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Guillot C, Bouchard C, Aenishaenslin C, Berthiaume P, Milord F, Leighton PA. Criteria for selecting sentinel unit locations in a surveillance system for vector-borne disease: A decision tool. Front Public Health 2022; 10:1003949. [PMID: 36438246 PMCID: PMC9686450 DOI: 10.3389/fpubh.2022.1003949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives With vector-borne diseases emerging across the globe, precipitated by climate change and other anthropogenic changes, it is critical for public health authorities to have well-designed surveillance strategies in place. Sentinel surveillance has been proposed as a cost-effective approach to surveillance in this context. However, spatial design of sentinel surveillance system has important impacts on surveillance outcomes, and careful selection of sentinel unit locations is therefore an essential component of planning. Methods A review of the available literature, based on the realist approach, was used to identify key decision issues for sentinel surveillance planning. Outcomes of the review were used to develop a decision tool, which was subsequently validated by experts in the field. Results The resulting decision tool provides a list of criteria which can be used to select sentinel unit locations. We illustrate its application using the case example of designing a national sentinel surveillance system for Lyme disease in Canada. Conclusions The decision tool provides researchers and public health authorities with a systematic, evidence-based approach for planning the spatial design of sentinel surveillance systems, taking into account the aims of the surveillance system and disease and/or context-specific considerations.
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Affiliation(s)
- Camille Guillot
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada,*Correspondence: Camille Guillot
| | - Catherine Bouchard
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Philippe Berthiaume
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - François Milord
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patrick A. Leighton
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada
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Turner HC, Bettis AA, Chu BK, McFarland DA, Hooper PJ, Ottesen EA, Bradley MH. The health and economic benefits of the global programme to eliminate lymphatic filariasis (2000-2014). Infect Dis Poverty 2016; 5:54. [PMID: 27388873 PMCID: PMC4937583 DOI: 10.1186/s40249-016-0147-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 05/18/2016] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Lymphatic filariasis (LF), also known as elephantiasis, is a neglected tropical disease (NTD) targeted for elimination through a Global Programme to Eliminate LF (GPELF). Between 2000 and 2014, the GPELF has delivered 5.6 billion treatments to over 763 million people. Updating the estimated health and economic benefits of this significant achievement is important in justifying the resources and investment needed for eliminating LF. METHOD We combined previously established models to estimate the number of clinical manifestations and disability-adjusted life years (DALYs) averted from three benefit cohorts (those protected from acquiring infection, those with subclinical morbidity prevented from progressing and those with clinical disease alleviated). The economic savings associated with this disease prevention was then analysed in the context of prevented medical expenses incurred by LF clinical patients, potential income loss through lost-labour, and prevented costs to the health system to care for affected individuals. The indirect cost estimates were calculated using the human capital approach. A combination of four wage sources was used to estimate the fair market value of time for an agricultural worker with LF infection (to ensure a conservative estimate, the lowest wage value was used). RESULTS We projected that due to the first 15 years of the GPELF 36 million clinical cases and 175 (116-250) million DALYs will potentially be averted. It was estimated that due to this notable health impact, US$100.5 billion will potentially be saved over the lifetimes of the benefit cohorts. This total amount results from summing the medical expenses incurred by LF patients (US$3 billion), potential income loss (US$94 billion), and costs to the health system (US$3.5 billion) that were projected to be prevented. The results were subjected to sensitivity analysis and were most sensitive to the assumed percentage of work hours lost for those suffering from chronic disease (changing the total economic benefit between US$69.30-150.7 billion). CONCLUSIONS Despite the limitations of any such analysis, this study identifies substantial health and economic benefits that have resulted from the first 15 years of the GPELF, and it highlights the value and importance of continued investment in the GPELF.
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Affiliation(s)
- Hugo C Turner
- London Centre for Neglected Tropical Disease Research, London, UK.
