Pacific program eliminate lymphatic filariasis

We hope that these success stories will be both a source of inspiration to the other regions of the world also engaged in such effort and a source of justifiable pride to all the countries and territories in the Pacific. Peter Wood prepared the maps. We are also grateful to the countries, program managers, and people of the Pacific Island countries and territories who participated in and supported this work.

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KI conceived of the special issue with bibliography and wrote the first draft of the editorial, which was later completed by PG and KI. KI and PG prepared and checked the biliography. Both authors read and approved the final manuscript. Correspondence to Kazuyo Ichimori. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Bibliography of published literature on lymphatic filariasis in the Pacific, Australia, and Japan, to July DOCX 86 kb. Reprints and Permissions. Ichimori, K. Trop Med Health 45, 34 Download citation. Received : 11 August Accepted : 25 October Published : 01 November Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Map 1. In Niue three cross-sectional population surveys were conducted. Niue reported an initial prevalence of 3. After two and five rounds of MDA, prevalence dropped to 1. Niue provides a unique case study because reliable cross-sectional population data was available.

Mathematical modelling by Michael et al has predicted that post-MDA LF prevalence will be influenced by higher LF prevalence at baseline, high MDA coverage and the use of vector control measures [ 11 ]. Unfortunately, inaccurate initial prevalence data preclude exact determination of the change in prevalence for these case study countries, other than Niue.

A relatively low initial prevalence 3. The remaining two countries Cook Islands and Samoa closely approached but failed to achieve that target. Local vector species and control strategies differ between the case study countries. In addition, Samoa has Ae. This mosquito species is of particular concern in the Pacific region, as there are currently no effective measures of control and it exhibits a trait called "limitation", meaning the mosquito becomes more efficient at transmitting LF when the prevalence within the population is low [ 12 ].

Vanuatu's primary LF vector is an Anopheles sp. Vanuatu has been implementing a treated bed-net programme since Models theorise that adding vector control to MDA campaigns will decrease the number of years required to meet the target prevalence, for a given baseline endemicity [ 11 ]. Again, the contribution of an Anopheles vector and a treated bed-net programme on the post-MDA prevalence of 0. Unfortunately, a lack of data precludes conclusions being drawn about which factors influenced the apparent decrease in prevalence for these countries and the degree to which MDA was associated with a decrease.

Most countries used non-standardised methods, with different sample sizes and convenience sampling to establish their prevalence at the start of the programme. While this is understandable due to logistic issues that are common in developing countries [ 13 ], it limits comparisons between initial and post-MDA LF antigenaemia prevalence except in Niue where the entire available population was included in each survey.

Similarly, a coverage survey was not carried out to assess the true coverage achieved. It is likely that higher MDA coverage has contributed to the low prevalence measured in the countries that achieved the programme target.

However, it is unfortunate that data limitations preclude exploration of the relationship between coverage levels and program performance. Inaccurate denominator population statistics are common in the Pacific and other regions in the world where LF programmes are underway or planned. Therefore, an independent means of assessing MDA coverage should be considered. Even if true denominator data was available for each country for every year, estimates of MDA coverage should be viewed with some caution, as it may only reflect drug distribution, rather than drug consumption.

Anecdotal reports to the WHO advised that the majority of Pacific MDAs were not "directly observed therapy", and as such, it is unknown whether all drugs were consumed. Directly observed therapy is highly recommended for LF programmes as it may increase compliance with drug administration and allow a more accurate estimate of MDA coverage. Community members who do not participate in MDA may serve as reservoirs of LF infection [ 15 ] and it has been recommended that social research approaches should be used to explore barriers to MDA compliance [ 16 , 17 ].

Clearly administration of targeted MDA will require the identification of groups that do not participate in the MDA and a recommendation of a minimum coverage to be reached. The use of appropriate social science methods in conjunction with a representative MDA coverage survey, could independently measure MDA coverage as well as uncover attitudes, behaviours or beliefs that may impact on the success of future LF elimination efforts.

Coverage surveys should also determine what proportion of doses was actually administered under direct observation. It is encouraging to observe that countries in the Pacific Programme to Eliminate Lymphatic Filariasis are achieving their LF elimination targets.

Although four to six rounds of MDA appear to diminish antigenaemia prevalence, essential for interrupting LF transmission, it is likely that baseline prevalence, MDA coverage and the presence of an efficient vector, such as Aedes polynesiensis , are important determinants of post-MDA outcome. This case study from the Pacific highlights the importance of collecting valid and representative data before initiating and during the delivery of public health programmes to learn about the factors that inhibit or promote target attainment.

Article PubMed Google Scholar. Google Scholar. Bull World Health Organ. Trop Med Int Health. Filaria J. Ottesen EA: Lymphatic filariasis: Treatment, control and elimination. Adv Parasitol. Geneva, Switzerland. Parasitol Today. Edited by: Pezzullo JC. Babu BV, Kar SK: Coverage, compliance and some operational issues of mass drug administration during the programme to eliminate lymphatic filariasis in Orissa, India. Download references.

Healthy and productive individuals and families for Filariasis-Free Philippines. Elimination of Filariasis as a public health problem thru comprehensive approach and universal access to quality health services. Filariasis is a major parasitic infection, which continues to be a public health problem in the Philippines.

It was first discovered in the Philippines in by foreign workers. Consolidated field reports showed a prevalence rate of 9. It is the second leading cause of permanent and long-term disability.