Disease Burden Estimation of Lymphatic Filariasis in an Endemic Area

Background: Anecdotal evidence collected by a community organization suggested high prevalence of lymphatic filariasis (LF) in Sitapur district, Uttar Pradesh. Village volunteers subsequently conducted a line listing in 13 villages of Pisawan block and recorded 261 cases of known LF complications, namely hydrocele and lymphedema. This being far higher than official projections, a block-wide cluster survey was conducted to estimate the disease burden more accurately. Methods: Cluster sampling techniques were applied, and 41 clusters selected within Pisawan block. Survey teams comprising one woman and man interviewed member of all households in the cluster, recording details of individuals suffering from hydrocele or lymphedema within them. Age and gender were noted, as well as duration of symptoms and details of any treatment availed. Results: A total of 1851 patients (1256 males and 595 females) were reported to have lymphedema, hydrocele, or both in the 6931 households surveyed. This equates to a prevalence rate of 4.95% (with 9.75% margin of error) in Pisawan block. With these calculations, an estimated 11,049 + 1077 patients with LF complications in Pisawan block, Sitapur, UP in 2016. Conclusions: The high prevalence rate of LF complications in Pisawan block is disconcerting, especially considering India's commitment to eliminate LF by 2020. Compliance with Mass Drug Administration (MDA) must be improved. Furthermore, the Morbidity Management and Disability Prevention (MMDP) component of the National Programme for Elimination of Lymphatic Filariasis (PELF) must be strengthened so that such patients can lead a productive life.