Abstract
Lymphatic filariasis (LF) is one of the most debilitating parasitic diseases worldwide, casting a shadow of socio-economic stigma over the affected underprivileged communities. The present study is a maiden investigation depicting LF prevalence in the previously unexplored remote eastern coalfield districts of West Bengal state, India during and after COVID-19 pandemic. A community-based cross-sectional survey (August 2021–March 2024) was conducted in four LF-endemic districts of West Bengal. Symptomatic cases were graded clinically, and asymptomatic infections confirmed by filaria-specific IgG/IgM and nocturnal microfilariae (mf) detection. Comorbidities were systematically recorded. Of 3705 individuals (50.7% females and 49.3% males) screened, the overall LF prevalence was 16.65% (95% CI:15.45% -17.85%, 617 individuals). Asymptomatic mf + ICT-positive cases accounted for 10.63% (95% CI, 9.64–11.62; n = 394), while 6.02% (95% CI, 5.30–6.82; n = 223) were symptomatic. Among the symptomatic cases, 144 had circulating mf, filaria-specific IgG/IgM (ICT positive) and clinical symptoms of lymphedema, most commonly Grade II (34.79%) and Grade III (43.48%). Chronic mf-negative lymphedema was observed in 2.13% (n = 79). Active LF prevalence, defined by mf and ICT positivity, was 14.52% (95% CI, 13.4–15.7; n = 538). Acute dermato-lymphangio-adenitis (ADLA) among the clinical categories was ranged between 8.71% and 39.79%. LF prevalence was higher in the rural areas, while hypertension, diabetes, and fungal infections as major comorbidities. The eastern coalfield region of West Bengal state presents heightened prevalence of severe chronic lymphedema and a marginal prevalence of new LF cases possibly due to interruption of mass drug administration in this neglected remote areas and poor morbidity management during COVID-19.
Data availability
The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
References
Weekly Epidemiological Record, 98, 41. (2023). https://iris.who.int/handle/10665/373356 (accessed June 14, 2025).
Global programme to eliminate lymphatic filariasis: progress report, 2021- Programme mondial pour l’ elimination de la filariose lymphatique: rapport de situation. (2021). https://appls.who.int/iris/handle/10665/363515 (accessed June 14, 2025).
Rajamanickam, A. & Babu, S. Unraveling the Dynamics of Human Filarial Infections: Immunological Responses, Host Manifestations, and Pathogen Biology. Pathogens 14, 223 (2025).
Bizhani, N., Hashemi Hafshejani, S., Mohammadi, N., Rezaei, M. & Rokni, M. B. Lymphatic filariasis in Asia: A systematic review and meta-analysis. Parasitol. Res. 120, 411–422 (2021).
WHO. Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030, 28. January, (2021). https://www.who.int/publications/i/item/9789240010352 (accessed June 08, 2025).
WHO. COVID-19: WHO issues interim guidance for implementation of NTD programmes. World Health Organization. (2020). https://www.who.int/neglected_diseases/news/COVID19-WHO-interim-guidance-implementation-NTD-programmes/en (accessed May 15, 2024).
WHO. Considerations for implementing mass treatment, active case-finding and population-based surveys for neglected tropical diseases in the context of the COVID-19 pandemic: interim guidance, 27 July 2020. accessed May 15, (2024). https://www.who.int/publications/i/item/WHO-2019-nCoV-neglected-tropical-diseases-2020-1
Prada, J. M. et al. Delays in lymphatic filariasis elimination programmes due to COVID-19, and possible mitigation strategies. Trans. R. Soc. Trop. Med. Hyg. 115, 261–268 (2021).
Lymphatic Filariasis (LF). is still endemic in certain areas of Purulia, Bankura, Paschim Bardhaman, Birbhum, Murshidabad, Uttar Dinajpur, Jalpaiguri & Alipurduar. West Bengal goes for Mass Drug Administration #MDA of anti-filarial drugs in these areas from 10 February #WBHealth. accessed June 08, (2025). https://x.com/wbdhfw/status/1756270970988630487?lang=en
Mass drug administration drive for Lymphatic Filariasis underway in West Bengal. accessed June 08, (2025). https://timesofindia.indiatimes.com/city/kolkata/mass-drug-administration-drive-for-lymphatic-filariasis-under-way-in-west-bengal/articleshow/97982971.cms
Ministry of Health & Family Welfare launches nationwide Sarva Dawa Sevan or Mass Drug. Administration (MDA) campaign to Eliminate Lymphatic Filariasis (LF). accessed June 08, (2025). https://www.pib.gov.in/PressReleaseIframePage.aspx?PRID=1898092
Ministry of Health and Family Welfare. Guidelines on Elimination of Lymphatic Filariasis. New Delhi: Directorate of National Vector Borne Disease Control Programme. (2009). https://ncvbdc.mohfw.gov.in/WriteReadData/l892s/43461824631532409675.pdf (accessed June 08, 2025).
Saha, I. et al. Prevalence of lymphatic filariasis based on morbidity and healthcare-seeking practices of patients in a Gram Panchayat of Paschim Burdwan District, West Bengal. Indian J. Community Med. 50(1), 193–196 (2025).
