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Fuller BB, Harris V, Parker C, Martinez A, Toubali E, Ebene BC, Asemanyi-Mensah K, Dembele M, Salissou AB, Kabré C, Meite A, Kane NM, Kargbo-Labour I, Batcho W, Diaby A, Yevstigneyeva V, Stukel DM. Contextual determinants of mass drug administration performance: Modelling fourteen years of lymphatic filariasis treatments in West Africa. PLoS Negl Trop Dis 2023; 17:e0011146. [PMID: 36827450 PMCID: PMC9994721 DOI: 10.1371/journal.pntd.0011146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/08/2023] [Accepted: 02/06/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Effective mass drug administration (MDA) is the cornerstone in the elimination of lymphatic filariasis (LF) and a critical component in combatting all neglected tropical diseases for which preventative chemotherapy is recommended (PC-NTDs). Despite its importance, MDA coverage, however defined, is rarely investigated systematically across time and geography. Most commonly, investigations into coverage react to unsatisfactory outcomes and tend to focus on a single year and health district. Such investigations omit more macro-level influences including sociological, environmental, and programmatic factors. The USAID NTD database contains measures of performance from thousands of district-level LF MDA campaigns across 14 years and 10 West African countries. Specifically, performance was measured as an MDA's epidemiological coverage, calculated as persons treated divided by persons at risk. This analysis aims to explain MDA coverage across time and geography in West Africa using sociological, environmental, and programmatic factors. METHODOLOGY The analysis links epidemiological coverage data from 3,880 LF MDAs with contextual, non-NTD data via location (each MDA was specific to a health district) and time (MDA month, year). Contextual data included rainfall, temperature, violence or social unrest, COVID-19, the 2014 Ebola outbreak, road access/isolation, population density, observance of Ramadan, and the number of previously completed MDAs. PRINCIPAL FINDINGS We fit a hierarchical linear regression model with coverage as the dependent variable and performed sensitivity analyses to confirm the selection of the explanatory factors. Above average rainfall, COVID-19, Ebola, violence and social unrest were all significantly associated with lower coverage. Years of prior experience in a district and above average temperature were significantly associated with higher coverage. CONCLUSIONS/SIGNIFICANCE These generalized and context-focused findings supplement current literature on coverage dynamics and MDA performance. Findings may be used to quantify typically anecdotal considerations in MDA planning. The model and methodology are offered as a tool for further investigation.
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Affiliation(s)
- Brian B. Fuller
- Helen Keller International, Washington, District of Columbia, United States of America
- * E-mail:
| | - Vance Harris
- FHI 360, Denver, Colorado, United States of America
| | - Caleb Parker
- FHI 360, Durham, North Carolina, United States of America
| | | | - Emily Toubali
- Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, District of Columbia, United States of America
| | - Blandine Clarisse Ebene
- National Programme for Onchocerciasis and Lymphatic Filariasis Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Kofi Asemanyi-Mensah
- Neglected Tropical Diseases Programme, Disease Control and Prevention Department, Ghana Health Service, Public Health Division, Accra, Ghana
| | - Massitan Dembele
- National Programme for the Elimination of LF, Ministry of Health, Bamako, Mali
| | | | - Cathérine Kabré
- Programme national de lutte contre les maladies tropicales négligées, Ministry of Health, Ouagadougou, Burkina Faso
| | - Aboulaye Meite
- Programme national de lutte contre les maladies tropicales négligées à chimiothérapie préventive, Ministry of Health, Abidjan, Côte d’Ivoire
| | - Ndeye Mbacke Kane
- National Neglected Tropical Diseases Control Program, Ministry of Health, Dakar, Senegal
| | - Ibrahim Kargbo-Labour
- Neglected Tropical Disease Programme, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Wilfrid Batcho
- Programme National de Lutte contre les Maladies Transmissibles, Ministry of Health, Cotonou, Benin
| | - Aissatou Diaby
- National Neglected Tropical Diseases Control Program, Ministry of Health, Conakry, Guinea
| | - Violetta Yevstigneyeva
- Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, District of Columbia, United States of America
| | - Diana Maria Stukel
- Act to End NTDs | West, FHI 360, Washington, District of Columbia, United States of America
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2
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Santoso, Yahya, Supranelfy Y, Suryaningtyas NH, Taviv Y, Yenni A, Arisanti M, Mayasari R, Mahdalena V, Nurmaliani R, Marini, Krishnamoorthy K, Pangaribuan HU. Risk of Recrudescence of Lymphatic Filariasis after Post-MDA Surveillance in Brugia malayi Endemic Belitung District, Indonesia. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 58:627-634. [PMID: 33412766 PMCID: PMC7806434 DOI: 10.3347/kjp.2020.58.6.627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022]
Abstract
Belitung district in Bangka-Belitung Province, Indonesia with a population of 0.27 million is endemic for Brugia malayi and 5 rounds of mass drug administration (MDA) were completed by 2010. Based on the results of 3 transmission assessment surveys (TAS), the district is declared as achieving elimination of lymphatic filariasis (LF) in 2017. The findings of an independent survey conducted by the National Institute of Health Research and Development (NIHRD) in the same year showed microfilaria (Mf) prevalence of 1.3% in this district. In 2019, NIHRD conducted microfilaria survey in 2 villages in Belitung district. Screening of 311 and 360 individuals in Lasar and Suak Gual villages showed Mf prevalence of 5.1% and 2.2% with mean Mf density of 120 and 354 mf/ml in the respective villages. Mf prevalence was significantly higher among farmers and fishermen compared to others and the gender specific difference was not significant. The results of a questionnaire based interview showed that 62.4% of the respondents reported to have participated in MDA in Lasar while it was 57.7% in Suak Gual village. About 42% of the Mf positive cases did not participate in MDA. Environmental surveys identified many swampy areas supporting the breeding of Mansonia vector species. Persistence of infection is evident and in the event of successful TAS3 it is necessary to monitor the situation and plan for focal MDA. Appropriate surveillance strategies including xenomonitoring in post-MDA situations need to be developed to prevent resurgence of infection. Possible role of animal reservoirs is discussed.
