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Montresor A, Cong DT, Sinuon M, Tsuyuoka R, Chanthavisouk C, Strandgaard H, Velayudhan R, Capuano CM, Le Anh T, Tee Dató AS. Large-scale preventive chemotherapy for the control of helminth infection in Western Pacific countries: six years later. PLoS Negl Trop Dis 2008; 2:e278. [PMID: 18846234 PMCID: PMC2565698 DOI: 10.1371/journal.pntd.0000278] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2001, Urbani and Palmer published a review of the epidemiological situation of helminthiases in the countries of the Western Pacific Region of the World Health Organization indicating the control needs in the region. Six years after this inspiring article, large-scale preventive chemotherapy for the control of helminthiasis has scaled up dramatically in the region. This paper analyzes the most recent published and unpublished country information on large-scale preventive chemotherapy and summarizes the progress made since 2000. Almost 39 million treatments were provided in 2006 in the region for the control of helminthiasis: nearly 14 million for the control of lymphatic filariasis, more than 22 million for the control of soil-transmitted helminthiasis, and over 2 million for the control of schistosomiasis. In general, control of these helminthiases is progressing well in the Mekong countries and Pacific Islands. In China, despite harboring the majority of the helminth infections of the region, the control activities have not reached the level of coverage of countries with much more limited financial resources. The control of food-borne trematodes is still limited, but pilot activities have been initiated in China, Lao People's Democratic Republic, and Vietnam.
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Gunawardena SA, A. Gunawardena GS. Acute large bowel obstruction due to Ascaris lumbricoides in a child from Sri Lanka. Trop Med Health 2008. [DOI: 10.2149/tmh.36.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Hong ST, Chai JY, Choi MH, Huh S, Rim HJ, Lee SH. A successful experience of soil-transmitted helminth control in the Republic of Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2006; 44:177-85. [PMID: 16969055 PMCID: PMC2532657 DOI: 10.3347/kjp.2006.44.3.177] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Soil-transmitted helminths (STH), namely Ascaris, Trichuris and hookworms (Ancylostoma and Necator), present a global health problem to about a half of the earthos population. In the Republic of Korea, STH were highly prevalent and were considered a high priority target for national control. To promote the control, a non-governmental organization named Korea Association for Parasite Eradication (currently Korea Association of Health Promotion) was founded in 1964, and mass fecal examination followed by selective mass chemotherapy with anthelmintics was performed twice a year from 1969 to 1995 targeting whole nationwide schoolchildren. Meanwhile, decreasing patterns of national STH infections have been monitored by 7 timeso quinquennial national surveys targeting general population. In 1971, the overall intestinal helminth egg positive rate was 84.3% (Ascaris 58.2%, Trichuris 65.4%, and hookworms 10.7%), which became 63.2% in 1976, 41.1% in 1981, 12.9% in 1986, 3.8% in 1992, 2.4% in 1997, and 4.3% (Ascaris 0.03%, Trichuris 0.02%, and hookworms 0%) in 2004. During the control period, national economy rapidly developed, and living standards including environment, sanitation, and agricultural technology greatly improved, which undoubtedly boosted the STH control effects. Our experience indicates that social driving force to establish an eligible national control system to conduct repeated mass chemotherapy, together with improvement of environment and sanitation, is important for initiating and achieving STH control in a developing community.
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Affiliation(s)
- Sung-Tae Hong
- Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Korea
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Padmasiri EA, Montresor A, Biswas G, de Silva NR. Controlling lymphatic filariasis and soil-transmitted helminthiasis together in South Asia: opportunities and challenges. Trans R Soc Trop Med Hyg 2006; 100:807-10. [PMID: 16546228 PMCID: PMC5626005 DOI: 10.1016/j.trstmh.2005.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2005] [Revised: 11/27/2005] [Accepted: 12/14/2005] [Indexed: 11/30/2022] Open
Abstract
Lymphatic filariasis (LF) and the major soil-transmitted helminth (STH) infections are co-endemic in many countries, particularly in Asia. Control strategies for both groups of infections have increasingly focused on the use of mass chemotherapy. With the use of albendazole, there is now a tool that is common to both. However, there are also important differences in their modes of transmission and epidemiology, and, as a result, in the overall control strategies. The Global Programme for the Elimination of Lymphatic Filariasis aims to eliminate LF through time-limited mass drug administration programmes. Control activities for STH are more diffuse, aiming to piggy-back de-worming onto existing services, such as school health activities; controlling morbidity, rather than eliminating infection, is the stated goal. In order to maximize health benefits to communities that are endemic for one or both of these infections, it is vitally important that policy makers and programme managers have a clear understanding of both commonalities and differences, and implement control strategies that allocate available resources in an optimal manner.
