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{{Short description|Prominence and Spread of a disease in India}}
'''Lymphatic filariasis in India''' refers to the presence of the disease [[lymphatic filariasis]] in India and the social response to the disease. In India, 99% of infections come from a [[Culex quinquefasciatus|type of mosquito]] spreading a [[Wuchereria bancrofti|type of worm]] through a [[mosquito bite]].<ref name="Agrawal 2006"/> The treatment plan provides 400 million people in India with medication to eliminate the parasite.<ref name="Bagcchi 2015"/> About 50 million people in India were carrying the worm as of the early 2010s, which is 40% of all the cases in the world.<ref>{{cite journal |last1=Hoti |first1=S |title=Filariasis of uncommon nature in India. |journal=Tropical Parasitology |date=January 2012 |volume=2 |issue=1 |pages=2–3 |doi=10.4103/2229-5070.97230 |pmid=23509678|pmc=3593514 |doi-access=free }}</ref> In collaboration with other countries around the world, India is participating in a global effort to [[Eradication of lymphatic filariasis|eradicate lymphatic filariasis]]. If the worm is eliminated from India then the disease could be permanently eradicated.<ref>{{cite web |last1=Ganguly |first1=NK |title=The final lap towards elimination of Lymphatic Filariasis |url=https://www.thehindubusinessline.com/specials/pulse/the-final-lap-towards-elimination-of-lymphatic-filariasis/article9972382.ece |website=[[Business Line]] |language=en |date=9 January 2018}}</ref><ref>{{cite web |last1=Senthilingam |first1=Meera |title=Every last worm: Eliminating Elephantiasis in India |url=https://www.cnn.com/2015/03/12/health/eliminating-elephantiasis-in-india/index.html |website=CNN |date=24 April 2015}}</ref> In October 2019 the Union health minister [[Harsh Vardhan (Delhi politician)|Harsh Vardhan]] said that India's current plan is on schedule to eradicate filariasis by 2021.<ref name="Sharma 2019">{{cite web |last1=Sharma |first1=Neetu Chandra |title=India to eliminate Lymphatic Filariasis by 2021: Harsh Vardhan |url=https://www.livemint.com/science/health/india-to-eliminate-lymphatic-filariasis-by-2021-harsh-vardhan-11572432801017.html |website=[[Mint (newspaper)|Livemint]] |language=en |date=30 October 2019}}</ref>

To treat, prevent, and eliminate the disease, the Indian government provides [[mass drug administration]] (MDA) to achieve [[mass deworming]]. The treatment is a few pills taken once a year for five years. The medication provided is [[diethylcarbamazine]].{{citation needed|date=January 2023}} For the treatment to work 60-80% of people in large regions must take this yearly treatment for several years.

==Treatment==
Treatment is done through a public health initiative in which most people in regions with the parasite take treatment. The treatment is a [[mass drug administration]] to cause [[mass deworming]]. In India the worm only lives in humans, so if everyone takes treatment, and everyone is cured, then the worm will be permanently eradicated. India participates in the global eradication program to eliminate the worm worldwide.{{citation needed|date=May 2021}}

[[Health education]] for the public is an essential part of the campaign.<ref name="Bagcchi 2015">{{cite journal |last1=Bagcchi |first1=Sanjeet |title=India tackles lymphatic filariasis |journal=The Lancet Infectious Diseases |date=April 2015 |volume=15 |issue=4 |page=380 |doi=10.1016/S1473-3099(15)70116-7|pmid=25809895 }}</ref> Hundreds of millions of people in affected communities have to agree to take the drugs once a year.<ref name="Bagcchi 2015"/> In a 2015 public health campaign called ''Hathipaon Mukt Bharat'' shows how the disease causes large feet, says the medicine is safe, and tells people to take it.<ref name="Bagcchi 2015"/>

