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Medeiros ZM, Vieira AVB, Xavier AT, Bezerra GSN, Lopes MDFC, Bonfim CV, Aguiar-Santos AM. Lymphatic Filariasis: A Systematic Review on Morbidity and Its Repercussions in Countries in the Americas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:316. [PMID: 35010576 PMCID: PMC8751179 DOI: 10.3390/ijerph19010316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
The Global Program to Eliminate Lymphatic Filariasis (GPELF) is a program that aims to eliminate lymphatic filariasis by 2030. The GPELF strategy is based on interrupting transmission using mass drug administration (MDA) and, in parallel, managing morbidity cases. However, it has been seen that there is a shortage of research in the literature and public policies regarding this last pillar. In this study, we reviewed the literature and available information regarding the burden of filarial morbidity. In addition, we identified that in the Americas, the implementation of structured services with regard to morbidity assistance in the Americas was scarce. We formed a review that aimed to assess the pathogenesis, epidemiology, repercussions, and treatment of filarial morbidity in countries in the Americas where lymphatic filariasis is endemic. Structured searches were carried out on PubMed, LILACS, Scopus, and Web of Science databases without time and language restrictions. Three reviewers evaluated the 2150 studies and performed data extraction, and quality assessment by assigning scores to the studies found. The current literature and available information on the burden of filarial morbidity, as well as the implementation of structured services with regard to morbidity assistance in the Americas, were all found to be scarce. Now that this knowledge gap has been identified, both health services and researchers need to seek the implementation and enhancement of the maintenance of GPELF strategies that relate to the morbidity pillar.
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Affiliation(s)
- Zulma M. Medeiros
- Fundação Oswaldo Cruz, Departamento de Parasitologia, Instituto Aggeu Magalhães, Recife 50670-420, Brazil; (Z.M.M.); (A.T.X.); (A.M.A.-S.)
- Programa de Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife 50100-130, Brazil
| | - Amanda V. B. Vieira
- Fundação Oswaldo Cruz, Departamento de Parasitologia, Instituto Aggeu Magalhães, Recife 50670-420, Brazil; (Z.M.M.); (A.T.X.); (A.M.A.-S.)
| | - Amanda T. Xavier
- Fundação Oswaldo Cruz, Departamento de Parasitologia, Instituto Aggeu Magalhães, Recife 50670-420, Brazil; (Z.M.M.); (A.T.X.); (A.M.A.-S.)
- Programa de Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife 50100-130, Brazil
| | - Gilberto S. N. Bezerra
- Materials Research Institute, Technological University of the Shannon: Midlands Midwest, N37 HD68 Athlone, Ireland;
| | | | - Cristine V. Bonfim
- Ministério da Educação, Fundação Joaquim Nabuco, Diretoria de Pesquisas Sociais, Recife 52061-540, Brazil;
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Pernambuco, Recife 50670-901, Brazil
| | - Ana M. Aguiar-Santos
- Fundação Oswaldo Cruz, Departamento de Parasitologia, Instituto Aggeu Magalhães, Recife 50670-420, Brazil; (Z.M.M.); (A.T.X.); (A.M.A.-S.)
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Xavier A, Oliveira H, Aguiar-Santos A, Barbosa Júnior W, da Silva E, Braga C, Bonfim C, Medeiros Z. Assessment of transmission in areas of uncertain endemicity for lymphatic filariasis in Brazil. PLoS Negl Trop Dis 2019; 13:e0007836. [PMID: 31765388 PMCID: PMC6917295 DOI: 10.1371/journal.pntd.0007836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 12/17/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been subjected to mass drug administration (MDA) and in places adjoining these endemic areas. While three municipalities in Brazil have completed MDA, the epidemiological situation remains uncertain in nine adjoining municipalities. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil. METHODOLOGY/PRINCIPLE FINDINGS For review of the literature, both formal and informal literature sources were accessed since the first reports of filariasis in the Metropolitan Region of Recife, Brazil. We conducted a school-based survey in 2016 using immunochromatographic card tests (ICTs) among schoolchildren aged 6-10 years living in nine municipalities contiguous with the endemic areas in which MDA was conducted. Our review of the literature identified eight studies involving surveys demonstrating that microfilariae had been circulating in eight of the municipalities since 1967, with a low prevalence of microfilaremia, isolated autochthonous cases, and treatment of individual cases. The school-based survey included 17,222 children in 185 urban schools in the nine areas of Brazil with uncertain endemicity. One child affected by allochthonous transmission was antigen positive based on ICT and lived in a municipality adjacent to Recife; this child's family came from Recife, but no other case was diagnosed within the family. CONCLUSIONS/SIGNIFICANCE The study results suggest that there is no transmission of LF in the municipalities investigated. However, these areas have population migration and socioenvironmental conditions favorable to mosquito breeding grounds; therefore, surveillance is strongly recommended in these areas.
