Abstract

This is a case report about a woman in her 50s who presented with pitting oedema in her left lower limb due to chronic filariasis. This case highlights a myriad of interdependent sociocultural factors that contribute to the persistence of filariasis despite good mass drug administration coverage. These factors include a lack of appropriate local self-governance, low health awareness, distrust in public healthcare services and cultural acceptance of cow dung as a holy or hygienic substance. Prohibitive costs and limited options for cleaner domestic fuels, coupled with the practice of using cow dung cakes as fuel, not only increase the chances of indoor air pollution but also positively influence mosquito breeding through accumulated indoor and outside dirty, stagnant water. An understanding of the complex community-specific sociocultural factors associated with filariasis should inform broader policies for filariasis elimination in India and other low- and middle-income countries.