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Affiliation(s)
- Santoso
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Yahya
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Yanelza Supranelfy
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Nungki Hapsari Suryaningtyas
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Yulian Taviv
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Aprioza Yenni
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Maya Arisanti
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Rika Mayasari
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Vivin Mahdalena
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Rizki Nurmaliani
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - Marini
- Baturaja Unit for Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, South Sumatera, Indonesia
| | - K Krishnamoorthy
- Vector Control Research Centre (VCRC), Medical Complex, Indira Nagar, Puducherry, India
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3
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Smith ME, Singh BK, Irvine MA, Stolk WA, Subramanian S, Hollingsworth TD, Michael E. Predicting lymphatic filariasis transmission and elimination dynamics using a multi-model ensemble framework. Epidemics 2018; 18:16-28. [PMID: 28279452 PMCID: PMC5340857 DOI: 10.1016/j.epidem.2017.02.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 11/28/2022] Open
Abstract
No single mathematical model captures all features of parasite transmission dynamics. Multi-model ensemble modelling can overcome biases of single models. A multi-model ensemble of three lymphatic filariasis models is proposed and evaluated. The multi-model ensemble outperformed the single models in predicting infection. The ensemble approach may improve use of models to inform disease control policy.
Mathematical models of parasite transmission provide powerful tools for assessing the impacts of interventions. Owing to complexity and uncertainty, no single model may capture all features of transmission and elimination dynamics. Multi-model ensemble modelling offers a framework to help overcome biases of single models. We report on the development of a first multi-model ensemble of three lymphatic filariasis (LF) models (EPIFIL, LYMFASIM, and TRANSFIL), and evaluate its predictive performance in comparison with that of the constituents using calibration and validation data from three case study sites, one each from the three major LF endemic regions: Africa, Southeast Asia and Papua New Guinea (PNG). We assessed the performance of the respective models for predicting the outcomes of annual MDA strategies for various baseline scenarios thought to exemplify the current endemic conditions in the three regions. The results show that the constructed multi-model ensemble outperformed the single models when evaluated across all sites. Single models that best fitted calibration data tended to do less well in simulating the out-of-sample, or validation, intervention data. Scenario modelling results demonstrate that the multi-model ensemble is able to compensate for variance between single models in order to produce more plausible predictions of intervention impacts. Our results highlight the value of an ensemble approach to modelling parasite control dynamics. However, its optimal use will require further methodological improvements as well as consideration of the organizational mechanisms required to ensure that modelling results and data are shared effectively between all stakeholders.
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Affiliation(s)
- Morgan E Smith
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Brajendra K Singh
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Michael A Irvine
- School of Life Sciences, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK
| | - Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Swaminathan Subramanian
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Pondicherry 650 006, India
| | - T Déirdre Hollingsworth
- School of Life Sciences, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK; Mathematics Institute, University of Warwick, Gibbet Hill Road, CV4 7AL Coventry, UK
| | - Edwin Michael
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA.
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Andersen BJ, Kumar J, Curtis K, Sanuku N, Satofan S, King CL, Fischer PU, Weil GJ. Changes in Cytokine, Filarial Antigen, and DNA Levels Associated With Adverse Events Following Treatment of Lymphatic Filariasis. J Infect Dis 2018; 217:280-287. [PMID: 29149303 PMCID: PMC5853815 DOI: 10.1093/infdis/jix578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/13/2017] [Indexed: 11/14/2022] Open
Abstract
Background Mild to moderate adverse events (AEs) are common after treatment of lymphatic filariasis (LF) and pose a major challenge for the global LF elimination program. We studied changes in cytokine levels and filarial worm components in plasma of subjects with and without AEs following treatment of LF. Methods Participants (n = 24) were hospitalized and monitored for AEs following treatment. Cytokines (27), filarial DNA, circulating filarial antigen (CFA), and immune complexes were measured in plasma samples collected before and after treatment. Results Levels for 16 cytokines increased after treatment in individuals with moderate AEs compared to individuals with no and/or mild AEs. These included 3 major proinflammatory cytokines (interleukin 6, tumor necrosis factor α, and interleukin 1β). Eotaxin-1 levels were elevated at baseline in individuals who developed moderate AEs after treatment; thus, eotaxin-1 is a potential biomarker for AE risk. CFA and filarial DNA levels increased more in individuals with moderate AEs after treatment than in people with no/mild AEs. Conclusions Increases in cytokine, filarial DNA, and CFA levels were associated with development of AEs following treatment of LF. Improved understanding of the pathogenesis of AEs may lead to improved methods for their prevention or management that could increase compliance in elimination programs.
