A cross-sectional evaluation of Mass Drug Administration for lymphatic filariasis elimination in Howrah District, West Bengal, India: from distribution to consumption

Abstract Background: Lymphatic filariasis (LF) remains a significant public health concern in India, contributing to substantial long-term disability. Mass Drug Administration (MDA) is a cornerstone of the national LF elimination strategy. This study evaluated the coverage and compliance of the 2025 MDA round conducted in Howrah District, West Bengal. Materials and Methods: A community-based cross-sectional study was conducted from March to June 2025 across four selected clusters using multistage random sampling. A total of 735 individuals from 165 households were surveyed. Participants included individuals aged 2 years and above, excluding pregnant women and those who were seriously ill. Information on drug receipt, consumption, supervision, and reasons for noncompliance was collected using a predesigned and pretested semi-structured questionnaire. Data analysis was performed using Microsoft Excel. Results: Among the 712 eligible individuals, 541 (76.0%) received the MDA drugs, and 455 (63.9%) consumed them. Supervised drug intake occurred in 48.9% of cases. Compliance rates were 79.3% for diethylcarbamazine and 81.1% for albendazole. Urban areas demonstrated higher drug distribution but comparatively lower consumption. The most common reason for noncompliance was a lack of adequate information. Conclusion: The inaugural MDA round in Howrah District achieved moderate coverage and compliance. Despite reasonably high rates of supervised consumption, knowledge gaps hindered optimal participation. Tailored communication strategies and operational enhancements are necessary to improve compliance in subsequent MDA rounds.