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Alison A Bettis
- London Centre for Neglected Tropical Disease Research, London, UK
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Brian K Chu
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA, USA
| | | | - Pamela J Hooper
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA, USA
| | - Eric A Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA, USA
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Hooper PJ, Chu BK, Mikhailov A, Ottesen EA, Bradley M. Assessing progress in reducing the at-risk population after 13 years of the global programme to eliminate lymphatic filariasis. PLoS Negl Trop Dis 2014; 8:e3333. [PMID: 25411843 PMCID: PMC4239000 DOI: 10.1371/journal.pntd.0003333] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/11/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF) as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF) began implementing mass drug administration (MDA) against LF in 2000-during which over 4.4 billion treatments have been distributed in 56 endemic countries-it is most appropriate to estimate the impact that the MDA has had on reducing the population at risk of LF. METHODOLOGY/PRINCIPAL FINDINGS To assess GPELF progress in reducing the population at-risk for LF, we developed a model based on defining reductions in risk of infection among cohorts of treated populations following each round of MDA. The model estimates that the number of people currently at risk of infection decreased by 46% to 789 million through 2012. CONCLUSIONS/SIGNIFICANCE Important progress has been made in the global efforts to eliminate LF, but significant scale-up is required over the next 8 years to reach the 2020 elimination goal.
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Affiliation(s)
- Pamela J. Hooper
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Brian K. Chu
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Alexei Mikhailov
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Eric A. Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
- ENVISION Project, RTI International, Washington D.C., United States of America
| | - Mark Bradley
- Global Health Programs, GlaxoSmithKline, London, United Kingdom
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Keating J, Yukich JO, Mollenkopf S, Tediosi F. Lymphatic filariasis and onchocerciasis prevention, treatment, and control costs across diverse settings: a systematic review. Acta Trop 2014; 135:86-95. [PMID: 24699086 DOI: 10.1016/j.actatropica.2014.03.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 03/21/2014] [Accepted: 03/23/2014] [Indexed: 11/18/2022]
Abstract
The control and eventual elimination of neglected tropical disease (NTD) requires the expansion of interventions such as mass drug administration (MDA), vector control, diagnostic testing, and effective treatment. The purpose of this paper is to present the evidence base for decision-makers on the cost and cost-effectiveness of lymphatic filariasis (LF) and onchocerciasis prevention, treatment, and control. A systematic review of the published literature was conducted. All studies that contained primary or secondary data on costs or cost-effectiveness of prevention and control were considered. A total of 52 papers were included for LF and 24 papers were included for onchocerciasis. Large research gaps exist on the synergies and cost of integrating NTD prevention and control programs, as well as research on the role of health information systems, human resource systems, service delivery, and essential medicines and technology for elimination. The literature available on costs and cost-effectiveness of interventions is also generally older, extremely focal geographically and of limited usefulness for developing estimates of the global economic burden of these diseases and prioritizing among various intervention options. Up to date information on the costs and cost-effectiveness of interventions for LF and onchocerciasis prevention are needed given the vastly expanded funding base for the control and elimination of these diseases.
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Affiliation(s)
- Joseph Keating
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States; Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States.
| | - Joshua O Yukich
- Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States; Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States.
| | - Sarah Mollenkopf
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, United States.
| | - Fabrizio Tediosi
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4001 Basel, Switzerland; University of Basel, Switzerland; Centre for Research on Health and Social Care Management (CERGAS), Università Bocconi, Milan, Italy.
