Background In Nepal, out of 75, 61 districts were endemic with lymphatic filariasis (LF) and completed 6 to 11 rounds of mass drug administration (MDA) with diethylcarbamazine (DEC) and albendazole from 2007 to 2017 in almost all endemic districts of Central Nepal with the aim of eliminating lymphatic filariasis by 2020 but due to fail in transmission assessment Survey (TAS) in some Terai districts of Nepal, aim of elimination was extended to 2030. Antigenemia prevalence have been consistently <2% in all sentinel and check spot sites since 2017 and transmission assessment survey passed in 2018 but in some foci there was low level persistent of infection of W. bancrofti was seen in 4 endemic districts of central Nepal so present study has been carried out with the aim of assessing antigenic prevalence in children borne after MDA program to understand evidence of new infection of LF in selected districts Methodology and principal findings Antigenemia survey was carried out in communities children whose borne after MDA program from selected districts of central Nepal. Two study districts had significantly improved infection to the prior study but two other districts had drastic change. Few hydrocele cases were found but no any children found antigen positive with hydrocele cases. Conclusions These results indicates that W. bancrofti transmission was near to break point in one hilly district (Lalitpur) and one Terai district (Bara) while other two districts from Terai (Mahottari) and hills (Dhading) may requires further intervention. Targeted testing and treatment along with comparative study of children with adult should be required similarly number of MDA rounds should be increased.

The authors have declared no competing interest.

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The study received the financial support from University Grants Commission (UGC) of Nepal (Award no. PhD/74-75/S&T-17). The funding bodies had no role in the design, data collection, analysis and interpretation of data and in writing the manuscript

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Field surveys were conducted as per the study protocols approved by the Nepal Health Research Council (NHRC/Reg.no. 629/2018). Informed consent was obtained from all the individuals screened for antigenemia. Information on the objective of the study and the expected benefits to the individual, and the community were provided.

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