SummaryThis paper reports on DEC distribution and compliance with treatment in a large-scale annual single-dose mass treatment programme to eliminate lymphatic filariasis in the south Indian state of Tamil Nadu. 76.9% of households (82.5% in rural areas and 58.0% in urban areas) were aware of drug distribution for control of filariasis. DEC was given to 70% (= distribution rate) (range 0-92%) of the population and 53.5% (range 12-89%) complied with treatment. The distribution rate was more than 75% in 74% of the villages and compliance was in the range of 51-75% in 76% of the villages. About 5% of the treated population reported side-effects. Distribution and compliance were higher in rural than urban areas and similar between males and females. Qualitative data showed that some socio-economic factors, logistic and drug-related problems and people's poor knowledge and perceived benefits of treatment played a role in a proportion of the population not receiving or taking the drug. The Tamil Nadu programme showed that large-scale repeated annual DEC mass treatment is feasible and that existing health services are capable of delivering the drug to all communities. While even poor to moderate compliance rates can reduce the vector transmission of infection to some extent, improved drug distribution and compliance with treatment are necessary to consolidate the gains of earlier rounds of treatment and achieve the goal of filariasis elimination within a reasonable time frame.

Purpose Sustainable development has now been recognised as the pivot around which development activities should revolve. Banking is an important component in the same and adoption of sustainable banking practices by various banking institutions is a strong driver to achieve sustainable development. The purpose of this paper is to study the level of adoption of sustainable banking tools and the extent to which banking institutions practice the same in India. In addition, the banking institutions have been ranked and categorised on basis of their sustainable banking performance. Design/methodology/approach The proposed framework focuses on the environmental and social conduct of the banks, who address the issues of sustainability in Indian banking sector. As there is a difference in the economic standards of developed and developing countries, the review of literature helps to figure out the gap in specific frameworks for assessing sustainable banking practices in developing countries. Previous researchers have made an attempt to develop a general framework for assessing the sustainable banking efforts of the banking sector. These studies fall short of indicators on the social dimension of sustainability specifically in the context of less developed countries like India, the social dimensions are is equally a major thrust area along with environmental indicators. Content analysis technique has been used to evaluate sustainable banking performance of the banks and Mann–Whitney U test used to determine the differences in sustainable banking performance of the banks in India. Findings In Indian banking sector, the adoption of the international sustainability code of conduct is still in its nascent stage. The research indicates that sustainability issues which are of the highest priority for the banks are directly related to their business operations such as financial inclusion, financial literacy and energy efficiency, and banks are more focussed on addressing social dimension of sustainability in banking rather than important dimensions of sustainable banking, namely, environmental management, development of green products and services and sustainability reporting. Practical implications The application of the proposed framework reflects the status quo of sustainable banking in India. This study is useful for the banks and all the stakeholders in understanding more about the shortcomings in integrating sustainability issues in banking. Further, the present study also redresses the extant research dearth in the field of sustainable banking in the Indian context. Originality/value This is one of the first studies evaluating the sustainable banking performance of the Indian banking sector.

SummaryThis study examined the direct and indirect costs due to acute form of lymphatic filariasis caused by Wuchereria bancrofti to the households in rural communities in Tamil Nadu state in south India. For nearly one-third of the acute adenolymphangitis (ADL) episodes the affected did not seek treatment and for 27% of the episodes they consulted health personnel, underwent treatment and paid for it. On average, the ADL patients spent Rupees (Rs.) 2.35 (US $ 0.07) per episode on treatment, but expenditure was as high as Rs. 32.11 (US $ 0.92) among those who paid. Doctor's fees and medicines constituted 83% of the total treatment costs. Patients with multiple and longer duration episodes and with better living conditions spent relatively more on treatment. The proportion of patients who spent money on treatment was smaller in poorer households, but their treatment costs formed a relatively higher proportion of their income than those of middle and high-income households. The ADL episodes curtailed economic and domestic activities. In 87% of the episodes, the affected were not able to attend any economic activity compared to 37% of the episodes in the case of controls. Patients spent only 0.68 ± 1.91 hours on economic activity compared to 4.40 ± 3.74 hours by the control individuals during the ADL episodes. The sign rank test showed that the mean difference of 3.73 ± 3.81 and 2.14 ± 1.83 hours in the time spent on economic and domestic activity respectively between cases and controls was highly significant (P < 0.01). Regression analysis demonstrated that the difference in the time spent on activities is only due to ADL and no socio-economic variable had any effect on it. The cost of treatment and loss in economic activities combined with high incidence in the study communities indicate the extent of the economic burden imposed by the hitherto neglected acute form of lymphatic filariasis and the necessity to control it.keywords Lymphatic filariasis, economic burden, rural areas, India correspondence K.D. Ramaiah, Vector