Mandal, B., Bhattacharjee, I., Mondal, D., Kundu, J. K. & Chandra, G. Bancroftian filariasis in four slums of Bankura, West Bengal, India. Asian Pac. J. Trop. Dis. 6 (9), 699–708 (2016).
Paramanik, M., Sarkar, N. & Chandra, G. Impact of lymphatic filariasis on married women from rural areas of Bankura District, West Bengal, India. J. Commun. Dis. 53 (1), 23–26 (2021).
Gayen, P. et al. A double-blind controlled field trial of doxycycline and albendazole in combination for the treatment of bancroftian filariasis in India. Acta Trop. 125(2), 150–156 (2013).
Daniel, W. W. & Cross, C. L. Biostatistics: a foundation for analysis in the health sciences (Wiley, 2018).
Lwanga, S. K. & Lemeshow, S. Sample size determination in health studies Vol. 1 (World Health Organization, 1991).
Surtani, S. et al. Platelet functions in lymphatic filariasis patients. Microvasc. Res. 152, 104642 (2024).
Lammie, P. J. et al. Recombinant antigen-based antibody assays for the diagnosis and surveillance of lymphatic filariasis - A multicenter trial. Filaria J. 3(1), 9 (2004).
Pantelias, A., King, J. D., Lammie, P. & Weil, G. J. Development and introduction of the filariasis test strip: A new diagnostic test for the Global Program to Eliminate Lymphatic Filariasis. Am. J. Trop. Med. Hyg. 106(5 Suppl), 56–60 (2022).
Mwesigye, V. et al. Detection of filarial IgG and IgM antibodies among individuals with lymphedema in the Kamwenge District, Western Uganda. Cureus 17(7), e87532 (2025).
Rajamanickam, A. & Babu, S. Unraveling the dynamics of human filarial infections: Immunological responses, host manifestations, and pathogen biology. Pathogens 14(3), 223 (2025).
Ata, A. H. et al. Antifilarial IgM versus IgG antibody determination in the diagnosis of Wuchereria bancrofti infection in Egyptians. J. Egypt. Soc. Parasitol. 23 (1), 277–288 (1993).
Mohanty, M. C., Satapathy, A. K., Sahoo, P. K. & Ravindran, B. Human bancroftian filariasis – A role for antibodies to parasite carbohydrates. Clin. Exp. Immunol. 124(1), 54–61 (2001).
WHO. Basic laboratory methods in medical parasitology. accessed June 12, (2024). https://iris.who.int/handle/10665/40793
Shenoy, R. K. Clinical and pathological aspects of filarial lymphedema and its management. Korean J. Parasitol. 46 (3), 119–125 (2008).
Madhu, S. V., Nitin, K., Sambit, D., Nishant, R. & Sanjay, K. ESI clinical practice guidelines for the evaluation and management of obesity in India. Indian J. Endocrinol. Metab. 26(4), 295–318 (2022).
Shah SN et al. Indian guidelines on hypertension-IV (2019). J. Hum. Hypertens. 34 (11), 745–758 (2020).
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 36(Suppl 1), S67–S74 (2013).
Vandenbroucke, J. P. et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann. Intern. Med. 147 (8), 163–194 (2007).
World Medical Association. World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA 310(20), 2191–2194 (2013).
Singh, R. K., Chaturvedi, A. & Kumari, K. Water-quality assessment of Damodar River and its tributaries and subtributaries in Dhanbad Coal mining areas of India based on WQI. Sustain. Water Resour. Manag. 5, 381–386 (2019).
Wynd, S., Melrose, W. D., Durrheim, D. N., Carron, J. & Gyapong, M. Understanding the community impact of lymphatic filariasis: A review of the sociocultural literature. Bull. World Health Organ. 85(6), 493–496 (2007).
de Aquino, L. T. et al. The impact of the COVID-19 pandemic on people with lymphedema in an endemic area for lymphatic filariasis in Brazil. Int. J. Public Health 68, 1605317 (2023).
Valle, D., Zaitchik, B., Feingold, B., Spangler, K. & Pan, W. Abundance of water bodies is critical to guide mosquito larval control interventions and predict risk of mosquito-borne diseases. Parasit. Vectors 6, 179 (2013).
Crocker, W., Maute, K., Webb, C. & French, K. Mosquito assemblages associated with urban water bodies, implications for pest and public health threats. Landsc. Urban Plan. 162, 115–125 (2017).
Singh, R. P., De Britto, L. & Vijayalakshmi, G. A study on “clinical epidemiology of filarial lymphedema patients attending filariasis clinic in Pondicherry”. Clin. Epidemiol. Glob. Health 8, 915–919 (2020).
Chakraborty, S., Gurusamy, M., Zawieja, D. C. & Muthuchamy, M. Lymphatic filariasis: Perspectives on lymphatic remodeling and contractile dysfunction in filarial disease pathogenesis. Microcirculation 20(5), 349–364 (2013).