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Richards FO, Emukah E, Graves PM, Nkwocha O, Nwankwo L, Rakers L, Mosher A, Patterson A, Ozaki M, Nwoke BEB, Ukaga CN, Njoku C, Nwodu K, Obasi A, Miri ES. Community-wide distribution of long-lasting insecticidal nets can halt transmission of lymphatic filariasis in southeastern Nigeria. Am J Trop Med Hyg 2013; 89:578-87. [PMID: 23939708 PMCID: PMC3771303 DOI: 10.4269/ajtmh.12-0775] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 05/17/2013] [Indexed: 11/07/2022] Open
Abstract
Lymphatic filariasis (LF) in rural southeastern Nigeria is transmitted mainly by Anopheles spp. mosquitoes. Potential coinfection with Loa loa in this area has prevented use of ivermectin in the mass drug administration (MDA) strategy for LF elimination because of potential severe adverse L. loa-related reactions. This study determined if long-lasting insecticidal net (LLIN) distribution programs for malaria would interrupt LF transmission in such areas, without need for MDA. Monthly entomologic monitoring was conducted in sentinel villages before and after LLIN distribution to all households and all age groups (full coverage) in two districts, and to pregnant women and children less than five years of age in the other two districts. No change in human LF microfilaremia prevalence was observed, but mosquito studies showed a statistically significant decrease in LF infection and infectivity with full-coverage LLIN distribution. We conclude that LF transmission can be halted in southeastern Nigeria by full-coverage LLIN distribution, without MDA.
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Affiliation(s)
- Frank O Richards
- Malaria, River Blindness, Lymphatic Filariasis, and Schistosomiasis Programs, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, USA.
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Koroma JB, Sesay S, Sonnie M, Hodges MH, Sahr F, Zhang Y, Bockarie MJ. Impact of three rounds of mass drug administration on lymphatic filariasis in areas previously treated for onchocerciasis in Sierra Leone. PLoS Negl Trop Dis 2013; 7:e2273. [PMID: 23785535 DOI: 10.1371/journal.pntd.0002273] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 05/06/2013] [Indexed: 11/19/2022] Open
Abstract
Background 1974–2005 studies across Sierra Leone showed onchocerciasis endemicity in 12 of 14 health districts (HDs) and baseline studies 2005–2008 showed lymphatic filariasis (LF) endemicity in all 14 HDs. Three integrated annual mass drug administration (MDA) were conducted in the 12 co-endemic districts 2008–2010 with good geographic, programme and drug coverage. Midterm assessment was conducted 2011 to determine impact of these MDAs on LF in these districts. Methodology/Principal Findings The mf prevalence and intensity in the 12 districts were determined using the thick blood film method and results compared with baseline data from 2007–2008. Overall mf prevalence fell from 2.6% (95% CI: 2.3%–3.0%) to 0.3% (95% CI: 0.19%–0.47%), a decrease of 88.5% (p = 0.000); prevalence was 0.0% (100.0% decrease) in four districts: Bo, Moyamba, Kenema and Kono (p = 0.001, 0.025, 0.085 and 0.000 respectively); and seven districts had reductions in mf prevalence of between 70.0% and 95.0% (p = 0.000, 0.060, 0.001, 0.014, 0.000, 0.000 and 0.002 for Bombali, Bonthe, Kailahun, Kambia, Koinadugu, Port Loko and Tonkolili districts respectively). Pujehun had baseline mf prevalence of 0.0%, which was maintained. Only Bombali still had an mf prevalence ≥1.0% (1.58%, 95% CI: 0.80%–3.09%)), and this is the district that had the highest baseline mf prevalence: 6.9% (95% CI: 5.3%–8.8%). Overall arithmetic mean mf density after three MDAs was 17.59 mf/ml (95% CI: 15.64 mf/ml–19.55 mf/ml) among mf positive individuals (65.4% decrease from baseline of 50.9 mf/ml (95% CI: 40.25 mf/ml–61.62 mf/ml; p = 0.001) and 0.05 mf/ml (95% CI: 0.03 mf/ml–0.08 mf/ml) for the entire population examined (96.2% decrease from baseline of 1.32 mf/ml (95% CI: 1.00 mf/ml–1.65 mf/ml; p = 0.000)). Conclusions/Significance The results show that mf prevalence decreased to <1.0% in all but one of the 12 districts after three MDAs. Overall mf density reduced by 65.0% among mf-positive individuals, and 95.8% for the entire population. Onchocerciasis studies across Sierra Leone between 1974 and 2005 showed that 12 of the 14 health districts (HDs) are endemic for onchocerciasis. Baseline lymphatic filariasis (LF) studies 2005–2008 showed that all 14 HDs of Sierra Leone are LF endemic. Three annual rounds of integrated mass drug administration (MDA) with ivermectin and albendazole 2008–2010 were conducted in the 12 HDs that are co-endemic for onchocerciasis and LF with good geographic, epidemiological drug (or programme) and drug coverage. A midterm evaluation study of mf prevalence and density was conducted in the 12 HDs in 2011. The hypothesis proposed for this study is that areas previously exposed to ivermectin treatment for onchocerciasis control may require less rounds of annual MDA to eliminate LF (i.e. reduce microfilaremia (mf) prevalence to <1%). Results of the midterm evaluation study showed very significant and rapid reduction of mf prevalence and density with 11 out of the 12 districts having mf prevalence <1%. Relatively low LF baseline prevalence and effective integrated MDA for onchocerciasis and LF have led to rapid reduction in LF prevalence.
