Fighting Filariasis in Tikamgarh amidst stigma and climate change

Thirty-two-year-old Chhaya Devi Rajput lives with her husband and daughter in Kudyala village, Tikamgarh. In 2018, she noticed unusual swelling and pain in her left leg. At first, she took medicine from a local doctor, but her condition worsened. Eventually, she was diagnosed with filariasis, a vector-borne disease.

Chhaya says that ASHA workers helped her get filariasis medicine from the nearby government health center. Later, she began treatment at AIIMS Bhopal. However, her struggles continue.

Tikamgarh is one of the districts in Madhya Pradesh where filariasis is common. In total, 11 districts in the state are affected. Before 2021, there were more than 150 active cases of filariasis here. These cases include many patients like Chhaya and Mahendra, whose lives have been disrupted by the disease.

Chhaya initially reported her filariasis to the village ASHA worker and maintained regular medication. However, when blisters developed on her foot last year, she sought care at Tikamgarh's district hospital, which referred her to AIIMS Bhopal. Though treatment healed the blisters on her shin, those on her foot persisted, severely impairing her mobility.

The disease has fundamentally altered Chhaya's daily life. She avoids sitting on the ground, knowing the struggle to stand again would be too great.

"I still have to tend to our farm because there's no alternative," Chhaya explains, resignation evident in her voice. "My restricted mobility has isolated me. I can't travel anywhere, and despite all treatments, my foot refuses to heal."

A mother of an 11-year-old daughter, Chhaya has faced mobility challenges since developing filariasis. The disease has limited her ability to do household and farm work, and she rarely goes out. She experiences severe foot pain at night, often disrupting her sleep, and is unable to climb stairs. "I'm the only one in the village! This shouldn't happen to anyone." She adds.

Social Stigma

Filariasis carries a strong social stigma. When the Ground Report team visited the village, many patients and their families refused to talk. Even educated families with affected members avoided interviews. People with filariasis often stay away from public gatherings like weddings, as they feel self-conscious about their swollen legs.  

Mahendra Chaurasia from Tikamgarh, who runs a tea stall near the Palera bus stand, shared his experience. He avoids visiting relatives and, when he must go, wears long socks to hide the swelling in his foot.

Understanding the disease

Filariasis, commonly known as elephantiasis, is a disfiguring and painful vector-borne disease. It's primarily caused by three parasitic worms: Wuchereria bancrofti, Brugia malayi, and Brugia timori. While these filarial worms are responsible for the infection, mosquitoes serve as the vectors that transmit the disease between humans.

The mosquito also gets infected when it bites an infected person and transmits the worm to a healthy person. Culex (found in urban and semi-urban areas), Anopheles (in rural areas) and Aedes (in the Pacific region) are their main carriers.

There are two types of filariasis. The first is lymphatic filariasis (LF) and the second is hydrocele. In the case of LF, there is swelling in the hands and feet. Whereas in the case of hydrocele, swelling occurs in the testicles.

Lymphatic filariasis is characterised by the World Health Organisation (WHO) as one of many neglected tropical diseases. The disease affects millions of people in tropical and subtropical areas. India accounts for 40% of the global human lymphatic filariasis burden, with 31 million people infected, and over 450 million at risk. Unfortunately, a paucity of data on what is happening limits how effectively it can be eradicated.

Linking climate change

An article published in Dialogue Earth draws the connection of this painful disease with the recent WHO study that indicates climate change may alter mosquito behaviour, potentially increasing the disease's spread through new vectors. 

Climate change is making filariasis more challenging by creating favourable conditions for mosquito breeding and waterlogging due to unpredictable weather. Rising temperatures and erratic rainfall contribute to the spread of disease-carrying mosquitoes. 

A study suggests that mosquito-borne diseases are re-emerging in areas where they had previously declined. However, the extent of climate change’s impact on disease transmission across different altitudes and population densities remains unclear. 

The study aims to measure how climate change will affect the duration of the transmission season and estimate the future population at risk based on varying population densities across different elevations.

Harimohan Rawat, District Malaria Officer of Tikamgarh, further explains,  

Climate change has brought summer early this year, starting in February. As temperatures rise, mosquito populations will grow, increasing the risk of malaria and filariasis. The situation worsens during heavy rainfall, further fuelling disease transmission.

Government efforts and results

In July 2024, the National Centre for Vector Borne Disease Control identified 345 endemic districts, including 12  in Madhya Pradesh. In 2020, a block-level action plan was introduced, and for 2025, 29 high-risk areas have been identified in Tikamgarh.

Filariasis intervention programs have shown some positive results, with cases in Tikamgarh declining each year. As part of these efforts, filariasis medication is distributed annually with the help of ASHA workers, Anganwadi staff, and the Health Department.

Rawat claims cases of filariasis have come down due to active monitoring of cases and identifying areas by the district malaria department. “Before 2021, there used to be more than 150 total active cases in Tikamgarh. Which are now down to around 60. In these areas, the 'Mass Drug Administration (MDA) has been successful in preventing this disease,” he adds.

According to the district health officers, if these figures are seen in the context of both types of filariasis, then the cases of hydrocele have decreased significantly. For example, under this programme, 300 night blood tests have been conducted in each area. 

Currently, The number of hydrocele patients in Tikamgarh has come down to 9 this year. The reason for this is the active operation of these patients. On the other hand, 6 new cases of LF filaria have been found in Tikamgarh. With these new cases, the total number of active cases of LF is 59.

Rawat adds that the situation in Tikamgarh due to filaria was not as bad as it appears in the data. He says that with the right mapping of cases by the department, providing medical facilities, night blood testing surveys and the hard work of the medical staff, filaria has been controlled. 

"Earlier, people used to avoid taking medicines. We persuade them in every way to take the medicine. This will prevent the spread of filaria. Also, with the help of accurate mapping and operation of hydrocele, the cases have come down, " shares Rawat.

"The department is in constant touch with every person suffering from filariasis. The most important role is that of ASHA. They are more familiar and reliable to people, which makes treatment easier, "says Dr. Anish Khan, malaria inspector, Palera block, Tikamgarh district.

ASHA teams are providing medical assistance to affected villagers. Bhuvan Vanskar, an ASHA worker, has been distributing filariasis medicine since February 10, 2025.  

Mor Pahadi village, with a population of around 900, has 135 children receiving medication under Bhuvan’s supervision.  

The Jan Abhiyan Council, under Madhya Pradesh’s Department of Planning and Economic Statistics, supports filariasis programs at the block level. 

Rajkumar Jain, coordinator for Jatara and Palera blocks, says, "We work with ASHA and the health department to distribute medicines and conduct testing. Our block now has only three new cases; the rest are old."

If seen from the point of view of statistics, success is seen in the efforts made to eradicate the disease at the block level. Apart from this, under the National Health Mission, funds are being given to the panchayats and municipal bodies to continue the cleaning work. 

In addition, the risk of infection is reduced by taking medications. The World Health Organization (WHO) runs the Global Programme to Eliminate Lymphatic Filariasis (GALF).

A target has been set to eliminate neglected tropical diseases (NTD) by 2030. The Government of India had set a target of 2020 for elimination of lymphatic filariasis, which has now been increased to 2030. However, there are only 5 years left in 2030, and there are still 345 districts in India where filariasis is endemic.

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