Directly observed treatment increases drug compliance in lymphatic filariasis mass drug administration

Main Article Content

Tutik Ida Rosanti
Sugeng Juwono Mardihusodo
Wayan T. Artama


Mass drug administration (MDA) has been one of the strategies for lymphatic filariasis elimination. Since the start of implementation in 2011 in Pekalongan, no study on MDA acceptability has yet been done. The objectives of the study were to determine the microfilaria rate (mf rate) and the risk factors of drug compliance in the MDA program.

A longitudinal study was conducted at Pabean region, Pekalongan City. There were 90 household heads as subjects, who were selected by proportional cluster random sampling. Microfilaria rate (mf rate) was determined by finger blood examination. Drug compliance was measured using questionnaires and observation sheets. Drug compliance observers, filariasis counseling participation, and presence of filariasis patients were factors influencing drug compliance.

Mf rate in 2015 was 1.35% and drug compliance rate was 86.80%. Reasons for failing to take drugs were fear of side effects (50%), refusals (25%), laziness (16.7%), and perceiving the drug to be useless (8.3%). The chi-square test shows a significant difference between the presence of drug compliance observer and compliance (p=0.006). Filariasis counseling participation and presence of filariasis patients did not show a significant difference with drug compliance (p= 0.986).

Families as the source of observers was associated with increased filariasis drug compliance. It is therefore essential to address the issues linked to low compliance to make the program more efficient and achieve the goal of filariasis elimination.

Article Details

How to Cite
Rosanti, T. I., Mardihusodo, S. J., & Artama, W. T. (2016). Directly observed treatment increases drug compliance in lymphatic filariasis mass drug administration. Universa Medicina, 35(2), 119–127.
Original Articles


. World Health Organization. Progress report 2000-2009 and strategic plan 2010-2020 of the global program to eliminate lymphatic filariasis: halfway towards eliminating lymphatic filariasis. Geneva: World Health Organization;2010.

Kementrian Kesehatan RI. Epidemiologi penyakit kaki gajah (filariasis) di Indonesia. Jakarta: Ditjen PP & PL Kemenkes RI;2009.

Ramdhani T, Soeyoko, Sumarni S. Culex quinquefasciatus sebagai vektor utama filariasis limfatik yang disebabkan Wuchereria bancrofti di kelurahan Pabean Kota Pekalongan. J Ekol Kes 2010;9:1303-10.

de Souza DK, Koudou B, Kelly-Hope LA, et al. Diversity and transmission competence in lymphatic filariasis vectors in West Africa, and the implications for accelerated elimination of Anopheles-transmitted filariasis. Parasit Vectors 2012;5:259.

Kementerian Kesehatan RI. Pengobatan masal filariasis. Jakarta: Ditjen PP & PL Kemenkes RI; 2009.

Nujum ZT. Coverage and compliance to mass drug administration for lymphatic filariasis elimination in a district of Kerala, India. Int Health 2011;3:22-6.

Koroma JB, Sesay S, Sonnie M, et al. Impact of three rounds of mass drug administration on lymphatic filariasis in areas previously treated for onchocerciasis in Sierra Leone. PLoS Negl Trop Dis 2013;7:e2273.

Eigege A, Kal A, Miri E, et al. Long-lasting insecticidal nets are synergistic with mass drug administration for interruption of lymphatic filariasis transmission in Nigeria. PloS Negl Trop Dis 2013;7:e2508.

Babu BV, Babu GR. Coverage of and compliance with mass drug administration under the programme to eliminate lymphatic filariasis in India: a systematic review. Trans R Soc Trop Med Hyg 2014;108:538-49.

Hussain MA, Sitha AK, Swain S, et al. Mass drug administration for lymphatic filariasis elimination in a coastal state of India: a study on barriers to coverage and compliance. Infect Dis Poverty 2014;3:31.

Lwanga SK, Lemeshow S. Sample size determination in health studies: a practical manual. Geneva: World Health Organization; 1991.

Sugiyono. Metode penelitian kuantitatif, kualitatif dan R & D. Bandung: CV.Alfabeta; 2011.

Kumar A, Sachan P. Measuring impact on filarial infection status in a community study : role of coverage of mass drug administration. Tropical Biomedicine 2014;31:225-9.

Kalimuthu M, Sunish IP, Nagaraj J, et al. Residual microfilaremia in rural pockets of South India after five rounds of DEC plus albendazole administration as part o the LF elimination campaign. J Vector Borne Dis 2015;52;182-4.

Vaishnav KG, Desai HS, Srivastava PK, et al. Impact of mass drug administration on elimination of lymphatic filariasis in Surat City India. J Comm Dis 2012;44:251-9.

Jones C, Tarimo DS, Malecela MN. Evidence of contiuned transmission of Wuchereria bancrofti and associated factors despite nine rounds of ivermectin and albendazole mass drug administration in Rufiji district Tanzania. Tanzania J Health Res 2015;17:1-9.

World Health Organization. Global programme to eliminate lymphatic filariasis: progres report 2014. Weekly Epidemiol Rec 2015;90:489-504.

Krentel A, Fischer PU, Weil GJ. A review of factors that influence individual compliance with mass drug administration for elimination of lymphatic filariasis. PloS Negl Trop Dis 2013;7: e2447.

Ghosh S, Samantha A, Kole S. Mass drug administration for elimination of lymphatic filariasis: recent experiences from a district of West Bengal, India. Trop Parasitol 2013;3:67-71.

Fernando SD, Rodrigo C, Rajapakse S. Current evidence on the use of antifilarial agents in the management of bancroftian filariasis. J Trop Med 2011, Article ID 175941, 12 pages. doi: 10.1155/2011/175941.

Offei M, Anto F. Compliance to mass drug administration programme for lymphatic filariasis elimination by community members and volunteers in the Ahanta West District of Ghana. J Bacteriol Parasitol 2014;5:180. doi: 10.4172/2155-9597.1000180.