Impact of Mass Drug Administration with Ivermectin, Diethylcarbamazine, and Albendazole in Elimination of Lymphatic Filariasis in Five Districts of Nepal Article Swipe
Ram Kumar Mahato
,
Gokarna Dahal
,
Yadu Chandra Ghimire
,
Rudra Prasad Marasini
,
David T. S. Hayman
,
Kaliannagounder Krishnamoorthy
,
Sudha Sharma
,
D.N. Sah
,
Ray R
,
Radha Subedi
,
K. Pandit
,
Shanta Paudel Khatiwada
,
Achut Babu Ojha
,
Saroj Mahaseth
,
Debasis Mahata
,
Molly Brady
,
Cosima Brucker
,
Briana Stone
,
Ashna Parajuli
,
Satya Raj Paudel
,
Bhim Prakash Devkota
,
Chandra Bhal Jha
,
Krishna Prasad Paudel
,
Bhim Prasad Sapkota
,
Bijay Bajracharya
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.06.03.25328869
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.06.03.25328869
Background Nepal aims to eliminate Lymphatic Filariasis (LF) by 2030. Mass drug administration (MDA) has ceased in 53 of 64 endemic districts. In 2023, five districts with persistent LF (≥2% antigen prevalence) completed two rounds of MDA using a three-drug regimen (Ivermectin, Diethylcarbamazine, and Albendazole; IDA), achieving over 65% coverage. An Epidemiological Monitoring Survey (EMS) was conducted to evaluate IDA’s impact. Methods A cross-sectional EMS was conducted 9 months post-MDA in 11 evaluation units (EUs) across five districts, using two sites per EU (n=22). A total of 6,829 individuals aged ≥20 years were sampled via multi-stage methods, with ≥300 blood samples per site. Data on demographics and MDA participation were collected. LF antigen testing was followed by night blood microfilariae testing in antigen-positive samples. Analysis included non-parametric tests, logistic and mixed-effects models accounting for site-level clustering, and penalized regression (lasso and ridge) to assess predictor importance and manage multicollinearity. Results Nine of 11 EUs passed EMS. Two EUs in Kapilvastu failed due to ≥1% microfilariae prevalence in at least one site. Microfilariae prevalence was negatively correlated with site MDA coverage (p = 0.04), but not antigen prevalence (p = 0.8). Overall, 4.63% of participants were antigen-positive and 0.34% were microfilariae-positive (ratio 14:1). Being female (OR 0.12; 95% CI: 0.04–0.36) and participation in latest MDA round (OR 0.34; 95% CI: 0.15–0.77) were associated with lower microfilariae prevalence. Conclusion Nine EUs met the EMS threshold for impact assessment eligibility. Female gender and participation in the most recent MDA round were protective against microfilariae. Targeted MDA strategies focusing on men and high-risk areas are recommended.
Related Topics
Concepts
Lymphatic filariasis
Diethylcarbamazine
Ivermectin
Albendazole
Mass drug administration
Filariasis
Anthelmintic
Helminthiasis
Wuchereria bancrofti
Medicine
Onchocerciasis
Administration (probate law)
Veterinary medicine
Helminths
Environmental health
Immunology
Surgery
Political science
Population
Law
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2025.06.03.25328869
- https://www.medrxiv.org/content/medrxiv/early/2025/06/04/2025.06.03.25328869.full.pdf
- OA Status
- green
- References
- 23
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411024150
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411024150Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1101/2025.06.03.25328869Digital Object Identifier
- Title
-
Impact of Mass Drug Administration with Ivermectin, Diethylcarbamazine, and Albendazole in Elimination of Lymphatic Filariasis in Five Districts of NepalWork title
- Type
-
preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-06-04Full publication date if available
- Authors
-
Ram Kumar Mahato, Gokarna Dahal, Yadu Chandra Ghimire, Rudra Prasad Marasini, David T. S. Hayman, Kaliannagounder Krishnamoorthy, Sudha Sharma, D.N. Sah, Ray R, Radha Subedi, K. Pandit, Shanta Paudel Khatiwada, Achut Babu Ojha, Saroj Mahaseth, Debasis Mahata, Molly Brady, Cosima Brucker, Briana Stone, Ashna Parajuli, Satya Raj Paudel, Bhim Prakash Devkota, Chandra Bhal Jha, Krishna Prasad Paudel, Bhim Prasad Sapkota, Bijay BajracharyaList of authors in order
- Landing page
-
https://doi.org/10.1101/2025.06.03.25328869Publisher landing page
- PDF URL
-
https://www.medrxiv.org/content/medrxiv/early/2025/06/04/2025.06.03.25328869.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.medrxiv.org/content/medrxiv/early/2025/06/04/2025.06.03.25328869.full.pdfDirect OA link when available
- Concepts
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Lymphatic filariasis, Diethylcarbamazine, Ivermectin, Albendazole, Mass drug administration, Filariasis, Anthelmintic, Helminthiasis, Wuchereria bancrofti, Medicine, Onchocerciasis, Administration (probate law), Veterinary medicine, Helminths, Environmental health, Immunology, Surgery, Political science, Population, LawTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
-
23Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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