Summary of study types, methods, and population.

Lymphatic filariasis (LF), commonly called “elephantiasis,” is one of the leading causes of disability around the world, with approximately 863 million people across 47 countries still living under threat of LF infection. India, with 40% of the global LF burden, is the most affected country that undertakes annual mass drug administration (MDA) using double and triple drug chemoprophylaxis in 157 LF-endemic districts. Consumption of drugs during MDA campaigns remains the biggest challenge for disease elimination in the country. PATH conducted a dual-phased study titled, “A Mixed-Method Study to Improve outcome of Mass Drug Administration in Two TAS failed Districts of Uttar Pradesh, India.” The study aimed to identify the critical factors in achieving optimal drug consumption among community members during MDA campaigns (pre-intervention phase), develop an intervention package (IP) for use in the government's subsequent MDA program to improve the coverage, and assess the impact (post-intervention phase). The quantitative data collection entailed house-to-house and drug administrator surveys, while qualitative data collection included in-depth interviews and rapid ethnography. The main reason for non-consumption was found to be fear of side effects, followed by away from home, lack of awareness, and suboptimal micro-planning. Post-IP measurements showed that there was an increase in evaluated coverage of 10.1% in Varanasi and 20.7% in Chitrakoot, as well as an increase in community awareness of 40% in Chitrakoot, with interpersonal communication being the most effective method for demand generation/ community awareness. An Intervention Package (IP), developed and piloted in the two study districts, was adopted by the state government of Uttar Pradesh and used across all 50 LF-endemic districts in the state.

淋巴丝虫病（Lymphatic filariasis, LF），俗称“象皮病”，是全球范围内造成残疾的主要病因之一，目前全球47个国家中约有8.63亿人仍面临淋巴丝虫病感染威胁。印度承担着全球40%的淋巴丝虫病负担，是受影响最严重的国家。该国在157个淋巴丝虫病流行区实施年度大规模药物给药（mass drug administration, MDA）工作，采用双联及三联药物化学预防方案。大规模药物给药活动期间的药物服用依从性问题，仍是该国实现疾病消除目标的最大阻碍。

国际组织PATH开展了一项两阶段研究，研究标题为《印度北方邦两个TAS不合格地区提升大规模药物给药效果的混合方法研究》。该研究旨在达成三大核心目标：其一，在干预前阶段，明确大规模药物给药活动中社区成员实现最优药物服用依从性的关键影响因素；其二，开发一套干预包（intervention package, IP），用于政府后续的大规模药物给药项目以提升药物覆盖覆盖率；其三，在干预后阶段，评估该干预包的实施效果。

该研究的定量数据收集工作涵盖入户调查与药物发放人员调查，定性数据收集则包括深度访谈与快速民族志研究。研究发现，药物服用不依从的首要原因为担忧药物不良反应，其次分别为研究对象外出不在家、缺乏疾病认知以及微观规划欠优化。

干预包实施后的评估结果显示，瓦拉纳西的药物覆盖评估率提升了10.1%，奇特拉库特则提升了20.7%；同时奇特拉库特的社区疾病认知水平提升了40%，其中人际传播是实现需求激发与社区认知提升的最有效方式。

本次在两个研究地区开发并试点的干预包（intervention package, IP），已被北方邦州政府采纳，并在该邦全部50个淋巴丝虫病流行区推广使用。