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Affiliation(s)
- Britt J Andersen
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Jessica Kumar
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Kurt Curtis
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Nelly Sanuku
- Papua New Guinea Institute of Medical Research, Goroka
| | | | - Christopher L King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Peter U Fischer
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Gary J Weil
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
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Moustafa MA, Salamah MMI, Thabet HS, Tawfik RA, Mehrez MM, Hamdy DM. Molecular xenomonitoring (MX) and transmission assessment survey (TAS) of lymphatic filariasis elimination in two villages, Menoufyia Governorate, Egypt. Eur J Clin Microbiol Infect Dis 2017; 36:1143-1150. [PMID: 28155014 DOI: 10.1007/s10096-017-2901-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/04/2017] [Indexed: 11/30/2022]
Abstract
Lymphatic filariasis (LF) is focally endemic in Egypt where the female mosquito, Culex pipiens, is responsible for its transmission. The aim of the study was to investigate the impact of implementation of the 13th round of MDA in two Egyptian villages in the Menoufyia Governorate area after failing the transmission assessment survey (TAS) in 2005 using two methods, and to decide whether it is safe to stop MDA in these, as well as in similar implementation units (IUs). To achieve this aim, both the immunochromatographic card test (ICT) and molecular xenomonitoring (MX) techniques were employed. A cross-sectional study was carried out in the villages in 2014 with two sections: Section (1): a school-based survey where all the primary school entrants (6-7) years of age were tested by ICT. Section (2): a mosquito-based survey where a total of 152 mosquito pools collected from Samalay and 167 from Kafr El-Tarainah were tested for the presence of the gDNA of Wuchereria bancrofti microfilaria by real-time PCR assays. The results revealed that all primary school children in both villages were 100% negative for antigenemia. Also, all mosquito pools were 100% negative for the microfilarial gDNA.
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Affiliation(s)
- M A Moustafa
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Abbassia, 11566, Cairo, Egypt
| | - M M I Salamah
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Abbassia, 11566, Cairo, Egypt
| | - H S Thabet
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Abbassia, 11566, Cairo, Egypt
| | - R A Tawfik
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Abbassia, 11566, Cairo, Egypt.
| | - M M Mehrez
- General Department for Malaria, Filariasis & Leishmaniasis Control, Endemic Diseases Control Sector, Ministry of Health and Population, Cairo, Egypt
| | - D M Hamdy
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Abbassia, 11566, Cairo, Egypt
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Kastner RJ, Stone CM, Steinmann P, Tanner M, Tediosi F. What Is Needed to Eradicate Lymphatic Filariasis? A Model-Based Assessment on the Impact of Scaling Up Mass Drug Administration Programs. PLoS Negl Trop Dis 2015; 9:e0004147. [PMID: 26451729 PMCID: PMC4599939 DOI: 10.1371/journal.pntd.0004147] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/17/2015] [Indexed: 11/18/2022] Open
Abstract
Background Lymphatic filariasis (LF) is a neglected tropical disease for which more than a billion people in 73 countries are thought to be at-risk. At a global level, the efforts against LF are designed as an elimination program. However, current efforts appear to aim for elimination in some but not all endemic areas. With the 2020 goal of elimination looming, we set out to develop plausible scale-up scenarios to reach global elimination and eradication. We predict the duration of mass drug administration (MDA) necessary to reach local elimination for a variety of transmission archetypes using an existing model of LF transmission, estimate the number of treatments required for each scenario, and consider implications of rapid scale-up. Methodology We have defined four scenarios that differ in their geographic coverage and rate of scale-up. For each scenario, country-specific simulations and calculations were performed that took into account the pre-intervention transmission intensity, the different vector genera, drug regimen, achieved level of population coverage, previous progress toward elimination, and potential programmatic delays due to mapping, operations, and administration. Principal Findings Our results indicate that eliminating LF by 2020 is unlikely. If MDA programs are drastically scaled up and expanded, the final round of MDA for LF eradication could be delivered in 2028 after 4,159 million treatments. However, if the current rate of scale-up is maintained, the final round of MDA to eradicate LF may not occur until 2050. Conclusions/Significance Rapid scale-up of MDA will decrease the amount of time and treatments required to reach LF eradication. It may also propel the program towards success, as the risk of failure is likely to increase with extended program duration. Lymphatic filariasis (LF) is a disease caused by filarial worms transmitted by different types of mosquitos that can lead to massive disability, including elephantiasis and hydrocele. LF has no significant zoonotic reservoir and is thought to be a potentially eradicable disease through once yearly treatment distributed by mass drug administration (MDA). In this study, we set out to determine how many treatments and over how much time it might take to globally eliminate and eradicate LF under different levels of treatment intensities. We created a model that took into account country-specific and disease-specific variables, and found that if the current intensity of MDA is maintained, 3,409 million treatments distributed over the next 37 years will be required. However, if treatment is rapidly expanded to the entire at-risk population in all endemic countries, eradication could be achieved with 4,159 million treatments and in less than half the time. While our estimates suggest more time may be needed to reach LF elimination than what is currently projected, with continued commitment, eradicating LF is within reach.
