Abstract
BackgroundThe objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been subjected to mass drug administration (MDA) and in places adjoining these endemic areas. While three municipalities in Brazil have completed MDA, the epidemiological situation remains uncertain in nine adjoining municipalities. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil.Methodology/Principle findingsFor review of the literature, both formal and informal literature sources were accessed since the first reports of filariasis in the Metropolitan Region of Recife, Brazil. We conducted a school-based survey in 2016 using immunochromatographic card tests (ICTs) among schoolchildren aged 6–10 years living in nine municipalities contiguous with the endemic areas in which MDA was conducted. Our review of the literature identified eight studies involving surveys demonstrating that microfilariae had been circulating in eight of the municipalities since 1967, with a low prevalence of microfilaremia, isolated autochthonous cases, and treatment of individual cases. The school-based survey included 17,222 children in 185 urban schools in the nine areas of Brazil with uncertain endemicity. One child affected by allochthonous transmission was antigen positive based on ICT and lived in a municipality adjacent to Recife; this child’s family came from Recife, but no other case was diagnosed within the family.Conclusions/SignificanceThe study results suggest that there is no transmission of LF in the municipalities investigated. However, these areas have population migration and socioenvironmental conditions favorable to mosquito breeding grounds; therefore, surveillance is strongly recommended in these areas.
Highlights
Lymphatic filariasis (LF) is a neglected tropical disease [1]
A review of data starting in 1967 from eight scientific reports highlighted the circulation of microfilaremia, infection of Culex quinquefasciatus with Wuchereria bancrofti, and morbidity owing to lymphatic filariasis
One child from a municipality in which mass drug administration (MDA) was conducted tested positive for lymphatic filariasis, but no other case was diagnosed in her family
Summary
Lymphatic filariasis (LF) is a neglected tropical disease [1]. Currently, 790 million people are at a risk of filariasis, 68 million are infected, and further 20 million experience chronic morbidity owing to this disease [2]. In Brazil, LF is a parasitic disease caused by Wuchereria bancrofti and transmitted by the Culex quinquefasciatus mosquito vector. This disease is limited to urban areas, and only four municipalities in the Metropolitan Region of Recife -State of Pernambuco are endemic: Recife, Olinda, Jaboatão dos Guararapes, and Paulista [6,7]. The objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil
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