The treatment program varies in different places in India. Various reports describe the variation, such as for Assam<ref name="Khan 2018">{{cite journal |last1=Khan |first1=AbdulMabood |title=Lymphatic filariasis elimination programme in Assam, India, needs change in mass drug administration strategy to target the focus of infection |journal=Indian Journal of Medical Research |date=2018 |volume=147 |issue=1 |pages=7–10 |doi=10.4103/ijmr.IJMR_1843_16|pmid=29749354 |pmc=5967220 |doi-access=free }}</ref> and Andhra Pradesh.<ref>{{cite journal |last1=Upadhyayula |first1=Suryanaryana Murty |last2=Mutheneni |first2=Srinivasa Rao |last3=Kadiri |first3=Madhusudhan Rao |last4=Kumaraswamy |first4=Sriram |last5=Nagalla |first5=Balakrishna |last6=Noor |first6=Abdisalan Mohamed |title=A Cohort Study of Lymphatic Filariasis on Socio Economic Conditions in Andhra Pradesh, India |journal=PLOS ONE |date=19 March 2012 |volume=7 |issue=3 |article-number=e33779 |doi=10.1371/journal.pone.0033779|pmid=22442721 |pmc=3307764 |bibcode=2012PLoSO...733779U |doi-access=free }}</ref>

Most people who take treatment have no negative effects or only mild [[adverse events]] which resolve without further treatment.<ref name="Kuttiatt 2020">{{cite journal |last1=Kuttiatt |first1=VS |last2=Somani |first2=RK |last3=Swaminathan |first3=S |last4=Krishnamoorthy |first4=K |last5=Weil |first5=GJ |last6=Purushothaman |first6=J |title=Frequency and Clinical Significance of Localized Adverse Events following Mass Drug Administration for Lymphatic Filariasis in an Endemic Area in South India. |journal=The American Journal of Tropical Medicine and Hygiene |date=January 2020 |volume=102 |issue=1 |pages=96–99 |doi=10.4269/ajtmh.19-0532 |pmid=31769393|pmc=6947773 }}</ref> A bigger problem than any side effects of treatment is people having fear of taking treatment, which leads them to refuse to take medicine.<ref name="Kuttiatt 2020"/> Various studies have examined why people in various Indian regions neglect to take the drugs.<ref>{{cite journal |last1=Banerjee |first1=S |last2=Bandyopadhyay |first2=K |last3=Khan |first3=MF |last4=Akkilagunta |first4=S |last5=Selvaraj |first5=K |last6=Tripathy |first6=JP |last7=Solanki |first7=R |last8=Kushwaha |first8=AS |last9=Deshmukh |first9=P |title=Coverage of mass drug administration for elimination of lymphatic filariasis in urban Nagpur, Central India: A mixed method study. |journal=Journal of Family Medicine and Primary Care |date=September 2019 |volume=8 |issue=9 |pages=3009–3014 |doi=10.4103/jfmpc.jfmpc_503_19 |pmid=31681683|pmc=6820416 |doi-access=free }}</ref>

==Vector==
99% of infections in India happen when the mosquito ''[[Culex quinquefasciatus]]'' spreads the worm ''[[Wuchereria bancrofti]]'' through a [[mosquito bite]].<ref name="Agrawal 2006">{{cite journal |last1=Agrawal |first1=VK |last2=Sashindran |first2=VK |title=Lymphatic Filariasis in India: Problems, Challenges and New Initiatives |journal=[[Medical Journal Armed Forces India]] |date=October 2006 |volume=62 |issue=4 |pages=359–362 |doi=10.1016/S0377-1237(06)80109-7|pmid=27688542 |pmc=5034168 }}</ref> Because the cause of this disease can be a different worm and parasite in different countries, each country has its own plan for control and treatment.<ref>{{cite journal |last1=Erickson |first1=Sara M. |last2=Thomsen |first2=Edward K. |last3=Keven |first3=John B. |last4=Vincent |first4=Naomi |last5=Koimbu |first5=Gussy |last6=Siba |first6=Peter M. |last7=Christensen |first7=Bruce M. |last8=Reimer |first8=Lisa J. |last9=Valenzuela |first9=Jesus G. |title=Mosquito-Parasite Interactions Can Shape Filariasis Transmission Dynamics and Impact Elimination Programs |journal=PLOS Neglected Tropical Diseases |date=12 September 2013 |volume=7 |issue=9 |article-number=e2433 |doi=10.1371/journal.pntd.0002433|pmid=24069488 |pmc=3772046 |doi-access=free }}</ref>

