Lymphatic filariasis is one of several neglected tropical diseases
with severely disabling and stigmatizing manifestations that are referred to as
‘neglected diseases of poverty’. It is a mosquito-borne disease found endemically
and exclusively in low-income contexts where, concomitantly, general
public health care is often deeply troubled and fails to meet the basic health
needs of impoverished populations. This presents particular challenges for the
implementation of mass drug administration (MDA), which currently is the
principal means of control and eventual elimination. Several MDA programmes
face the dilemma that they are unable to attain and maintain the required drug
coverage across target groups. In recognition of this, a qualitative study was
conducted in the Morogoro and Lindi regions of Tanzania to gain an understanding
of community experiences with, and perceptions of, the MDA campaign
implemented in 2011 by the National Lymphatic Filariasis Elimination
Programme. The study revealed a wide variation of perceptions and experiences
regarding the aim, rationale and justification of MDA. There were positive
sentiments about the usefulness of the drugs, but many study participants were
sceptical about the manner in which MDA is implemented. People were particularly
disappointed with the limited attempts by implementers to share information
and mobilize residents. In addition, negative sentiments towards MDA
for lymphatic filariasis reflected a general feeling of desertion and marginalization
by the health care system and political authorities. However, the results
suggest that if the communities are brought on board with genuine respect for
their integrity and informed self-determination, there is scope for major improvements
in community support for MDA-based control activities.