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Affiliation(s)
- EA Padmasiri
- WHO South East Asian Regional Office, Indraprastha Estate, New Delhi 110 002, India
| | - A Montresor
- WHO Office, 63 Tran Hung Dao Street, Mail P.O. Box 52, Hanoi, Viet Nam
| | - G Biswas
- WHO, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - NR de Silva
- Faculty of Medicine, University of Kelaniya, P. O. Box 6, Ragama, Sri Lanka
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Speare R, Latasi FF, Nelesone T, Harmen S, Melrose W, Durrheim D, Heukelbach J. Prevalence of soil transmitted nematodes on Nukufetau, a remote Pacific island in Tuvalu. BMC Infect Dis 2006; 6:110. [PMID: 16836746 PMCID: PMC1560385 DOI: 10.1186/1471-2334-6-110] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2006] [Accepted: 07/12/2006] [Indexed: 11/18/2022] Open
Abstract
Background The population of Nukufetau, a remote coral atoll island in Tuvalu in the Western Pacific, received annual mass drug administration (MDA) of diethylcarbamazine and albendazole under the Pacific Elimination of Lymphatic Filariasis program in 2001, 2002 and 2003, with the last MDA occurring six months before a cross-sectional survey of the whole population for soil transmitted helminths (STH). Methods A cross-sectional survey in May 2004 recruited 206 residents (35.2% of the population) who provided a single faecal sample that was preserved, concentrated and examined microscopically. Results Overall prevalence of STH was 69.9%; only hookworm and Trichuris trichiura were diagnosed. Trichuris was present in 68.4% with intensity of infection being light in 56.3%, medium in 11.7% and heavy in 0.5%. Hookworm occurred in 11.7% with intensity of infection 11.2% being light and medium in 0.5%. Twenty individuals (9.7%) had dual infections. The prevalence of Trichuris was constant across all ages while the prevalence of hookworm was significantly lower in residents below 30 years of age. In the age group 5–12 years comparison of results with a 2001 survey [1] suggested that the prevalence of STH has declined minimally, due to sustained high prevalence of Trichuris, while hookworm has declined dramatically from 34.4% to 1.6%. Conclusion The results of this survey suggest that although the MDA appears to have reduced hookworm prevalence in residents below 30 years of age, there has been minimal effect on Trichuris prevalence. An integrated program to control STH is required.