Vyas, S., Sharma, N., Archisman, Roy, P. & Kumar, R. Repercussions of lockdown on primary health care in India during COVID-19. J. Family Med. Prim. Care. 10 (7), 2436–2443 (2021).
National Health Mission. West Bengal State Report. accessed June 12, (2024). https://www.nhm.gov.in/images/pdf/nrhm-in-state/state-wise-information/wb/wb_report.pdf
WHO. Lymphatic filariasis: managing morbidity and preventing disability: an aide-mémoire for national programme managers. https://iris.who.int/bitstream/handle/10665/339931/9789240017061-eng.pdf
Sibi, J. M., Mohan, V., Deepa, M., Babu, S. & Aravindhan, V. Modulatory effect of filarial infection on the systemic hormone levels in subjects with metabolic syndrome (DM-LF5). Front Endocrinol (Lausanne) 13, 1011942 (2022).
Tenhagen, M., Lodewijk, L., Cense, H. A. & Busch, O. R. Clinical appearance and management of massive, localized lymphedema in morbidly obese patients: Report of 2 cases. Updates. Surg. 66(1), 81–83 (2014).
Aravindhan, V. et al. Decreased prevalence of lymphatic filariasis among diabetic subjects associated with a diminished pro-inflammatory cytokine response (CURES 83). PLoS Negl. Trop. Dis. 4 (6), e707 (2010).
Hübner, M. P., Stocker, J. T. & Mitre, E. Inhibition of type 1 diabetes in filaria-infected non-obese diabetic mice is associated with a T helper type 2 shift and induction of FoxP3 + regulatory T cells. Immunology 127(4), 512–522 (2009).
Mukherjee, S., Kundu, R. & Vidaković, M. Metaflammation in obesity and diabetes. Front. Endocrinol. 15, 1540999 (2025).
Sinha, A., Mohapatra, S., Mohanty, S., Pati, S. & Sahoo, P. K. Mass drug administration for lymphatic filariasis elimination amidst COVID-19 pandemic in Odisha, India: A step towards achieving SDG-3. Trop. Doct. 52(4), 556–559 (2022).
Mohanty, S. et al. Mass drug administration to eliminate lymphatic filariasis: A population-based coverage and compliance study in Eastern India. Clin. Epidemiol. Glob. Health. 30, 101860 (2024).
India steps up campaign to eliminate lymphatic filariasis by. (2027). https://www.pib.gov.in/PressReleaseIframePage.aspx?PRID=2101250 (accessed June 12, 2025).
WHO. Stopping transmission and providing care services to end lymphatic filariasis in West Bengal. accessed June 12, (2025). https://www.who.int/india/news-room/feature-stories/detail/west-bengal-stopping-transmission-and-providing-care-services-to-end-lymphatic-filariasis
Acknowledgements
We thank the Department of Biotechnology (DBT)(BT/PR50228/MED/29/1651/2023) (SM and JB), Department of Science and Technology-Science & Engineering Research Board (DST-SERB) (Ref no.- CRG/2021/002605) (SM and JB), West Bengal DSTBT (WBDSTBT) (1116(Sanc.)/STBT-11012(12)/7/2024-WBSCST SEC) (SM) and University Grants Commission (UGC) (Ref no. F.2-12/2019(STRIDE-1) (SM) for supporting his research activities and laboratory through awarding research grants. PC thanks DST, Govt. of India for the award of the DST-INSPIRE fellowship (IF190998). The technical help by Mr. Bikash Mondal, phlebotomist, (Puruliya), and former associates of IBIL Dr. Nabarun Chandra Das, Dr. Ritwik Patra, Mr. Chiranjib Guin, and Mr. Shubham Ghosh (Project Assistants) are duly acknowledged for their assistance in the sampling studies. We also acknowledge Biorender.com, SRPlot, GraphPad Prism (version 8.00), Origin (Learning Edition 2025), and Q-GIS Platform (version 3.18) for illustrations and graphical representations.
Funding
The research embodied in the manuscript is funded by Department of Biotechnology (DBT) (BT/PR50228/MED/29/1651/2023), DST-Science & Engineering Research Board (SERB), (Ref no.- CRG/2021/002605) University Grants Commission (UGC) (Ref no. F.2–12/2019(STRIDE-1), Govt. of India and West Bengal DSTBT (WBDSTBT) (1116(Sanc.)/STBT-11012(12)/7/2024-WBSCST SEC), Govt. of West Bengal. Funders had no role in manuscript preparation and decision of publication.
Author information
Authors and Affiliations
Contributions
PC, BKM, SD, and SM have curated the data. The investigation, methodology was conducted by PC and SM. Formal analysis was done by PC, AS, JB and SM. PC, JB and SM visualised and validated the data. Project administration, funding acquisition, resources, supervision was done by JB and SM. All the supervision was done by SM. The writing – original draft, and writing– review & editing was done by PC, JB and SM.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Chakraborty, P., Sadhu, A., Modak, B.K. et al. High prevalence of bancroftian filariasis and comorbidities in the eastern coalfield regions of West Bengal, India following COVID-19 disruption. Sci Rep (2026). https://doi.org/10.1038/s41598-026-43973-z
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-43973-z