In the mass drug administrations (MDA) that form the principal strategy of the Global Programme to Eliminate Lymphatic Filariasis, treatment coverages of at least 65%-80% will be needed if the programme is to be successful. In the Indian state of Tamil Nadu, where treatment coverages were typically <65%, a comprehensive strategy of advocacy and communication, called the "communication for behavioural impact" (COMBI) campaign, has been developed and implemented, in an attempt to improve treatment coverage. This strategy combined advocacy, aimed at state-, district- and village-level administrations, with communication activities targeted at individual communities. The main aim was to alter the behaviour of many of those included in the rounds of MDA, so that they would be more likely to accept and consume the diethylcarbamazine tablets offered to them. The COMBI campaign had two variants, COMBI(+) and the more intensive COMBI(+ +), each of which has been implemented in six districts. Both the variants included the "personal selling" of treatment, via door-to-door visiting by a total of 113,500 filaria-prevention assistants. These assistants were able to visit 34%-49% of the households in each target community. In the COMBI(+ +) districts, up to 44% and 38% of households received information on lymphatic filariasis and its elimination via television commercials and posters, respectively. Overall, 78% of the villages in the COMBI(+ +) districts and 33% of those in the COMBI(+) districts were considered to have had good exposure to the communication campaign. At the end of this campaign about 30% more people (than pre-campaign) believed that lymphatic filariasis could be eliminated and many of those targeted considered lymphatic filariasis to be a dreadful disease, knew that a particular day had been designated "Filaria Day", and thought that the tablets offered in MDA should be consumed to prevent or eliminate the disease. Apparently as the result of the COMBI campaign, drug consumption increased, from 33% of those living in endemic communities, to 37% in the COMBI(+) districts and to 49% in the COMBI(+ +). Coverages as high as 65%-73% were recorded among those who had had the maximum exposure to the communication campaign. These results indicate that the COMBI campaign favourably changed the perception and behaviour of the people towards the elimination of lymphatic filariasis. The costs of the COMBI(+) and COMBI(+ +) strategies were only U.S.$0.002 and U.S.$0.009 per capita, respectively.

This year-long study investigated the epidemiology of acute filarial episodes due to Wuchereria bancrofti in 2 rural villages in south India. The annual incidence of 96.5 episodes/1000 population was significantly higher in males (108.5) than females (84.1) an strongly age dependent. First occurrence of acute disease was observed in 0.86% of the population, and the average duration of each episode was 3.6 +/- 2.0 d. Although more than half (63.5%) of the affected individuals suffered only 1 episode, a few experienced as many as 8 over the one-year period. Individuals with chronic disease were more prone to acute attacks, with 82.9% of the total episodes occurring in this group. No seasonal pattern was observed in the frequency of episodes. Probit analysis showed that the number of episodes per affected person was dependent on sex and chronic condition. Swelling of lymph nodes in the inguinal region and fever were the most common symptoms of acute disease. The high incidence and resulting debility observed in this study suggest that acute episodes are a significant health problem associated with lymphatic filariasis. There is clearly a need for more studies on this acute form of filarial disease to aid the understanding of the aetiology and epidemiology of acute episodes, in planning appropriate control interventions, and in evaluating the resulting health burden.

SummaryT h e functional impairment caused by lymphatic filariasis was assessed through qualitative and quantitative methods in rural areas of Tamil Nadu, South India. About 66% of the patients said that their occupational activities were hampered by the disease. They either work fewer hours or alter their activity. Some had completely given up their job. Domestic chores of most of the female patients were also impeded. Most of those affected try to avoid travel. T h e disability was worse In patients with acute disease. In view of the results of our and other similar studies, the disabilityadjusted life years lost due to lymphatic filariasis must be revised and the public health importance of the disease reassessed. Considerable functional impairment coupled with recent information on economic burden and productivity loss caused by lymphatic filariasis necessitates paying more attention to the control of the disease.

SummaryLymphatic ®lariasis (LF) is targeted for global elimination. Repeated annual single-dose mass treatment with anti®larials has been recommended as the principal strategy to achieve LF elimination. This requires an effective and sustainable strategy to deliver the drug, diethylcarbamazine (DEC), to communities. In this study, a new drug delivery strategy ± community-directed treatment (comDT) ± was developed and implemented and its effectiveness compared with that of the traditional health servicesorganized drug delivery, in rural areas of Tamil Nadu, India. Qualitative and quantitative data showed that the communities and health services were able to distribute the drug in almost all villages. The drug distribution rate and treatment compliance rate of comDT and health services treatment were statistically compared after adjusting them for clustering. Under the comDT 68% (n 20 villages; range: 0±97%) of the population received DEC, compared with 74% (n 20 villages; range: 48±95%) with the health services treatment strategy (P > 0.05). However, only about 53% (range: 0±91%) of comDT recipients and 59% (range: 32±79%) of those who received DEC from the health services consumed the drug (P > 0.05). Although statistically not signi®cant, the distribution and compliance rates were lower under the comDT strategy. Also, the strategy's operationalization appears to be dif®cult because of some social factors, and the tradition of communities' dependence on health services for treatment, whereas health services-organized distribution was much less cumbersome and found to be more acceptable to people. However, the distribution (74%) and compliance rates (59%) achieved by health services were also only moderate and may not be adequate to eliminate LF in a reasonable time frame. Health services manpower alone may not be suf®cient to distribute the drug. We conclude that drug distribution by health services is the best option for India and participation of the community volunteers and village level government staffs in the programme is necessary to effectively distribute the drug and attain the desirable levels of treatment compliance to eliminate LF.keywords lymphatic ®lariasis, drug delivery, elimination, rural areas, India correspondence K. D. Ramaiah, Vector

Sustainability reporting is at the core of designing corporate sustainability environment. The study has been conducted on Indian banking sector to examine the extent of sustainability reporting by the banks operating in India. Sustainability report, corporate social responsibility report, business responsibility report and annual report (FY 2015-16 & 2016-17) of the banks were analysed and coded using content analysis technique against sustainability indicators derived from review of literature, GRI G4 guidelines, and National Voluntary Guidelines on responsible business conduct. This is one of the first studies to examine the extent of sustainability reporting by the commercial banks in India in line with major sustainability-related standards & guidelines. The result of the study shows that the banks in India are much slower in adopting sustainability reporting practices. It was found that sustainability issues which are of the highest priorities for the banks are directly related to their business operations like financial inclusion, financial literacy, energy efficient technology etc. The environmental consideration indicators are relatively unaddressed by most of the banks in India. The results of the study also show that there is a significant difference in the disclosure of environmental and internal socio-environmental indicators between public and private sector banks in India. This study is expected to contribute to banking sector and all the stakeholders in understanding more about the limitations in implementing sustainable reporting in India.