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Okorie PN, McKenzie FE, Ademowo OG, Bockarie M, Kelly-Hope L. Nigeria Anopheles vector database: an overview of 100 years' research. PLoS One 2011; 6:e28347. [PMID: 22162764 PMCID: PMC3230596 DOI: 10.1371/journal.pone.0028347] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 11/07/2011] [Indexed: 11/19/2022] Open
Abstract
Anopheles mosquitoes are important vectors of malaria and lymphatic filariasis (LF), which are major public health diseases in Nigeria. Malaria is caused by infection with a protozoan parasite of the genus Plasmodium and LF by the parasitic worm Wuchereria bancrofti. Updating our knowledge of the Anopheles species is vital in planning and implementing evidence based vector control programs. To present a comprehensive report on the spatial distribution and composition of these vectors, all published data available were collated into a database. Details recorded for each source were the locality, latitude/longitude, time/period of study, species, abundance, sampling/collection methods, morphological and molecular species identification methods, insecticide resistance status, including evidence of the kdr allele, and P. falciparum sporozoite rate and W. bancrofti microfilaria prevalence. This collation resulted in a total of 110 publications, encompassing 484,747 Anopheles mosquitoes in 632 spatially unique descriptions at 142 georeferenced locations being identified across Nigeria from 1900 to 2010. Overall, the highest number of vector species reported included An. gambiae complex (65.2%), An. funestus complex (17.3%), An. gambiae s.s. (6.5%). An. arabiensis (5.0%) and An. funestus s.s. (2.5%), with the molecular forms An. gambiae M and S identified at 120 locations. A variety of sampling/collection and species identification methods were used with an increase in molecular techniques in recent decades. Insecticide resistance to pyrethroids and organochlorines was found in the main Anopheles species across 45 locations. Presence of P. falciparum and W. bancrofti varied between species with the highest sporozoite rates found in An. gambiae s.s, An. funestus s.s. and An. moucheti, and the highest microfilaria prevalence in An. gambiae s.l., An. arabiensis, and An. gambiae s.s. This comprehensive geo-referenced database provides an essential baseline on Anopheles vectors and will be an important resource for malaria and LF vector control programmes in Nigeria.
