Background: In most sub-Saharan Africa, the National Lymphatic Filariasis Elimination Programme (NLFEP)
is based on annual mass drug administration (MDA) with ivermectin and albendazole. In order to interrupt
transmission, 4–6 rounds of MDA are required with at least 60–70% minimum effective coverage. Children
born since the introduction of the MDA programme are recommended for assessing the interruption of
transmission. The objective of this study was lymphatic filariasis transmission status after nine rounds of
MDA in Rufiji district, Tanzania.
Methods: This cross sectional survey involved 270 heads of household. Parents or guardians were
interviewed on behalf of the schoolchildren about their participation in MDA programme. Status of LF
prevalence was assessed by measuring
Wuchereria bancrofti
circulating filarial antigens (CFA) in blood
samples from standard one school children (6 – 9 years) using immunochromatographic test cards.
Results: A total of 413 standard one schoolchildren were tested for CFA; 59 (14.3%) had CFA. Two thirds
(66.8%) of the children did not participate in 2011 MDA round. Prevalence of CFA was significantly lower in
younger (6.4%) than older children (40.4%) (p<0.05). Participation in the last (2011) MDA did not
significantly change the prevalence
W. bancrofti CFA (χ
2 = 0.723, p=0.4). The recorded MDA coverage for 5
years including 2011 was above the 60–70 % minimum effective coverage. The community reported
coverage was 40.4% for last MDA (2011), for previous MDAs was 53.0%; being far below the minimum
effective coverage. Though the large majority (97.0%) of households had heard of LF, only about half
(57.0%) knew it was transmitted by mosquitoes. Less than a half (43.6%) of households were aware of the
adverse effects of LF, therefore motivated to participate in MDA.
Conclusion: The findings indicate that LF transmission has continued in Rufiji district despite nine rounds of
MDA. Low compliance to MDAs due to community and programmatic factors were responsible for the
continued LF transmission. Detailed entomological studies are required to establish LF transmission
dynamics and the programmatic factors associated with MDA implementation in the area.