[Update] Analysis and Evaluation of the Second Round of Preventive Drug Administration for Lymphatic Filariasis in West New Britain Province

Between November and December 2024, the second round of Mass Drug Administration (MDA) for lymphatic filariasis (LF) was conducted in West New Britain Province (WNBP). The results were presented at a Post-MDA Workshop meeting in Kimbe in May 2025, marking the completion of the MDA program in the province.

Following the first round of MDA conducted in 2023, the second round of MDA was implemented using a combination of three medicines (IDA): ivermectin (1.776 million tablets, donated by Merck & Co., USA), diethylcarbamazine (1.86 million tablets, donated by Eisai Co., Japan), and albendazole (378,000 tablets, donated by GlaxoSmithKline (GSK), UK) , all provided free of charge to Papua New Guinea (PNG) through the World Health Organization (WHO). This contributed significantly to the elimination of LF in the province. On the other hand, azithromycin, effective against yaws and administered concurrently during the first MDA, was not available in sufficient quantities to cover the entire population. Therefore, distribution was limited to suspected yaws cases and their contacts.

The results showed that out of an estimated provincial population of around 320,000 (excluding pregnant women, the elderly, and some infants), a total of 257,083 people took IDA medicines, representing an MDA coverage rate of 79%. For azithromycin, 22,018 individuals (6.8%) received treatment. Across all four areas of the province, the IDA MDA coverage rate remained high at 78–80%, significantly exceeding the WHO-recommended target threshold of 65% (see Table 1). The higher the MDA coverage rate, the greater the potential to interrupt LF transmission and advance toward elimination. In addition, screening for skin-related Neglected Tropical Diseases (NTDs), conducted simultaneously with drug administration, reported 164 suspected LF cases, 18,334 suspected yaws cases, and 7,128 cases of scabies. Similar to the first MDA, a large number of suspected skin-related NTD cases were identified.

Following the completion of the MDA at the end of 2024, the Coverage Evaluation Survey (CES) was carried out in February 2025 by staff from the Provincial Health Authority Headquarters (PHAQ). The survey interviewed 403 households (2,304 people) across 26 areas of the province. The proportion of respondents who reported having taken the MDA medicines was 79.1%. Among those who did not take the medicines, the main reasons cited were “being absent during the MDA” (42.0%), “not being informed about the campaign” (8.7%), and “the team did not come” (0.3%). For those who received medicines but did not take them, the main reasons were “concerns about side effects” (15.7%) and “lack of sufficient information” (15.5%).

Compared with the first-round MDA survey, the proportion of people who “were not informed about the campaign” dropped from 14.2% to 8.7%, and “the team did not come to their areas” fell from 5.0% to 0.3%. Meanwhile, “concerns about side effects” decreased dramatically from 65.7% to 15.7%. These changes indicate improvements in public awareness, better access to medicines, and reduced anxiety about taking them.

On 8–9 May 2025, the Post-MDA Workshop was held in Kimbe, co-hosted by this project, the National Department of Health (NDoH), and WHO, for PHA representatives. In addition to presenting the overall results, health facility representatives shared feedback on MDA implementation in their respective areas.

Common challenges highlighted included: hesitation among some residents to take the medicines, shortages of manpower to carry out MDA activities, the existence of hard-to-reach areas, unpredictable weather conditions (with rough seas during bad weather in particular), weak communication infrastructure, and delays in financial acquittals for PHA operational costs. On the other hand, many positive aspects were also reported, such as improved cost-effectiveness of mass drug distribution and secondary benefits for skin diseases. One health facility reported that they provided daily life guidance and lymphedema care advice to identified LF patients during the MDA period. For skin diseases that are difficult to diagnose, the WHO officer provided lectures on clinical signs during pre- and post-MDA trainings, and Pidgin-language materials on skin conditions supported by WHO, contributing to improved knowledge and skills among health workers. Training sessions for local volunteers and staff were also conducted at each health facility before MDA implementation, helping to build capacity for disease control and establish systems for ongoing care and monitoring.

In this round of MDA, our project mainly collaborated with relevant organisations and stakeholders to strengthen LF control through the following support:

Key support provided by the Project:

Following the completion of the required rounds of MDA in the province, the next activity will be an IDA Impact Survey to assess the LF endemic status after MDA. This survey is scheduled to take place after an interval of at least six months, expected around late 2025 to 2026. A total of three surveys will be conducted every two years, and it is required that all rounds achieve a “Pass.”

PNG, in line with WHO’s Roadmap for NTD Elimination, is aiming to eliminate LF by 2030. As LF transmission can be interrupted through consistent medicine intake, NDoH and PHAs will continue to take the lead, strengthening operational structures in the target areas to steadily advance activities to stop further transmission.

Further information is available on the JICA Papua New Guinea Office Website.

“Official Launch of Mass Drug Administration (MDA) Round 2 in West New Britain Province; The Project for Elimination of Lymphatic Filariasis Phase 2” (Posted on 9 December 2024)

“Working Together for a Lymphatic Filariasis-Free Future: Post-MDA Workshop” (Posted on 28 May 2025)