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Affiliation(s)
- Amanda Xavier
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- * E-mail:
| | - Heloize Oliveira
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- Agência Pernambucana de Vigilância Sanitária, Secretaria de Saúde do Estado de Pernambuco, Recife, Brazil
| | - Ana Aguiar-Santos
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Walter Barbosa Júnior
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Ellyda da Silva
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Cynthia Braga
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Cristine Bonfim
- Diretoria de Pesquisas Sociais, Fundação Joaquim Nabuco, Ministério da Educação, Recife, Brazil
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Pernambuco, Recife, Brazil
| | - Zulma Medeiros
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
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Silva E, Xavier A, Silva E, Barbosa Júnior W, Rocha A, Freitas V, Oliveira P, Aguiar-Santos AM, Bonfim C, Medeiros Z. Evaluation of lymphatic filariasis in endemic area of Brazil where mass drug administration is not required. Pathog Glob Health 2019; 113:143-148. [PMID: 31138026 DOI: 10.1080/20477724.2019.1623546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Mass drug administration (MDA) is the main counter-transmission strategy of the Global Programme to Eliminate Lymphatic Filariasis. In endemic countries, there are areas where MDA is not required. However, there is no standard approach in these areas, and studies are important to evaluate the epidemiological status. This study aimed to investigate lymphatic filariasis and strategies developed for its control in an area where MDA is not required. Together with the 2018 morbidity evaluation, a survey was conducted using point-of-care immunochromatographic test-AD12 tests for diagnostic screening in an area where MDA is not required. The methodology also included desk research based on Health Department reports of the control activities for lymphatic filariasis during 2003-2016. Among the 934 cases investigated in 2018, there was a 0.64% prevalence of circulating filarial antigen positive, comprising five adults and one 2-year-old child. Six patients aged 39-63 years had filarial disease. Fourteen surveys have already been conducted as control activities, and since 2009, there have been no positive cases. This study showed that the prevalence of antigenemia decreased from 2.97% in 2003 to 0.64% in 2018. Moreover, the transmission of filariasis infection was under control in this area. Our study provides insights into the surveillance phase by identifying areas of low transmission and where MDA is not required. Although we have not identified cases of filarial infection, there is a need to provide services that will provide assist those already affected with morbidity and help reduce and prevent disability.
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Affiliation(s)
- Ellyda Silva
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Amanda Xavier
- b Programa de Pós-graduação em Ciências da Saúde , Universidade de Pernambuco (UPE) , Recife , Pernambuco , Brasil
| | - Elis Silva
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Walter Barbosa Júnior
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Abraham Rocha
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil.,d Secretaria de Saúde do Estado de Pernambuco , Laboratório do Hospital Otávio de Freitas , Recife , Pernambuco , Brazil
| | - Vania Freitas
- e Secretária Municipal de Saúde de Jaboatão dos Guararapes , Diretoria de Vigilância em Saúde , Jaboatão dos Guararapes , Pernambuco , Brazil
| | - Paula Oliveira
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Ana Maria Aguiar-Santos
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Cristine Bonfim
- f Diretoria de Pesquisas Sociais, Núcleo de Estudos em Estatísticas Sociais , Fundação Joaquim Nabuco (FUNDAJ) , Recife , Pernambuco , Brasil.,g Programa de Pós-graduação em Saúde Coletiva , Universidade Federal de Pernambuco (UFPE) , Recife , Pernambuco , Brasil
| | - Zulma Medeiros
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil.,b Programa de Pós-graduação em Ciências da Saúde , Universidade de Pernambuco (UPE) , Recife , Pernambuco , Brasil.,c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