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Affiliation(s)
- Randee J. Kastner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christopher M. Stone
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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7
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Stolk WA, Stone C, de Vlas SJ. Modelling lymphatic filariasis transmission and control: modelling frameworks, lessons learned and future directions. ADVANCES IN PARASITOLOGY 2015; 87:249-91. [PMID: 25765197 DOI: 10.1016/bs.apar.2014.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Mathematical modelling provides a useful tool for policy making and planning in lymphatic filariasis control programmes, by providing trend forecasts based on sound scientific knowledge and principles. This is now especially true, in view of the ambitious target to eliminate lymphatic filariasis as a public health problem globally by the year 2020 and the short remaining timeline to achieve this. To meet this target, elimination programmes need to be accelerated, requiring further optimization of strategies and tailoring to local circumstances. Insights from epidemiological transmission models provide a useful basis. Two general models of lymphatic filariasis transmission and control are nowadays in use to support decision-making, namely a population-based deterministic model (EPIFIL) and an individual-based stochastic model (LYMFASIM). Model predictions confirm that lymphatic filariasis transmission can be interrupted by annual mass drug administration (MDA), but this may need to be continued much longer than the initially suggested 4-6 years in areas with high transmission intensity or poor treatment coverage. However, the models have not been validated against longitudinal data describing the impact of MDA programmes. Some critical issues remain to be incorporated in one or both of the models to make predictions on elimination more realistic, including the possible occurrence of systematic noncompliance, the risk of emerging parasite resistance to anthelmintic drugs, and spatial heterogeneities. Rapid advances are needed to maximize the utility of models in decision-making for the ongoing ambitious lymphatic filariasis elimination programmes.
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Affiliation(s)
- Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Chris Stone
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
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Rao RU, Nagodavithana KC, Samarasekera SD, Wijegunawardana AD, Premakumara WDY, Perera SN, Settinayake S, Miller JP, Weil GJ. A comprehensive assessment of lymphatic filariasis in Sri Lanka six years after cessation of mass drug administration. PLoS Negl Trop Dis 2014; 8:e3281. [PMID: 25393404 PMCID: PMC4230885 DOI: 10.1371/journal.pntd.0003281] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 09/19/2014] [Indexed: 11/19/2022] Open
Abstract
Background The Sri Lankan Anti-Filariasis Campaign conducted 5 rounds of mass drug administration (MDA) with diethycarbamazine plus albendazole between 2002 and 2006. We now report results of a comprehensive surveillance program that assessed the lymphatic filariasis (LF) situation in Sri Lanka 6 years after cessation of MDA. Methodology and Principal Findings Transmission assessment surveys (TAS) were performed per WHO guidelines in primary school children in 11 evaluation units (EUs) in all 8 formerly endemic districts. All EUs easily satisfied WHO criteria for stopping MDA. Comprehensive surveillance was performed in 19 Public Health Inspector (PHI) areas (subdistrict health administrative units). The surveillance package included cross-sectional community surveys for microfilaremia (Mf) and circulating filarial antigenemia (CFA), school surveys for CFA and anti-filarial antibodies, and collection of Culex mosquitoes with gravid traps for detection of filarial DNA (molecular xenomonitoring, MX). Provisional target rates for interruption of LF transmission were community CFA <2%, antibody in school children <2%, and filarial DNA in mosquitoes <0.25%. Community Mf and CFA prevalence rates ranged from 0–0.9% and 0–3.4%, respectively. Infection rates were significantly higher in males and lower in people who denied prior treatment. Antibody rates in school children exceeded 2% in 10 study sites; the area that had the highest community and school CFA rates also had the highest school antibody rate (6.9%). Filarial DNA rates in mosquitoes exceeded 0.25% in 10 PHI areas. Conclusions Comprehensive surveillance is feasible for some national filariasis elimination programs. Low-level persistence of LF was present in all study sites; several sites failed to meet provisional endpoint criteria for LF elimination, and follow-up testing will be needed in these areas. TAS was not sensitive for detecting low-level persistence of filariasis in Sri Lanka. We recommend use of antibody and MX testing as tools to complement TAS for post-MDA surveillance. Lymphatic Filariasis (LF, also known as “elephantiasis”) is a disabling and deforming disease that is caused by parasitic worms that are transmitted by mosquitoes. The Sri Lankan Anti-Filariasis Campaign provided five annual rounds of mass drug administration (MDA) with diethylcarbamazine and albendazole between 2002 and 2006 in all endemic areas (districts or implementation units), and this reduced infection rates to very low levels in all sentinel and spot check sites. Transmission Assessment Surveys (TAS, surveys for filarial antigenemia in primary school children) performed in 2012–2013 (about 6 years after the last round of MDA) showed that all 11 evaluation units in formerly endemic areas easily satisfied a key World Health Organization target for LF elimination programs. More comprehensive surveillance was performed with other tests to assess LF parameters in 19 study sites in the same eight districts. We detected evidence of persistent LF in all districts and evidence of ongoing transmission in several areas. Exposure monitoring (screening for anti-filarial antibodies in primary school children) and molecular xenomonitoring (detecting filarial DNA in mosquito vectors) were much more sensitive than TAS for detecting low level persistence of filariasis in Sri Lanka. These methods are complementary to TAS, and they are feasible for use by some national filariasis elimination programs. Results from this study suggest that TAS alone may not be sufficient for assessing the success of filariasis elimination programs.