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Affiliation(s)
- Rick Speare
- Anton Breinl Centre for Public Health and Tropical Medicine, WHO Collaborating Centre for Lymphatic Filariasis, James Cook University, Townsville 4811, Queensland, Australia
| | | | | | - Sonia Harmen
- Anton Breinl Centre for Public Health and Tropical Medicine, WHO Collaborating Centre for Lymphatic Filariasis, James Cook University, Townsville 4811, Queensland, Australia
| | - Wayne Melrose
- Anton Breinl Centre for Public Health and Tropical Medicine, WHO Collaborating Centre for Lymphatic Filariasis, James Cook University, Townsville 4811, Queensland, Australia
| | - David Durrheim
- Anton Breinl Centre for Public Health and Tropical Medicine, WHO Collaborating Centre for Lymphatic Filariasis, James Cook University, Townsville 4811, Queensland, Australia
- Health Protection, Hunter New England Population Health, Locked Bag 10, Wallsend 2287, New South Wales, Australia
| | - Jorg Heukelbach
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza CE 60430-140, Brazil
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Rajendran R, Sunish IP, Mani TR, Munirathinam A, Arunachalam N, Satyanarayana K, Dash AP. Community-based study to assess the efficacy of DEC plus ALB against DEC alone on bancroftian filarial infection in endemic areas in Tamil Nadu, south India. Trop Med Int Health 2006; 11:851-61. [PMID: 16772007 DOI: 10.1111/j.1365-3156.2006.01625.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As part of the Global Programme for Elimination of Lymphatic Filariasis (GPELF), India is implementing mass drug administration (MDA) with annual single dose of diethylcarbamazine (DEC) with and without albendazole (ALB). The impact of MDAs on filarial infections and soil-transmitted helminth (STH) infections was assessed during a 3-year period in two communities, one with DEC + ALB and the other with DEC alone. Prior to each MDA (during 2001, 2002 and 2003), filarial indices (microfilaraemia and antigenaemia) were assessed from blood samples of 450-650 persons aged 2-25 years and STH infections in stool samples (Kato-Katz method) from 325 to 500 children aged 9-10 years. Mosquitoes resting indoors were collected to determine the filarial infection status. The microfilaraemia prevalence decreased significantly (P < 0.05) in both arms, with the highest decline in the DEC + ALB arm (72%vs. 51%). Decline in micrefilaria intensity was also higher in the DEC + ALB arm (81.4%vs. 48.5%). In this arm alone, the antigenaemia prevalence was reduced significantly (62%; P < 0.001). The reduction in STH prevalence was lower in the DEC alone arm (6.5%; NS) than in the DEC + ALB arm (70.9%; P < 0.001). Also, the egg reduction in DEC alone arm was only half that of DEC + ALB arm (49%vs. 97%). Our community-based follow-up study showed higher and sustained benefits with regard to filarial and STH infections for the two-drug arm over the DEC alone arm. The trends suggest that at least 10 MDAs may be necessary to achieve the goal of elimination.
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Affiliation(s)
- R Rajendran
- Centre for Research in Medical Entomology, Madurai, India.
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Lammie PJ, Fenwick A, Utzinger J. A blueprint for success: integration of neglected tropical disease control programmes. Trends Parasitol 2006; 22:313-21. [PMID: 16713738 DOI: 10.1016/j.pt.2006.05.009] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 03/28/2006] [Accepted: 05/10/2006] [Indexed: 11/22/2022]
Abstract
The rapid expansion of chemotherapy-based control programmes for neglected tropical diseases has been catalysed by funding from the Bill and Melinda Gates Foundation, donations of several drugs from pharmaceutical manufacturers, and the reduced price of the drug praziquantel. Focussing on lymphatic filariasis, schistosomiasis and soil-transmitted helminthiasis, we review here the progress made to date with the implementation and integration of large-scale control programmes. Unresolved issues include a means for rapid identification of communities at highest risk of co-morbidity, cost-effective approaches for integrating the technical interventions into setting-specific packages, and determination of the most appropriate and sustainable delivery systems.
