Despite the controversies surrounding the side effects of the drug, the Tamil Nadu health department has decided to administer Diethylcarbamazine citrate (DEC) tablets to about three crore people on September 4 as scheduled in the state in a Mass Drug Administration (MDA) programme, as part of the WHO-Central Government initiative to eradicate filariasis.
According to the state health department, the programme will be implemented in 14 districts of the state namely Kancheepuram, Thiruvalluvar, Vellore, Thiruvannamalai, Villupuram, Cuddallore, Nagapatinam, Tiruvarur, Tanjur, Trichy, Pudukkottai, Perambalur, Kanyakumari and Chennai, as about 20 districts have been found to be endemic to the disease. One trained volunteer who will be a resident of a particular area will visit at least 50 households in an area on the day, and about 1,20,000 health volunteers have been trained for the purpose. Children aged between 1-5 will be given 100 mg, 6-15 will be given 200 mg and 16 and above will be given 300 mg of DEC. Children below two years, ailing patients and pregnant women will be excluded from the programme.
However, a notification of the department in its website has cautioned that the 'DEC will not cure elephantiasis, but sufferings can be reduced by foot hygiene, washing, massaging, physical exercises and treatment of infection in the lymphoderma limbs. It also has said 'DEC was the safest drug with no major side effects and minor side effects are rare. It is also effective to kill the micro-filariae of the parasite, if found in the human blood. It further said Tamil Nadu has 25864 lymphodema cases and 8794 hydrocele cases and about three crore people are living in 13 filaria endemic districts of the state. Due to the disease, the state is losing 112 million man-days a year and cause to lose an economic income of Rs 335 crore annually.
It may be noted that some of the southern states like Kerala, Andhra Pradesh, Karnataka, Goa etc had postponed the same MDA programme during 5th of June this year due to various reasons, including availability of the drug and concerns on side effects. Even a Public Interest Litigation (PIL) was filed in the Kerala High Court to issue orders to the Kerala Government to refrain from administering the drug citing the drug has many side effects and it should not be administered to majority of the state population as the disease is confined only to some parts of the state. The petitioner also had complained the State Government neither conducted elaborate studies and surveys nor ensured adequate medical supervision for administering the drug. It is learnt that the High Court later rejected the petition after it felt satisfactory on the preparation for the programme and expert opinion from the government side. However, Kerala is yet to implement the programme.
Amidst the hues and cries of a section of medical experts, NGOs, cultural leaders and experts that it had been documented in scientific journals that DEC could cause adverse reactions like fever, headache and nausea, allergic inflammation of the skin, encephalitis, retinal hemorrhage etc, the health department officials and a section of experts maintain the drug is safe to be administered in an MDA programme.