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Affiliation(s)
- Ramakrishna U. Rao
- Department of Internal Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | | | | | | | | | | | - Sunil Settinayake
- Anti Filariasis Campaign, Sri Lanka Ministry of Health, Colombo, Sri Lanka
| | - J. Phillip Miller
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Gary J. Weil
- Department of Internal Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail:
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9
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Ramaiah KD, Ottesen EA. Progress and impact of 13 years of the global programme to eliminate lymphatic filariasis on reducing the burden of filarial disease. PLoS Negl Trop Dis 2014; 8:e3319. [PMID: 25412180 PMCID: PMC4239120 DOI: 10.1371/journal.pntd.0003319] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/06/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A Global Programme to Eliminate Lymphatic Filariasis was launched in 2000, with mass drug administration (MDA) as the core strategy of the programme. After completing 13 years of operations through 2012 and with MDA in place in 55 of 73 endemic countries, the impact of the MDA programme on microfilaraemia, hydrocele and lymphedema is in need of being assessed. METHODOLOGY/PRINCIPAL FINDINGS During 2000-2012, the MDA programme made remarkable achievements - a total of 6.37 billion treatments were offered and an estimated 4.45 billion treatments were consumed by the population living in endemic areas. Using a model based on empirical observations of the effects of treatment on clinical manifestations, it is estimated that 96.71 million LF cases, including 79.20 million microfilaria carriers, 18.73 million hydrocele cases and a minimum of 5.49 million lymphedema cases have been prevented or cured during this period. Consequently, the global prevalence of LF is calculated to have fallen by 59%, from 3.55% to 1.47%. The fall was highest for microfilaraemia prevalence (68%), followed by 49% in hydrocele prevalence and 25% in lymphedema prevalence. It is estimated that, currently, i.e. after 13 years of the MDA programme, there are still an estimated 67.88 million LF cases that include 36.45 million microfilaria carriers, 19.43 million hydrocele cases and 16.68 million lymphedema cases. CONCLUSIONS/SIGNIFICANCE The MDA programme has resulted in significant reduction of the LF burden. Extension of MDA to all at-risk countries and to all regions within those countries where MDA has not yet reached 100% geographic coverage is imperative to further reduce the number of microfilaraemia and chronic disease cases and to reach the global target of interrupting transmission of LF by 2020.
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Affiliation(s)
- K. D. Ramaiah
- Consultant on Lymphatic Filariasis, Tagore Nagar, Pondicherry, India
| | - Eric A. Ottesen
- Neglected Tropical Disease Support Center, The Task Force for Global Health, Decatur, Georgia, United States of America
- ENVISION Project, RTI International, Washington, D.C., United States of America
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Smits HL. Prospects for the control of neglected tropical diseases by mass drug administration. Expert Rev Anti Infect Ther 2014; 7:37-56. [DOI: 10.1586/14787210.7.1.37] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tediosi F, Steinmann P, de Savigny D, Tanner M. Developing eradication investment cases for onchocerciasis, lymphatic filariasis, and human African trypanosomiasis: rationale and main challenges. PLoS Negl Trop Dis 2013; 7:e2446. [PMID: 24244762 PMCID: PMC3820723 DOI: 10.1371/journal.pntd.0002446] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Don de Savigny
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Modeling the impact and costs of semiannual mass drug administration for accelerated elimination of lymphatic filariasis. PLoS Negl Trop Dis 2013; 7:e1984. [PMID: 23301115 PMCID: PMC3536806 DOI: 10.1371/journal.pntd.0001984] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 11/07/2012] [Indexed: 11/25/2022] Open
Abstract
The Global Program to Eliminate Lymphatic Filariasis (LF) has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA) programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels. Results were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020. The Global Program to Eliminate Lymphatic Filariasis (LF) employs annual mass drug administration (MDA) of antifilarial drugs to reduce infection rates in populations and interrupt transmission. While this program is working well in many countries, progress has been slow in others, and some countries have not yet started MDA programs. We used computer simulation modeling and cost projections to study how increasing MDA frequency from once to twice per year would affect program duration and costs. Our results suggest that semiannual MDA is likely to reduce the time required to eliminate LF by 50% and reduce total program costs (excluding the cost of donated drugs) in most situations. For these and other reasons, we expect semiannual MDA to be superior to annual MDA in most endemic settings. Semiannual MDA should be considered as a means of accelerating LF elimination in areas where it can be implemented, because this may improve prospects for global elimination of LF by the target year 2020.
