Year: 2026 | Month: July-September | Volume: 11 | Issue: 3 | Pages: 350-361
DOI: https://doi.org/10.52403/ijshr.20260338
Comparative Evaluation of Coverage - Compliance of Mass Drug Administration and associated factors for noncompliance: A Coverage Evaluation Survey of Lymphatic filariasis endemic Districts of Madhya Pradesh
Ashish Raghuwanshi1, Akanksha Karkhur2, Ram Lakhan Meena3, Pahram Adhikari4, Sanjeev Kumar5, Pradeep Sukla6, Kalpna Arya7
1Post Graduate 3rd _year student, 2Post Graduate 2nd_year student, 3Post Graduate 2nd _year student, 4Professor (designated), 5Assistant Professor, 6Professor and Head of Department, 7Senior Resident,
Department of Community Medicine, Government Medical College, Datia, Madhya Pradesh, India
Corresponding Author: Dr. Ashish Raghuwanshi
ABSTRACT
Background: Mass Drug Administration (MDA) using diethylcarbamazine, ivermectin, and albendazole was a key strategy for interrupting transmission of lymphatic filariasis. Adequate drug distribution and consumption were essential for achieving effective coverage and elimination targets. This study compared mass drug administration coverage and compliance and identified major reasons for non-compliance in endemic districts of Madhya Pradesh.
Methods: A community-based cross-sectional Coverage Evaluation Survey was conducted in selected implementation units of Tikamgarh and Niwari districts of Madhya Pradesh during February-March 2025. Two implementation units from Tikamgarh and one from Niwari were included. One urban ward and three rural villages were selected from each implementation unit. House-to-house visits were conducted, and eligible individuals were interviewed regarding receipt and consumption of mass drug administration medicines. Distribution coverage, compliance, effective coverage, coverage-compliance gap, and reasons for non-compliance were assessed. Data were analysed using descriptive and comparative statistics.
Results: A total of 1,819 individuals were surveyed, of whom 1,743 [95.82%] were eligible for mass drug administration. In Tikamgarh, 1,098 of 1,169 eligible individuals [93.93%] received the medicines, compared with 498 of 574 [86.76%] in Niwari. Drug distribution coverage was significantly higher in Tikamgarh than Niwari [χ²=25.61, df =1, p-value< 0.001]. Among recipients, 963 [87.70%] in Tikamgarh and 435 [87.35%] in Niwari consumed the medicines, with no significant difference in compliance [χ²=0.04, df=1, p=0.842]. Effective coverage was significantly higher in Tikamgarh [82.38%] than Niwari [75.78%] [χ²=10.54, df=1, p=0.0012]. Among the eligible population, 206 (17.62%) individuals in Tikamgarh and 139 (24.22%) in Niwari did not consume the distributed drugs. Lack of awareness or scientific information was the most frequently reported reason for non-compliance in both districts.
Conclusion: Tikamgarh achieved significantly higher drug distribution and effective coverage than Niwari, while compliance among recipients was comparable between districts. The findings indicated that differences in effective coverage were primarily attributable to drug distribution rather than consumption among recipients. Strengthening interpersonal communication, scientific information, counselling, and community mobilisation could improve drug uptake and support future lymphatic filariasis elimination efforts.
Keywords: Mass drug administration; lymphatic filariasis; effective coverage; Coverage Evaluation Survey; non-compliance.