in Nepal. It is second only to leprosy among diseases resulting in permanent disability. However, it is estimated that about 2.6 million in Nepal are at risk (11% of the total population).

The World Health Organization (WHO) estimates that 40 million people in 83 countries have the disease, with one-third each in Africa and India. WHO is committed to eliminating the disease by 2020. Elephantiasis is the enlargement of the limbs and extremities, making them appear like elephant legs in size, texture, and colour. It is the result of a parasitic infection by roundworms (entering the body as larvae via infected mosquitoes). The worms block the body’s lymphatic system causing fluids to collect in the tissues, leading to swelling. The swelling makes it difficult to use the limbs, causing disability.

The treatment has been shown to be effective as a preventative measure to reduce the number of carrier insects in a particular area. Mosquito bed netting is also recommended at night.

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