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Knopp S, Steinmann P, Hatz C, Keiser J, Utzinger J. Nematode Infections:. Infect Dis Clin North Am 2012; 26:359-81. [DOI: 10.1016/j.idc.2012.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodríguez-Pérez MA, Unnasch TR, Real-Najarro O. Assessment and monitoring of onchocerciasis in Latin America. ADVANCES IN PARASITOLOGY 2012; 77:175-226. [PMID: 22137585 DOI: 10.1016/b978-0-12-391429-3.00008-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Onchocerciasis has historically been one of the leading causes of infectious blindness worldwide. It is endemic to tropical regions both in Africa and Latin America and in the Yemen. In Latin America, it is found in 13 foci located in 6 different countries. The epidemiologically most important focus of onchocerciasis in the Americas is located in a region spanning the border between Guatemala and Mexico. However, the Amazonian focus straddling the border of Venezuela and Brazil is larger in overall area because the Yanomami populations are scattered over a very large geographical region. Onchocerciasis is caused by infection with the filarial parasite Onchocerca volvulus. The infection is spread through the bites of an insect vector, black flies of the genus Simulium. In Africa, the major vectors are members of the S. damnosum complex, while numerous species serve as vectors of the parasite in Latin America. Latin America has had a long history of attempts to control onchocerciasis, stretching back almost 100 years. The earliest programmes used a strategy of surgical removal of the adult parasites from affected individuals. However, because many of the adult parasites lodge in undetectable and inaccessible areas of the body, the overall effect of this strategy on the prevalence of infection was relatively minor. In 1988, a new drug, ivermectin, was introduced that effectively killed the larval stage (microfilaria) of the parasite in infected humans. As the microfilaria is both the stage that is transmitted by the vector fly and the cause of most of the pathologies associated with the infection, ivermectin opened up a new strategy for the control of onchocerciasis. Concurrent with the use of ivermectin for the treatment of onchocerciasis, a number of sensitive new diagnostic tools were developed (both serological and nucleic acid based) that provided the efficiency, sensitivity and specificity necessary to monitor the decline and eventual elimination of onchocerciasis as a result of successful control. As a result of these advances, a strategy for the elimination of onchocerciasis was developed, based upon mass distribution of ivermectin to afflicted communities for periods lasting long enough to ensure that the parasite population was placed on the road to local elimination. This strategy has been applied for the past decade to the foci in Latin America by a programme overseen by the Onchocerciasis Elimination Program for the Americas (OEPA). The efforts spearheaded by OEPA have been very successful, eliminating ocular disease caused by O. volvulus, and eliminating and interrupting transmission of the parasite in 8 of the 13 foci in the region. As onchocerciasis approaches elimination in Latin America, several questions still need to be addressed. These include defining an acceptable upper limit for transmission in areas in which transmission is thought to have been suppressed (e.g. what is the maximum value for the upper bound of the 95% confidence interval for transmission rates in areas where transmission is no longer detectable), how to develop strategies for conducting surveillance for recrudescence of infection in areas in which transmission is thought to be interrupted and how to address the problem in areas where the mass distribution of ivermectin seems to be unable to completely eliminate the infection.
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Affiliation(s)
- Mario A Rodríguez-Pérez
- Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Ciudad Reynosa, Tamaulipas, México
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15
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Preventive chemotherapy in human helminthiasis: theoretical and operational aspects. Trans R Soc Trop Med Hyg 2011; 105:683-93. [PMID: 22040463 DOI: 10.1016/j.trstmh.2011.08.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 04/29/2011] [Accepted: 06/23/2011] [Indexed: 11/21/2022] Open
Abstract
Preventive chemotherapy (PC), the large-scale distribution of anthelminthic drugs to population groups at risk, is the core intervention recommended by the WHO for reducing morbidity and transmission of the four main helminth infections, namely lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiasis. The strategy is widely implemented worldwide but its general theoretical foundations have not been described so far in a comprehensive and cohesive manner. Starting from the information available on the biological and epidemiological characteristics of helminth infections, as well as from the experience generated by disease control and elimination interventions across the world, we extrapolate the fundamentals and synthesise the principles that regulate PC and justify its implementation as a sound and essential public health intervention. The outline of the theoretical aspects of PC contributes to a thorough understanding of the different facets of this strategy and helps comprehend opportunities and limits of control and elimination interventions directed against helminth infections.