The typical prevention for filariasis is through the use of medication.<ref name="Sadanandane 2018">{{cite journal |last1=Sadanandane |first1=C |last2=Gunasekaran |first2=K |last3=Boopathi Doss |first3=PS |last4=Jambulingam |first4=P |title=Field evaluation of the biolarvicide, spinosad 20 per cent emulsifiable concentrate in comparison to its 12 per cent suspension concentrate formulation against ''Culex quinquefasciatus'', the vector of bancroftian filariasis in India. |journal=The Indian Journal of Medical Research |date=January 2018 |volume=147 |issue=1 |pages=32–40 |doi=10.4103/ijmr.IJMR_1369_15 |pmid=29749358|pmc=5967213 |doi-access=free }}</ref> However, in some areas, using the pesticide [[spinosad]] to eliminate mosquitoes is helpful to prevent the spread.<ref name="Sadanandane 2018"/>

To eliminate the disease neither humans nor mosquitoes should have the parasite.<ref name="Subramanian 2020">{{cite journal |last1=Subramanian |first1=S |last2=Jambulingam |first2=P |last3=Krishnamoorthy |first3=K |last4=Sivagnaname |first4=N |last5=Sadanandane |first5=C |last6=Vasuki |first6=V |last7=Palaniswamy |first7=C |last8=Vijayakumar |first8=B |last9=Srividya |first9=A |last10=Raju |first10=HKK |title=Molecular xenomonitoring as a post-MDA surveillance tool for global programme to eliminate lymphatic filariasis: Field validation in an evaluation unit in India. |journal=PLOS Neglected Tropical Diseases |date=January 2020 |volume=14 |issue=1 |article-number=e0007862 |doi=10.1371/journal.pntd.0007862 |pmid=31978060|pmc=7001988 |doi-access=free }}</ref> The usual way to determine whether filariasis is eliminated from an area is to test humans for the parasite.<ref name="Subramanian 2020"/> In some special cases India uses [[molecular xenomonitoring]] to examine captured mosquitoes and determine if they carry the parasite.<ref name="Subramanian 2020"/>

==Epidemiology==
By 2006 there were 20 million people infected and with symptoms, 30 million people infected but asymptomatic, and 470 million people who were at potential risk.<ref name="Agrawal 2006" /> In 2005 95% of the cases in India were in Andhra Pradesh, Bihar, Gujarat, Kerala, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh and [[West Bengal]].<ref name="Pani 2005">{{cite journal|last1=Pani|first1=SP|last2=Kumaraswami|first2=V|last3=Das|first3=LK|date=2005|title=Epidemiology of lymphatic filariasis with special reference to urogenital-manifestations|journal=Indian Journal of Urology|volume=21|issue=1|page=44|doi=10.4103/0970-1591.19551|doi-access=free}}</ref>

India has 40% of the world's [[lymphatic filariasis]] (LF) cases.<ref name="Ramaiah 2000">{{cite journal |last1=Ramaiah |first1=Kapa D |last2=Das |first2=Pradeep K |last3=Michael |first3=Edwin |last4=Guyatt |first4=Helen L |title=The Economic Burden of Lymphatic Filariasis in India |journal=Parasitology Today |date=June 2000 |volume=16 |issue=6 |pages=251–253 |doi=10.1016/S0169-4758(00)01643-4|pmid=10827432 }}</ref> For patients, one of the major costs of treating the disease is that of being unable to work for some time.<ref name="Ramaiah 2000" /> A year 2000 survey reported that about half the people in India were at risk of contracting LF.<ref>{{cite journal |last1=Sabesan |first1=S. |last2=Palaniyandi |first2=M. |last3=Das |first3=P. K. |last4=Michael |first4=E. |title=Mapping of lymphatic filariasis in India |journal=Annals of Tropical Medicine & Parasitology |date=3 Jul 2000 |volume=94 |issue=6 |pages=591–606 |doi=10.1080/00034983.2000.11813582|pmid=11064761 |s2cid=35526107 }}</ref> Men and women are equally susceptible to this disease, but in the past, there have been barriers to women accessing treatment.<ref>{{cite journal |last1=Bandyopadhyay |first1=Lalita |title=Lymphatic filariasis and the women of India |journal=Social Science & Medicine |date=May 1996 |volume=42 |issue=10 |pages=1401–1410 |doi=10.1016/0277-9536(95)00288-X|pmid=8735896 }}</ref> An estimate from the year 2000 reported that filariasis in India caused an annual economic loss of ₹5000 [[crore]] ({{US$|1000000000}}).<ref name="Ramaiah 2000" />

