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ORIGINAL ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 3  |  Page : 736-742

Directly observed therapy and repeat house-to-house visit: pincer movement for mass drug administration in West Bengal, India


1 Department of Community Medicine, Bankura Sammilani Medical College, Bankura, West Bengal, India
2 Department of Forensic Medicine, Bankura Sammilani Medical College, Bankura, West Bengal, India

Correspondence Address:
Dibakar Haldar
Anandapally, Sitko Road, Duttapara, Baruipur, Kolkata 700144, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.198792

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Objective The aim of this study was to assess the effect of directly observed therapy (DOT) on coverage, the compliance of mass drug administration (MDA), and to find out correlates of noncompliance. Background MDA for the elimination of lymphatic filariasis (LF) by 2015 in West Bengal (WB) has been criticized for undercoverage and mere distribution of antifilarial medicines for unsupervised consumption. To overcome these shortcomings, the government of WB adopted DOT for MDA. Participants and methods A cross-sectional survey was conducted in three villages of three blocks and two wards of one municipality of Bankura district, WB, India, selected randomly. Information was collected by interviewing inhabitants of randomly selected households. Results Overall, appropriate medicine distribution and consumption were 71.31 and 53.21%, respectively. Multivariate analysis revealed that medicine consumption was higher among the following: participants who belonged to the Hindu religion; people of poor socioeconomic status; those who were distributed medicine by a routine health worker acting as drug administrators;; those whose consumption was supervised and those who had complied to MDA previously. Almost three-fourth consumptions were unsupervised. 58.73% respondents knew about LF and 42% knew about transmission; 50.79% had heard about MDA and 39.68% stated that MDA is to avoid LF. Noncompliance to the distributed medicines might be due to lack of awareness about LF and MDA. The reasons for noncompliance were as follows: 'fear of adverse reaction' (63.72%), 'didn't know why to consume' (23.89%), and 'healthy' (20.35%) were causes of noncompliance. Conclusion Despite DOT and repeat house visit coverage of MDA, we fell short of target. Mass mobilization with effective supervision is the need of hour for universal coverage of MDA with supervised consumption of tablets.


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