Bulawayo – Thirty-six-year-old Siyenkosini Moyo walks into Collen Bawn Clinic in Gwanda District, ready to take his medication, with no questions asked. As standard, a nurse stops him for a quick chat to ensure he has the right information before he gets his treatment. 

“I saw the poster and meant to ask for some time off at work to come to the clinic,” he says. 

“When we got to the site, we were advised to come and get the medications and I was one of the first to take up the opportunity. This is important because for me, my health that comes first,” he said.

In a concerted effort to combat parasitic diseases, Zimbabwe launched a Mass Drug Administration (MDA) campaign against lymphatic filariasis, commonly known as elephantiasis, targeting 1.4 million in Mutoko, Kariba, Centenary, Chiredzi, Gutu, Gwanda and Mhondoro districts. At least 1 million people were reached during the campaign which ran from September 16 to 28, 2024, translating to 73% of the targeted population. This is the first time the country is using the triple-drug therapy with ivermectin, diethylcarbamazine, and albendazole (IDA) which is much more effective against LF. 

As the campaign rolls out in targeted communities, the number of tablets being administered is determined by one’s height. In addition, this is one of the programmes where more men are turning up for treatment compared to other campaigns the country has conducted in the past. Nurses attributed this to the disfiguring visible manifestations such as scrotal swelling.

A Ward 4 Village Health Worker, Sixolisile Ncube, is stationed at an outreach point at Lumene shopping center. She is overseeing the initial screening process, where residents are measured for height before proceeding to nurses for detailed registration and medication distribution.

"Based on our training, we understand that lymphatic filariasis is transmitted through mosquitos," Ncube explains. "This outreach is strategically timed to ensure our community members are protected from the disease which is not commonly understood around here."

Her sentiments align with Gwanda District Nursing Officer Sister Filter Sibanda, who pointed out that the initiative served as both a treatment and awareness campaign as “most people are now coming out and presenting at facilities following the social mobilization exercise we carried out ahead of the campaign.”

Lymphatic filariasis is a parasitic disease caused by filarial worms, a type of roundworm. These worms are transmitted to humans through the bites of infected mosquitoes. In severe cases, elephantiasis can cause significant disability and can even lead to amputation. However, with early diagnosis and treatment, the progression of the disease can be slowed or stopped.

The MDAs are guided by a comprehensive population and community-based survey conducted in 2021. This survey identified districts with low treatment coverage for lymphatic filariasis, schistosomiasis, and intestinal worms, highlighting areas where intervention is urgently needed. Prevalence estimates from the 2021 survey indicate that regarding lymphatic filariasis, 39 districts were endemic in 2015. Only two rounds of LF MDAs were implemented in 2016 and 2017, followed by a confirmatory mapping exercise in 2021. The first phase of this mapping identified 16 priority districts, of which only two were found to be endemic for LF. Plans are underway to conduct further confirmatory mapping in the remaining 23 districts.

To ensure success of the MDA campaigns, WHO has provided over 3,6 million (3,631,000) Praziquantel tablets to cover 1,815,500 people, for albendazole 8,789 boxes of 200 tablets to cover 1,757,800 people and for Ivermectin 6,116 bottles of 500 tablets. WHO's support extends beyond medication, encompassing vital roles in the planning stages, advocacy and communication efforts, and providing technical and supervisory guidance throughout implementation. The MDAs for bilharzia and intestinal worms will be conducted from 14-21 October 2024. 

“People affected by LF are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty. Efforts such as mass campaigns and MDAs go a long way in eliminating this disease and hence preventing unnecessary suffering and contribute to poverty reduction,” Dr Mkhokheli Ngwenya, WHO Zimbabwe Acting Team Lead for Communicable and Non-Communicable Diseases.