An independent evaluation of the national programme for the elimination of lymphatic filariasis

Tc Yahathugoda,Wa Samarawickrema,Mv Weerasooriya

doi:10.4038/gmj.v18i1.5514

Tc Yahathugoda, Wa Samarawickrema + Show 1 more

Open Access

https://doi.org/10.4038/gmj.v18i1.5514

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Journal: Galle Medical Journal	Publication Date: May 8, 2013
Citations: 5	License type: cc-by

Affiliation: University of Ruhuna

Abstract

This review covers studies carried out by an independent research group related to the national programme for the elimination of lymphatic filariasis. Research carried out under each step of the elimination ladder provided new information to assist future activities of the programme. For disease mapping a Rapid assessment procedure (RAP) has been validated. A positive significant correlation was established between ordinary peoples' information on filariasis prevalence and actual infection status based on clinical and immunological examinations. The data on hydrocoele, elephantiasis and socioeconomic indicators obtained by RAP through GN s of Hambantota, Matara and Galle were subjected to Geographical Information System (GIS) using TNTmips software and maps were prepared to analyse the disease distribution. National Mass Drug Administrations (MDAs) were monitored and evaluated. Overall drug coverage had reached 80% except in municipality areas. The community-wide treatments suppressed the mf prevalence and density to significantly low levels. The effect of MDAs on soil-transmitted helminthiasis was also studied. A significant decline was observed in the prevalence. At verification stage, sites in endemic and non-endemic zones were checked with most reliable urine ELISA method. Results showed low level of ongoing transmission at non-threatening level. Before lymphoedema management programme, the information on lymphoedema and its management was collected. Many had acute inflammatory episodes (AIEs) with fever. Components of lymphoedema management protocol (LMP) were ignored by many. LMP was then applied to a sample of 27 patients: 14 were monitored daily as daily follow-up group (DFU) and 13 once a month as monthly follow-up group (MFU). Evaluations were carried out at one year and found that the benefits received were significantly higher in DFU. Galle Medical Journal, Vol 18: No. 1, March 2013:Page 31-43 DOI: http://dx.doi.org/10.4038/gmj.v18i1.5514

Highlights

The national Anti-Filariasis Campaign (AFC) was inaugurated in 1947 when Wuchereria bancrofti infection was confined to coastal endemic belt extending from Negombo to Matara and several high endemic foci of Brugia malayi were located at Southern, Western Northwestern and Eastern provinces (Figure 1)
The estimate of community hydrocoele prevalence obtained by ordinary people (IndQ) showed a positive and significant correlation with the clinical levels determined by clinicians (CE) and the prevalence levels by urine ELISA
Ordinary people's information on lymphatic filariasis prevalence can be used as preliminary information to identify endemic areas

Summary

Introduction

The national Anti-Filariasis Campaign (AFC) was inaugurated in 1947 when Wuchereria bancrofti infection was confined to coastal endemic belt extending from Negombo to Matara and several high endemic foci of Brugia malayi were located at Southern, Western Northwestern and Eastern provinces (Figure 1). Indirect questionnaire method (IndQ) (RAP) was validated using hydrocoele prevalence (% males) by clinicians (CE) and urine ELISA (IgG4) in a study carried out at Hambantota (8). Matara municipality showed much improved Figures of 97.8% awareness of the MDA and 78.1% drug coverage compared to Colombo.

Results

Conclusion