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Affiliation(s)
- Patricia Nkem Okorie
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Richards FO, Eigege A, Miri ES, Kal A, Umaru J, Pam D, Rakers LJ, Sambo Y, Danboyi J, Ibrahim B, Adelamo SE, Ogah G, Goshit D, Oyenekan OK, Mathieu E, Withers PC, Saka YA, Jiya J, Hopkins DR. Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria. PLoS Negl Trop Dis 2011; 5:e1346. [PMID: 22022627 PMCID: PMC3191131 DOI: 10.1371/journal.pntd.0001346] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 08/22/2011] [Indexed: 11/18/2022] Open
Abstract
The current strategy for interrupting transmission of lymphatic filariasis (LF) is annual mass drug administration (MDA), at good coverage, for 6 or more years. We describe our programmatic experience delivering the MDA combination of ivermectin and albendazole in Plateau and Nasarawa states in central Nigeria, where LF is caused by anopheline transmitted Wuchereria bancrofti. Baseline LF mapping using rapid blood antigen detection tests showed mean local government area (LGA) prevalence of 23% (range 4–62%). MDA was launched in 2000 and by 2003 had been scaled up to full geographic coverage in all 30 LGAs in the two states; over 26 million cumulative directly observed treatments were provided by community drug distributors over the intervention period. Reported treatment coverage for each round was ≥85% of the treatment eligible population of 3.7 million, although a population-based coverage survey in 2003 showed lower coverage (72.2%; 95% CI 65.5–79.0%). To determine impact on transmission, we monitored three LF infection parameters (microfilaremia, antigenemia, and mosquito infection) in 10 sentinel villages (SVs) serially. The last monitoring was done in 2009, when SVs had been treated for 7–10 years. Microfilaremia in 2009 decreased by 83% from baseline (from 4.9% to 0.8%); antigenemia by 67% (from 21.6% to 7.2%); mosquito infection rate (all larval stages) by 86% (from 3.1% to 0.4%); and mosquito infectivity rate (L3 stages) by 76% (from 1.3% to 0.3%). All changes were statistically significant. Results suggest that LF transmission has been interrupted in 5 of the 10 SVs, based on 2009 finding of microfilaremia ≥1% and/or L3 stages in mosquitoes. Four of the five SVs where transmission persists had baseline antigenemia prevalence of >25%. Longer or additional interventions (e.g., more frequent MDA treatments, insecticidal bed nets) should be considered for ‘hot spots’ where transmission is ongoing. Lymphatic filariasis is a mosquito transmitted disease that is best known for causing elephantiasis (grossly swollen legs and genitals). The current strategy for halting lymphatic filariasis in sub Saharan Africa is to establish programs that deliver 6 or more years of annual doses of tablets in community wide treatment programs (called mass drug administration). The tablets are safe, and donated by Merck & Co. and GlaxoSmithKline. We describe a mass drug administration program in central Nigeria that has, since 2000, provided over 23 million cumulative annual treatments to a population of 3.7 million persons. To assess what should be happening generally throughout the program area, lymphatic filariasis infection was monitored in ten ‘sentinel villages.’ In 2009, sentinel village monitoring showed that lymphatic filariasis infection had been reduced between 67–86% compared to levels present when the program began. However, these results were not as good as desired, and suggest that longer or increased efforts are needed beyond 6 years if lymphatic filariasis elimination is to be achieved.
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Affiliation(s)
| | | | | | | | | | - Davou Pam
- University of Jos, Plateau State, Jos, Nigeria
| | - Lindsay J. Rakers
- The Carter Center, Atlanta, Georgia, United States of America
- * E-mail:
| | | | | | | | | | - Gladys Ogah
- Nasarawa State Ministry of Health, Lafia, Nigeria
| | | | | | - Els Mathieu
- Centers for Disease Control, Atlanta, Georgia, United States of America
| | | | - Yisa A. Saka
- Nigeria Federal Ministry of Health, Abuja, Nigeria
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Bush S, Hopkins A. Public-private partnerships in neglected tropical disease control: the role of nongovernmental organisations. Acta Trop 2011; 120 Suppl 1:S169-72. [PMID: 21470555 DOI: 10.1016/j.actatropica.2011.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 11/24/2010] [Accepted: 01/18/2011] [Indexed: 10/18/2022]
Abstract
Successful public-private partnerships for health control have usually included nongovernmental development organisations (NGDOs), and these have long been in the forefront of pinpointing particular social and health issues. The immensely successful control and elimination programmes for onchocerciasis are a case in point. NGDOs were the driving force in early advocacy for onchocerciasis control in West Africa, leading eventually to the remarkably effective and long lasting partnership of the Onchocerciasis Control Programme (OCP). With the donation of Mectizan(®), NGDOs were the driving force in developing onchocerciasis control in non-OCP countries, especially programmes for community based action. These were, further modified by the African Programme for Onchocerciasis Control (APOC) to become the successful Community Directed Interventions. NGDOs came together to coordinate activities in partnership with the World Health Organisation (WHO). Innovations by NGDOs led to integration of mass drug administration for Vitamin A deficiency and then for other parasitic diseases, leading to the current trend of preventive chemotherapy. The success of the NGDO Group for Onchocerciasis Control has led to the creation of similar groups for trachoma control and lymphatic filariasis elimination. These groups have now come together to form an NGDO Network for Neglected Tropical Disease control.