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Affiliation(s)
- Patrick J Lammie
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
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Oqueka T, Supali T, Ismid IS, Rückert P, Bradley M, Fischer P. Impact of two rounds of mass drug administration using diethylcarbamazine combined with albendazole on the prevalence of Brugia timori and of intestinal helminths on Alor Island, Indonesia. FILARIA JOURNAL 2005; 4:5. [PMID: 16014169 PMCID: PMC1201159 DOI: 10.1186/1475-2883-4-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2004] [Accepted: 07/13/2005] [Indexed: 11/17/2022]
Abstract
Background Annual mass drug administration (MDA) using diethylcarbamizine (DEC, 6 mg/kg) combined with albendazole (alb, 400 mg) is recommended by the Global Programme to Eliminate Lymphatic Filariasis (GPELF). This strategy has been shown to be efficient in the of control bancroftian filariasis, but data on brugian filariasis as well as on the positive side effects on intestinal helminths are lacking. Methods The effect of one selective treatment and two rounds of MDA using DEC and alb on the prevalence and intensity of Brugia timori infection were studied on Alor island using a cross-sectional and a cohort approach. Before the campaign and ten months after each treatment cycle microfilariae (mf) were assessed by filtration of night blood. Before and ten months after MDA, stool samples were collected and the prevalence of intestinal helminths were determined. Results In all, the mf-rate dropped from 26.8% before any treatment to 3.8% following the second MDA. Almost all mf-positive, treated individuals showed very low mf densities. The crude prevalence of hookworm dropped from 25.3% to 5.9%. The reduction of prevalence of Ascaris lumbricoides (32.3% to 27.6%) and Trichuris trichiura (9.4% to 8.9%) was less pronounced. Within a cohort of 226 individuals, which was examined annually, the prevalence of A. lumbricoides dropped from 43.8% to 26.5% and of T. trichiura from 12.8% to 6.6%. The results indicate that this MDA approach reduces not only the mf prevalence of B. timori but also the prevalence of hookworm and to a lesser extent also of A. lumbricoides and T. trichiura. Conclusion The MDA using DEC and alb as recommended by GPELF is extremely effective for areas with brugian filariasis. The beneficial effect of MDA on intestinal helminths may strengthen the national programme to eliminate lymphatic filariasis in Indonesia and may set resources free which are otherwise used for deworming campaigns of schoolchildren.
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Affiliation(s)
- Tim Oqueka
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, D-20359 Hamburg, Germany
| | - Taniawati Supali
- Department of Parasitology, Faculty of Medicine, University of Indonesia, Salemba 6, Jakarta 10430, Indonesia
| | - Is Suhariah Ismid
- Department of Parasitology, Faculty of Medicine, University of Indonesia, Salemba 6, Jakarta 10430, Indonesia
| | - Paul Rückert
- German Technical Co-operation (GTZ), P.O. box 1217, Kupang 85000, Indonesia
| | - Mark Bradley
- Global Community Partnerships, GlaxoSmithKline, 980 Great West Road, Brentfort Middlesex TW8 9GS, U.K
| | - Peter Fischer
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Strasse 74, D-20359 Hamburg, Germany
- Department of Internal Medicine, Infectious Diseases Division, Washington University School of Medicine, 660 S. Euclid, Campus box 8051, St. Louis, MO 63110, USA
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Mani TR, Rajendran R, Sunish IP, Munirathinam A, Arunachalam N, Satyanarayana K, Dash AP. Effectiveness of two annual, single-dose mass drug administrations of diethylcarbamazine alone or in combination with albendazole on soil-transmitted helminthiasis in filariasis elimination programme. Trop Med Int Health 2004; 9:1030-5. [PMID: 15361118 DOI: 10.1111/j.1365-3156.2004.01298.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A longitudinal community-trial on the control of soil-transmitted helminths (STHs), as part of a lymphatic filariasis elimination campaign, was taken up in two revenue blocks of southern India in the years 2001 and 2002 to assess the impact of two annual single-dose mass drug administration (MDA) of diethylcarbamazine (DEC) + albendazole (ALB) with that of DEC alone. The prevalences and intensities of STHs were studied among cross-sectional samples of school children aged 9-10 years by using the Kato-Katz technique at baseline and 11 months after each MDA. The combined drug mass treatment produced a higher reduction in the prevalence (RIP) (51-77%) and the egg reduction rate (ERR) (92-98%) compared with 12-15% RIP and 58-62% ERR of DEC alone mass treatment. The effect of two-drug therapy after two annual treatments was relatively long lasting as shown by RIP and ERR indicating that the reinfection rates were relatively lower in this approach than single-drug therapy. This study demonstrates that mass drug co-administration of DEC + ALB in Global Programme for Elimination of Lymphatic Filariasis (GPELF) targeted at the community had a synergistic and sustainable effect against soil-transmitted helminthiasis and provided considerable 'beyond filariasis' benefits. The additional advantages accrued to the community underscore the importance of scaling-up GPELF to cover the entire population at risk.
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Affiliation(s)
- T R Mani
- Centre for Research in Medical Entomology, Madurai, India.
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