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Diurnally subperiodic filariasis in India-prospects of elimination: precept to action? Parasitol Res 2011; 109:1-8. [PMID: 21286754 DOI: 10.1007/s00436-011-2252-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 01/12/2011] [Indexed: 10/18/2022]
Abstract
The elimination of lymphatic filariasis in the Andaman and Nicobar Islands provides unique opportunities and challenges at the same time. Since these islands are remote, are sparsely populated, and have poor transport networks, mass drug administration programs are likely to be difficult to implement. Diurnally subperiodic Wuchereria bancrofti vectored by Downsiomyia nivea was considered for the scope of vector control options. Considering the bioecology of this mosquito, vector control including personal protection measures may not be feasible. However, since these islands are covered by separate administrative machinery which also plays an important role in regulating the food supply, the use of diethylcarbamazine (DEC)-fortified salt as a tool for the interruption of transmission is appealing. DEC-fortified salt has been successfully pilot tested in India and elsewhere, operationally used by China for eliminating lymphatic filariasis. Administration of DEC-fortified salt though simple, rapid, safe, and cost-effective, challenges are to be tackled for translating this precept into action by evolving operationally feasible strategy. Although the use of DEC-fortified salt is conceptually simple, it requires commitment of all sections of the society, an elaborate distribution mechanism that ensures the use of DEC-fortified salt only in the endemic communities, and a vigorous monitoring mechanism. Here, we examine the inbuilt administrative mechanisms to serve the tribal people, health infrastructure, and public distribution system and discuss the prospects of putting in place an operationally feasible strategy for its elimination.
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Abstract
Lymphatic filariasis and onchocerciasis are parasitic helminth diseases that constitute a serious public health issue in tropical regions. The filarial nematodes that cause these diseases are transmitted by blood-feeding insects and produce chronic and long-term infection through suppression of host immunity. Disease pathogenesis is linked to host inflammation invoked by the death of the parasite, causing hydrocoele, lymphoedema, and elephantiasis in lymphatic filariasis, and skin disease and blindness in onchocerciasis. Most filarial species that infect people co-exist in mutualistic symbiosis with Wolbachia bacteria, which are essential for growth, development, and survival of their nematode hosts. These endosymbionts contribute to inflammatory disease pathogenesis and are a target for doxycycline therapy, which delivers macrofilaricidal activity, improves pathological outcomes, and is effective as monotherapy. Drugs to treat filariasis include diethylcarbamazine, ivermectin, and albendazole, which are used mostly in combination to reduce microfilariae in blood (lymphatic filariasis) and skin (onchocerciasis). Global programmes for control and elimination have been developed to provide sustained delivery of drugs to affected communities to interrupt transmission of disease and ultimately eliminate this burden on public health.
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Affiliation(s)
- Mark J Taylor
- Liverpool School of Tropical Medicine, Liverpool, UK.
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Chu BK, Hooper PJ, Bradley MH, McFarland DA, Ottesen EA. The economic benefits resulting from the first 8 years of the Global Programme to Eliminate Lymphatic Filariasis (2000-2007). PLoS Negl Trop Dis 2010; 4:e708. [PMID: 20532228 PMCID: PMC2879371 DOI: 10.1371/journal.pntd.0000708] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 04/20/2010] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Between 2000-2007, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) delivered more than 1.9 billion treatments to nearly 600 million individuals via annual mass drug administration (MDA) of anti-filarial drugs (albendazole, ivermectin, diethylcarbamazine) to all at-risk for 4-6 years. Quantifying the resulting economic benefits of this significant achievement is important not only to justify the resources invested in the GPELF but also to more fully understand the Programme's overall impact on some of the poorest endemic populations. METHODOLOGY To calculate the economic benefits, the number of clinical manifestations averted was first quantified and the savings associated with this disease prevention then analyzed in the context of direct treatment costs, indirect costs of lost-labor, and costs to the health system to care for affected individuals. Multiple data sources were reviewed, including published literature and databases from the World Health Organization, International Monetary Fund, and International Labour Organization PRINCIPAL FINDINGS An estimated US$21.8 billion of direct economic benefits will be gained over the lifetime of 31.4 million individuals treated during the first 8 years of the GPELF. Of this total, over US$2.3 billion is realized by the protection of nearly 3 million newborns and other individuals from acquiring lymphatic filariasis as a result of their being born into areas freed of LF transmission. Similarly, more than 28 million individuals already infected with LF benefit from GPELF's halting the progression of their disease, which results in an associated lifetime economic benefit of approximately US$19.5 billion. In addition to these economic benefits to at-risk individuals, decreased patient services associated with reduced LF morbidity saves the health systems of endemic countries approximately US$2.2 billion. CONCLUSIONS/SIGNIFICANCE MDA for LF offers significant economic benefits. Moreover, with favorable program implementation costs (largely a result of the sustained commitments of donated drugs from the pharmaceutical industry) it is clear that the economic rate of return of the GPELF is extremely high and that this Programme continues to prove itself an excellent investment in global health.