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Ramaiah KD, Vanamail P, Yuvaraj J, Das PK. Effect of annual mass administration of diethylcarbamazine and albendazole on bancroftian filariasis in five villages in south India. Trans R Soc Trop Med Hyg 2011; 105:431-7. [PMID: 21601901 DOI: 10.1016/j.trstmh.2011.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 04/08/2011] [Accepted: 04/08/2011] [Indexed: 11/23/2022] Open
Abstract
Annual mass drug administration (MDA) is the recommended strategy for lymphatic filariasis (LF) elimination. We assessed the effect of six rounds of mass administration of diethylcarbamazine (DEC) and albendazole (ALB) on microfilaria (Mf) prevalence and intensity and vector infection and infectivity rates and circulating filarial antigenaemia (CFA) in a group of five villages in south India, endemic for Culex-transmitted bancroftian filariasis. During different rounds of MDA, 60-70% of the eligible population (>15 kg body weight) was treated. The MDA reduced the Mf prevalence from 8.10% (CI 6.18-10.01) to 1.01% (CI 0.31-1.71) (P<0.05) and geometric mean intensity of Mf from 0.31 (CI 0.22-0.40) to 0.02 (CI 0.00-0.04) (P<0.05), equivalent to a fall of 86% and 94% respectively. The vector infection and infectivity rates declined from 13.11% (CI 11.52-14.70) to 0.78% (CI 0.16-1.40) (P<0.05) and 1.04% (CI 0.56-1.52) to 0.13% (CI 0.00-0.39) (P<0.05), respectively. Four out of the five villages recorded <0.5% Mf prevalence and 0% vector infection rate. Circulating filarial antigenaemia (CFA) fell by 86% in the total population and 100% in 1-10 year old children. One of the five villages, which showed the highest baseline vector infection rate, showed >1.0% Mf rate. The results suggest that six rounds of mass administration of DEC and ALB, with 60-70% treatment coverage, is likely to achieve total interruption of transmission and elimination of LF in the majority of villages.
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Fernando SD, Rodrigo C, Rajapakse S. Current evidence on the use of antifilarial agents in the management of bancroftian filariasis. J Trop Med 2011; 2011:175941. [PMID: 21234244 DOI: 10.1155/2011/175941] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Accepted: 11/29/2010] [Indexed: 11/17/2022] Open
Abstract
Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis.
Diethylcarbamazine (DEC) remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM) is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB) in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA) are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level.
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Vanamail P, Gunasekaran S. Possible relationship among socio-economic determinants, knowledge and practices on lymphatic filariasis and implication for disease elimination in India. Int J Public Health 2011; 56:25-36. [PMID: 20549294 DOI: 10.1007/s00038-010-0159-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 04/30/2010] [Accepted: 05/06/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To assess the socio-economic determinants, knowledge and practices on lymphatic filariasis in India and discuss the implications for elimination. METHODS A case-control study was undertaken to obtain knowledge and practice measures on various dimensions of the Wuchereria bancroftian filarial disease using a structured questionnaire. A structural equation model, a statistical technique for testing and estimating causal relationships using a combination of statistical data and qualitative causal assumptions, was developed. RESULTS Among the affected individuals, the model was able to explain more than 90% of the variance in awareness about the lymphatic filariasis, 58% of the variance in prevention aspects of the disease and 24% of the variance in people's knowledge about mosquitoes. The corresponding values in non-infected individuals were 49, 24 and 34%, respectively. A significant positive effect of education on awareness and prevention aspects of the disease was noted among the non-infected individuals. However, among the affected individuals, the awareness on various aspects of the disease was completely absent. CONCLUSIONS The present analysis highlights the crucial role played by formal education on creating awareness about lymphatic filariasis and how to prevent this vector-borne disease. The importance of education on intervention measures against mosquito breeding and biting is also dealt with in the analysis for planning an effective and sustainable control program.
