Accelerating Lymphatic filariasis (LF) elimination in Myanmar

Lymphatic Filariasis (LF) is a neglected topical disease caused by parasitic worms transmitted through the bites of infected mosquitoes. This disease, often referred to as elephantiasis, can lead to severe disability and social stigmatization, affecting the quality of life of millions of people worldwide. LF is one of the public health problems in Myanmar prevalent mostly in the central and coastal regions. It is endemic in 45 districts with an estimated 32.6 million population at - risk. 

The first ever MDA (mass drug administration) was implemented in Myanmar in 2001 and 100% geographic coverage was achieved in 2013. Transmission Assessment Surveys (TAS) were conducted in 30 districts until 2019. All districts achieved less than 2% antigenicity. By the end of 2019, 30 of 45 districts did not require MDA. In 2020, MDA was implemented in the remaining 15 districts. 13.9m (97.3%) eligible at – risk population was reached. By consistently administering these drugs over several years, the transmission of the disease has been effectively interrupted, bringing Myanmar closer to its goals of LF elimination. 

In 2022, WHO supported LF Programme to switch the strategy from double drug MDA (Diethly Carbamazine plus Albendazole) to triple drug MDA (Ivermectin, Diethly Carbamazine plus Albenda- zole- IDA) to accelerate LF elimination. This was implemented in 2 districts as a pilot programme with WHO’s support. The IDA MDA was delivered to 1.4m population in 2 districts of Rakhine amid complex operational environment - with scarcity of human resource, disturbances of supply chain, difficulty in transportation, and data and reporting delays. Despite this, 92.2% eligible population ingested the drugs. This support is contributing to accelerate LF elimination and prevent suffering from the long - term disabilities that could arise in person with the parasite. 

WHO also supported in the development of National Action Plan to Eliminate Lymphatic Filariasis in Myanmar (2021 -2030) using new accelerator -triple drugs (IDA), MMDP guideline, IDA guideline, IDA guideline for program managers at different level (Myanmar Language), SOP for IDA for Basic health Staff, SOP for drug administration team. WHO funded and facilitated IDA training Basic Health staff, conducted advocacy meetings for IDA MDA and supported printing and distribution of awareness materials for the campaign. In addition, WHO specifically delivered thousands of IEC materials and 4m tablets of Ivermectin, 3.6 m tablets of DEC, and 1.4 m of Albendazole. 

Despite substantial progress, Myanmar faces various challenges in its quest to eliminate LF. Reaching remote communities due to geographic barriers and limited infrastructure. Sustaining LF elimination efforts will require expansion of IDA and consistent availability of resources. Reducing social stigma and increasing awareness about the disease remain ongoing challenges. 

Myanmar’s commitment to eliminate LF is an inspiring example of a country dedication to improving the health and wellbeing of the local population. With continued support from the donors, partners and dedication of healthcare workers, Myanmar will be on its way to achieve the goal of LF elimination by 2030. Through collaborative efforts and a focus on community engagement, Myanmar can look forward to a brighter LF free future for its people.