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Souza WVD, Albuquerque MDFPMD, Vazquez E, Bezerra LCA, Mendes ADCG, Lyra TM, Araujo TVBD, Oliveira ALSD, Braga MC, Ximenes RADA, Miranda-Filho DDB, Cabral Silva APDS, Rodrigues L, Martelli CMT. Microcephaly epidemic related to the Zika virus and living conditions in Recife, Northeast Brazil. BMC Public Health 2018; 18:130. [PMID: 29329574 PMCID: PMC5767029 DOI: 10.1186/s12889-018-5039-z] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 01/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Starting in August 2015, there was an increase in the number of cases of neonatal microcephaly in Northeast Brazil. These findings were identified as being an epidemic of microcephaly related to Zika virus (ZIKV) infection. The present study aims to analyse the spatial distribution of microcephaly cases in Recife (2015–2016), which is in Northeast Brazil, and its association with the living conditions in this city. Methods This was an ecological study that used data from reported cases of microcephaly from the State Health Department of Pernambuco (August 2015 to July 2016). The basic spatial unit of analysis was the 94 districts of Recife. The case definition of microcephaly was: neonates with a head circumference of less than the cut-off point of −2 standard deviations below the mean value from the established Fenton growth curve. As an indicator of the living conditions of the 94 districts, the percentage of heads of households with an income of less than twice the minimum wage was calculated. The districts were classified into four homogeneous strata using the K-means clustering algorithm. We plotted the locations of each microcephaly case over a layer of living conditions. Results During the study period, 347 microcephaly cases were reported, of which 142 (40.9%) fulfilled the definition of a microcephaly case. Stratification of the 94 districts resulted in the identification of four strata. The highest stratum in relation to the living conditions presented the lowest prevalence rate of microcephaly, and the overall difference between this rate and the rates of the other strata was statistically significant. The results of the Kruskal-Wallis test demonstrated that there was a strong association between a higher prevalence of microcephaly and poor living conditions. After the first 6 months of the study period, there were no microcephaly cases recorded within the population living in the richest socio-economic strata. Conclusion This study showed that those residing in areas with precarious living conditions had a higher prevalence of microcephaly compared with populations with better living conditions.
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Affiliation(s)
- Wayner Vieira de Souza
- The Aggeu Magalhães Research Center -FIOCRUZ/PE, Av. Professor Moraes Rego, s/n Cidade Universitária, Recife, Pernambuco, CEP 50.740-465, Brazil.
| | | | - Enrique Vazquez
- Pan American Health Organization, Setor de Embaixadas Norte, Lote 19, Brasília, CEP 70800-400, Brazil
| | | | - Antonio da Cruz Gouveia Mendes
- The Aggeu Magalhães Research Center -FIOCRUZ/PE, Av. Professor Moraes Rego, s/n Cidade Universitária, Recife, Pernambuco, CEP 50.740-465, Brazil
| | - Tereza Maciel Lyra
- The Aggeu Magalhães Research Center -FIOCRUZ/PE, Av. Professor Moraes Rego, s/n Cidade Universitária, Recife, Pernambuco, CEP 50.740-465, Brazil
| | - Thalia Velho Barreto de Araujo
- Universidade Federal de Pernambuco, Av. Prof. Moares Rego, 1235, Cidade Universitáia, Recife, Pernambuco, CEP 50670-901, Brazil
| | - André Luiz Sá de Oliveira
- The Aggeu Magalhães Research Center -FIOCRUZ/PE, Av. Professor Moraes Rego, s/n Cidade Universitária, Recife, Pernambuco, CEP 50.740-465, Brazil
| | - Maria Cynthia Braga
- The Aggeu Magalhães Research Center -FIOCRUZ/PE, Av. Professor Moraes Rego, s/n Cidade Universitária, Recife, Pernambuco, CEP 50.740-465, Brazil
| | - Ricardo Arraes de Alencar Ximenes
- Universidade Federal de Pernambuco, Av. Prof. Moares Rego, 1235, Cidade Universitáia, Recife, Pernambuco, CEP 50670-901, Brazil.,Universidade de Pernambuco, Avenida Agamenon Magalhães, S/N, Santo Amaro, Recife, Pernambuco, CEP 501100-010, Brazil
| | | | | | - Laura Rodrigues
- London School of Hygiene & Tropical Medicine, Keppel Street, London, UK
| | - Celina Maria Turchi Martelli
- The Aggeu Magalhães Research Center -FIOCRUZ/PE, Av. Professor Moraes Rego, s/n Cidade Universitária, Recife, Pernambuco, CEP 50.740-465, Brazil.,Universidade Federal de Goiás, Avenida Esperança, S/N, Campus Samambaia, Goiânia, Goiás, CEP 74690-900, Brazil
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