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Affiliation(s)
- Brian K Chu
- Lymphatic Filariasis Support Center, The Task Force for Global Health, Decatur, Georgia, USA.
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Bitran R, Martorell B, Escobar L, Munoz R, Glassman A. Controlling And Eliminating Neglected Diseases In Latin America And The Caribbean. Health Aff (Millwood) 2009; 28:1707-19. [DOI: 10.1377/hlthaff.28.6.1707] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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Ramaiah KD. Lymphatic filariasis elimination programme in India: progress and challenges. Trends Parasitol 2009; 25:7-8. [DOI: 10.1016/j.pt.2008.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Revised: 10/10/2008] [Accepted: 10/15/2008] [Indexed: 10/21/2022]
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LYMFASIM, a simulation model for predicting the impact of lymphatic filariasis control: quantification for African villages. Parasitology 2008; 135:1583-98. [PMID: 19006602 DOI: 10.1017/s0031182008000437] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
LYMFASIM is a simulation model for lymphatic filariasis transmission and control. We quantified its parameters to simulate Wuchereria bancrofti transmission by Anopheles mosquitoes in African villages, using a wide variety of reported data. The developed model captures the general epidemiological patterns, but also the differences between communities. It was calibrated to represent the relationship between mosquito biting rate and the prevalence of microfilariae (mf) in the human population, the age-pattern in mf prevalence, and the relation between mf prevalence and geometric mean mf intensity. Explorative simulations suggest that the impact of mass treatment depends strongly on the mosquito biting rate and on the assumed coverage, compliance and efficacy. Our sensitivity analysis showed that some biological parameters strongly influence the predicted equilibrium pre-treatment mf prevalence (e.g. the lifespan of adult worms and mf). Other parameters primarily affect the post-treatment trends (e.g. severity of density dependence in the mosquito uptake of infection from the human blood, between-person variability in exposure to mosquito bites). The longitudinal data, which are being collected for evaluation of ongoing elimination programmes, can help to further validate the model. The model can help to assess when ongoing elimination activities in African populations can be stopped and to design surveillance schemes. It can be a valuable tool for decision making in the Global Programme to Eliminate Lymphatic Filariasis.
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El-Setouhy M, Abd Elaziz KM, Helmy H, Farid HA, Kamal HA, Ramzy RMR, Shannon WD, Weil GJ. The effect of compliance on the impact of mass drug administration for elimination of lymphatic filariasis in Egypt. Am J Trop Med Hyg 2007; 77:1069-73. [PMID: 18165524 PMCID: PMC2196399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
We studied effects of compliance on the impact of mass drug administration (MDA) with diethylcarbamazine and albendazole for lymphatic filariasis (LF) in an Egyptian village. Baseline microfilaremia (mf) and filarial antigenemia rates were 11.5% and 19.0%, respectively. The MDA compliance rates were excellent (> 85%). However, individual compliance was highly variable; 7.4% of those surveyed after five rounds of MDA denied having ever taken the medications and 52.4% reported that they had taken all five doses. The mf and antigenemia rates were 0.2% and 2.7% in those who reported five doses of MDA and 8.3% and 13.8% in those who reported zero doses. There was no significant difference in residual infection rates among those who had taken two or more doses. These results underscore the importance of compliance for LF elimination programs based on MDA and suggest that two ingested doses of MDA are as effective as five doses for reducing filariasis infection rates.
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Affiliation(s)
- Maged El-Setouhy
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Khaled M. Abd Elaziz
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Hanan Helmy
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Hoda A. Farid
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Hussein A. Kamal
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Reda M. R. Ramzy
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - William D. Shannon
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Gary J. Weil
- Research and Training Center on Vectors of Diseases, Ain Shams University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Divisions of Infectious Diseases and General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
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Weil GJ, Ramzy RMR. Diagnostic tools for filariasis elimination programs. Trends Parasitol 2007; 23:78-82. [PMID: 17174604 DOI: 10.1016/j.pt.2006.12.001] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Revised: 10/27/2006] [Accepted: 12/06/2006] [Indexed: 11/26/2022]
Abstract
The ambitious and exciting Global Programme to Eliminate Lymphatic Filariasis (GPELF) is largely based on a strategy of mass drug administration (MDA) of repeated rounds of antifilarial medications to endemic populations around the world. Diagnostic tools are important to GPELF because they affect decisions regarding where to distribute MDA, how to measure its effects, how to define targets and endpoints for stopping MDA, and how to monitor populations for possible resurgence of filariasis transmission following suspension of MDA. This article reviews available diagnostic tests for filariasis and their potential use as tools for different phases of filariasis elimination programs.
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Affiliation(s)
- Gary J Weil
- Infectious Diseases Division, Washington University School of Medicine, Campus Box 8051, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
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Ichimori K, Tupuimalagi-Toelupe P, Toeaso Iosia V, M. Graves P. Wuchereria bancrofti Filariasis Control in Samoa before PacELF (Pacific Programme to Eliminate Lymphatic Filariasis). Trop Med Health 2007. [DOI: 10.2149/tmh.35.261] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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