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Ottesen EA, Hooper PJ, Bradley M, Biswas G. The global programme to eliminate lymphatic filariasis: health impact after 8 years. PLoS Negl Trop Dis 2008; 2:e317. [PMID: 18841205 PMCID: PMC2556399 DOI: 10.1371/journal.pntd.0000317] [Citation(s) in RCA: 195] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 09/15/2008] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In its first 8 years, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) achieved an unprecedentedly rapid scale-up: >1.9 billion treatments with anti-filarial drugs (albendazole, ivermectin, and diethylcarbamazine) were provided via yearly mass drug administration (MDA) to a minimum of 570 million individuals living in 48 of the 83 initially identified LF-endemic countries. METHODOLOGY To assess the health impact that this massive global effort has had, we analyzed the benefits accrued first from preventing or stopping the progression of LF disease, and then from the broader anti-parasite effects ('beyond-LF' benefits) attributable to the use of albendazole and ivermectin. Projections were based on demographic and disease prevalence data from publications of the Population Reference Bureau, The World Bank, and the World Health Organization. RESULT Between 2000 and 2007, the GPELF prevented LF disease in an estimated 6.6 million newborns who would otherwise have acquired LF, thus averting in their lifetimes nearly 1.4 million cases of hydrocele, 800,000 cases of lymphedema and 4.4 million cases of subclinical disease. Similarly, 9.5 million individuals--previously infected but without overt manifestations of disease--were protected from developing hydrocele (6.0 million) or lymphedema (3.5 million). These LF-related benefits, by themselves, translate into 32 million DALYs (Disability Adjusted Life Years) averted. Ancillary, 'beyond-LF' benefits from the >1.9 billion treatments delivered by the GPELF were also enormous, especially because of the >310 million treatments to the children and women of childbearing age who received albendazole with/without ivermectin (effectively treating intestinal helminths, onchocerciasis, lice, scabies, and other conditions). These benefits can be described but remain difficult to quantify, largely because of the poorly defined epidemiology of these latter infections. CONCLUSION The GPELF has earlier been described as a 'best buy' in global health; this present tally of attributable health benefits from its first 8 years strengthens this notion considerably.
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Affiliation(s)
- Eric A Ottesen
- Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia, United States of America.
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Grady CA, Beau de Rochars M, Direny AN, Orelus JN, Wendt J, Radday J, Mathieu E, Roberts JM, Streit TG, Addiss DG, Lammie PJ. Endpoints for lymphatic filariasis programs. Emerg Infect Dis 2007; 13:608-10. [PMID: 17553278 PMCID: PMC2725965 DOI: 10.3201/eid1304.061063] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
In 2000, annual mass administration of diethlycarbamazine and albendazole began in Leogane Commune, Haiti, to interrupt transmission of lymphatic filariasis (LF). After 5 years of treatment, microfilaremia, antigenemia, and mosquito infection rates were significantly reduced, but LF transmission was not interrupted. These finding have implications for other LF elimination programs.
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Affiliation(s)
| | | | | | | | - Joyanna Wendt
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeanne Radday
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Els Mathieu
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - David G. Addiss
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Abstract
PURPOSE OF REVIEW Ivermectin was first discovered and used in veterinary medicine over 20 years ago. This review highlights some of the recent published research from 2005 through June 2006 on the use of ivermectin in both helminth and arthropod infection. RECENT FINDINGS In recent years, several published studies have detailed the expanding role for ivermectin in multiple endo and ectoparasitic infections, including scabies, pediculosis, soil transmitted helminths, gnathostomiasis and myiasis. In addition, there is increasing experience with parenteral ivermectin for the treatment of disseminated strongyloidiasis. The success of ivermectin in reducing Onchocerca volvulus and Wuchereria bancrofti transmission through universal treatment in disease control programs continues to be well documented, but recent epidemiologic data describe suboptimal response to ivermectin by O. volvulus in a minority of individuals, the molecular markers for which are currently under investigation. SUMMARY Over 20 years of research and clinical use have advanced ivermectin from its beginnings as a veterinary anthelmintic to its significant role in several successful disease control programs. Nevertheless, further research is needed to understand the basis for suboptimal response and to better define optimal drug regimens for varying diseases.