==Society and culture==
The ''[[Sushruta Samhita]]'', an [[Ayurvedic]] Indian text, described filariasis in the 6th century BCE.<ref name="Agrawal 2006"/> The disease is timeless and present throughout Indian history. Indian physicians in the 500s wrote about the disease.<ref name="Gordon 2018">{{cite journal |last1=Gordon |first1=CA |last2=Jones |first2=MK |last3=McManus |first3=DP |title=The History of Bancroftian Lymphatic Filariasis in Australasia and Oceania: Is There a Threat of Re-Occurrence in Mainland Australia? |journal=Tropical Medicine and Infectious Disease |date=4 June 2018 |volume=3 |issue=2 |page=58 |doi=10.3390/tropicalmed3020058 |pmid=30274454|pmc=6073764 |doi-access=free }}</ref> In the 1500s the European explorer [[Jan Huyghen van Linschoten]] visited Goa and wrote about people with filariasis symptoms there.<ref name="Gordon 2018"/>

In 1955 the Indian government established the National Filaria Control Programme (NFCP) as a project to limit the spread of the disease.<ref name="Sabesan 2010">{{cite journal |last1=Sabesan |first1=S |last2=Vanamail |first2=P |last3=Raju |first3=KH.K |last4=Raju |first4=P |title=Lymphatic filariasis in India: Epidemiology and control measures |journal=Journal of Postgraduate Medicine |date=2010 |volume=56 |issue=3 |pages=232–8 |doi=10.4103/0022-3859.68650|pmid=20739779 |doi-access=free }}</ref><ref name="Agrawal 2006"/> By 1959 that organization proposed various plans for controlling or eliminating the disease.<ref>{{cite journal |last1=Beye |first1=H. K. |last2=Wright |first2=W. H. |title=The National Filaria Control Program (NFCP) of India: investigative challenges. |journal=Bulletin of the National Society of India for Malaria and Other Mosquito-Borne Diseases |date=1959 |volume=7 |issue=2 |pages=45–52 |url=https://www.cabdirect.org/cabdirect/abstract/19610801377 |publisher=Indian Society for Malaria and Other Communicable Diseases}}</ref> Infections spread out of control from 1955 until 1995 in which time the number of cases increased several fold.<ref name="Agrawal 2006"/> Reasons for the disease's expansion included increased urban population and a rapidly changing country which exposed people to new circumstances with mosquitoes.<ref name="Ramaiah 1993">{{cite journal |last1=Ramaiah |first1=KD |title=A rational approach to the control of filariasis in India. |journal=The National Medical Journal of India |date=1993 |volume=6 |issue=3 |pages=114–6 |pmid=8329989}}</ref>

[[File:J.P. Nadda releasing the Accelerated Plan for Elimination of Lymphatic Filariasis (LF) 2018 for India, at the 10th meeting of Global Alliance to Eliminate Lymphatic Filariasis (GAELF), in New Delhi.JPG|thumb|right|Various people in Delhi present a 2018 plan for eliminating LF with government support of [[Jagat Prakash Nadda|J.P. Nadda]]]]
In 1997 India joined a [[World Health Assembly]] resolution to eliminate LF by 2020.<ref name="Sabesan 2010" /> In India to achieve this goal healthcare must be very accessible to almost everyone at risk for the disease.<ref>{{cite journal|last1=Agrawal|first1=VK|last2=Sashindran|first2=VK|date=October 2006|title=Lymphatic Filariasis in India: Problems, Challenges and New Initiatives|journal=Medical Journal Armed Forces India|volume=62|issue=4|pages=359–362|doi=10.1016/S0377-1237(06)80109-7|pmc=5034168|pmid=27688542}}</ref> The Indian government originally planned to eliminate the disease by 2015, then shifted the date to 2017, then to 2020.<ref name="Times 2017">{{cite web|url=https://timesofindia.indiatimes.com/india/the-epidemic-you-dont-know-about/articleshow/61680295.cms|title=filariasis in india: The epidemic you don't know about|author1=TNN|date=17 November 2017|website=The Times of India|language=en}}</ref> Various media outlets have discussed how India might meet the goal or what it should happen next if more time is required.<ref>{{cite news|author1=TNN|url=https://timesofindia.indiatimes.com/india/the-epidemic-you-dont-know-about/articleshow/61680295.cms|title=Filariasis in india: The epidemic you don't know about|date=17 November 2017|work=[[The Times of India]]|publisher=[[The Times Group]]|language=en}}</ref><ref>{{cite news|last1=Basu|first1=Snigdha|url=https://www.ndtv.com/india-news/not-stigma-but-awareness-a-hurdle-to-eradicate-lymphatic-filariasis-by-2020-1821048|title=Not Stigma But Awareness A Hurdle To Eliminate Lymphatic Filariasis By 2020|date=8 March 2018|work=[[NDTV]]}}</ref><ref>{{cite web|url=https://www.huffingtonpost.in/dr-nibedita-rath/india-is-set-to-fail-its-target-of-eradicating-filariasis-by-2020_a_23080071/|title=India Is Set To Fail Its Target Of Eradicating Filariasis By 2020|last1=Rath|first1=Nibedita|last2=Dash|first2=Sambit|date=22 August 2017|website=[[HuffPost|HuffPost India]]|publisher=[[AOL]]|language=en}}</ref>

In 2015 the Indian government launched a health campaign called ''Hathipaon Mukt Bharat'' (Filaria Free India) to encourage public participation in eliminating LF.<ref>{{cite journal|last1=Bagcchi|first1=Sanjeet|date=April 2015|title=India tackles lymphatic filariasis|journal=The Lancet Infectious Diseases|volume=15|issue=4|page=380|doi=10.1016/S1473-3099(15)70116-7|pmid=25809895}}</ref><ref>{{cite web |last1=McNeil |first1=Donald G. |title=India Begins Campaign to Eliminate Elephantiasis |url=https://www.nytimes.com/2015/03/03/health/india-begins-campaign-to-eliminate-elephantiasis.html |website=The New York Times |date=2 March 2015}}</ref> In the program everyone in an area with the disease takes pill medicine once a year for five years.<ref name="Times 2017" /> The drug is diethylcarbamazine citrate and [[albendazole]] and is in the form of about four pills which people take all at once.<ref name="Times 2017" />

==Research==
Public health researchers have applied machine learning techniques to improve public health monitoring for filariasis in India.<ref>{{cite journal |last1=Kondeti |first1=PK |last2=Ravi |first2=K |last3=Mutheneni |first3=SR |last4=Kadiri |first4=MR |last5=Kumaraswamy |first5=S |last6=Vadlamani |first6=R |last7=Upadhyayula |first7=SM |title=Applications of machine learning techniques to predict filariasis using socio-economic factors. |journal=Epidemiology and Infection |date=2 September 2019 |volume=147 |pages=e260 |doi=10.1017/S0950268819001481 |pmid=31475670|pmc=6805759 }}</ref>

A 2019 report identified dogs in Kerala who have another worm which can cause filariasis, ''[[Brugia malayi]]''.<ref name="Sadarama 2019">{{cite journal |last1=Sadarama |first1=PV |last2=Chirayath |first2=D |last3=Pillai |first3=UN |last4=Unny |first4=NM |last5=Lakshmanan |first5=B |last6=Sunanda |first6=C |title=Canine ''Brugia malayi'' microfilarial excretory/secretory protein-based antibody assay for the diagnosis of brugian filariasis in dogs. |journal=Journal of Parasitic Diseases |date=December 2019 |volume=43 |issue=4 |pages=549–553 |doi=10.1007/s12639-019-01125-3 |pmid=31749523|pmc=6841868 }}</ref> This worm is not known to infect people in India.<ref name="Sadarama 2019"/> If necessary tests are ready to identify the dogs carrying the disease.<ref name="Sadarama 2019"/>

==References==
{{reflist}}

==Further consideration==
* {{Citation |last1=Das |first1=PK |last2=Pani |first2=SP |last3=Krishnamoorthy |first3=K |date=June 2002 |title=Prospects of eliminating lymphatic filariasis in India |journal=ICMR Bulletin |publisher=[[Indian Council of Medical Research]] |location=New Delhi |url=https://www.icmr.nic.in/sites/default/files/icmr_bulletins/bumayjun02.pdf}}
* {{cite web |last1=Kazmin |first1=Amy |title=The race to zero: how to eliminate an ancient disease |url=https://ig.ft.com/special-reports/elephantiasis/ |website=[[Financial Times]] |date=2017}}

[[Category:Lymphatic filariasis|India]]
[[Category:Diseases and disorders in India]]

Lymphatic filariasis in India - Revision history

Janandh: created the info basic info.