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Affiliation(s)
- Leanne M Fox
- Division of Infectious Diseases, Children's Hospital, Boston, Massachusetts 02115, USA.
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Kyelem D, Medlock J, Sanou S, Bonkoungou M, Boatin B, Molyneux DH. Short communication: Impact of long-term (14 years) bi-annual ivermectin treatment on Wuchereria bancrofti microfilaraemia. Trop Med Int Health 2005; 10:1002-4. [PMID: 16185234 DOI: 10.1111/j.1365-3156.2005.01489.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ivermectin has been and continues to be extensively used to control onchocerciasis in areas of hyper and mesoendemicity within the African Programme of Onchocerciasis Control. As programmes to eliminate lymphatic filariasis (LF) caused by Wuchereria bancrofti expand, areas of coendemicity with onchocerciasis will be incorporated into LF programmes. This study reports that in villages which were hyperendemic for onchocerciasis after some 14 years of treatment with ivermectin, no W. bancrofti could be detected in a population of 1210 individuals whilst in adjacent villages a prevalence of around 3% was found. Despite the long period of ivermectin treatment Mansonella perstans did not appear to respond to ivermectin in this setting.
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Affiliation(s)
- D Kyelem
- Liverpool School of Tropical Medicine, Liverpool, UK
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Richards FO, Eigege A, Pam D, Kal A, Lenhart A, Oneyka JOA, Jinadu MY, Miri ES. Mass ivermectin treatment for onchocerciasis: lack of evidence for collateral impact on transmission of Wuchereria bancrofti in areas of co-endemicity. Filaria J 2005; 4:6. [PMID: 16022728 PMCID: PMC1208930 DOI: 10.1186/1475-2883-4-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Accepted: 07/15/2005] [Indexed: 11/10/2022]
Abstract
There has long been interest in determining if mass ivermectin administration for onchocerciasis has 'unknowingly' interrupted lymphatic filariasis (LF) transmission where the endemicity of the two diseases' overlaps. We studied 11 communities in central Nigeria entomologically for LF by performing mosquito dissections on Anopheline LF vectors. Six of the communities studied were located within an onchocerciasis treatment zone, and five were located outside of that zone. Communities inside the treatment zone had been offered ivermectin treatment for two-five years, with a mean coverage of 81% of the eligible population (range 58-95%). We found 4.9% of mosquitoes were infected with any larval stage of W. bancrofti in the head or thorax in 362 dissections in the untreated villages compared to 4.7% infected in 549 dissections in the ivermectin treated villages (Mantel-Haenszel ChiSquare 0.02, P = 0.9). We concluded that ivermectin annual therapy for onchocerciasis has not interrupted transmission of Wuchereria bancrofti (the causative agent of LF in Nigeria).
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Affiliation(s)
- FO Richards
- The Carter Center, One Copenhill, Atlanta GA 30307, USA
| | - A Eigege
- The Carter Center, One Copenhill, Atlanta GA 30307, USA
| | - D Pam
- Department of Zoology, University of Jos, Jos, Plateau State, Nigeria
| | - A Kal
- The Carter Center, One Copenhill, Atlanta GA 30307, USA
| | - A Lenhart
- The Carter Center, One Copenhill, Atlanta GA 30307, USA
| | - JOA Oneyka
- Department of Zoology, University of Jos, Jos, Plateau State, Nigeria
| | - MY Jinadu
- Room 913, Phase II, Federal Secretariat, Federal Ministry of Health, Lagos, Nigeria
| | - ES Miri
- The Carter Center, One Copenhill, Atlanta GA 30307, USA
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