Abstract
BackgroundThe Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000, and nearly all endemic countries in the Americas, Eastern Mediterranean and Asia-Pacific regions have now initiated the WHO recommended mass drug administration (MDA) campaign to interrupt transmission of the parasite. However, nearly 50% of the LF endemic countries in Africa are yet to implement the GPELF MDA strategy, which does not include vector control. Nevertheless, the recent scale up in insecticide treated /long lasting nets (ITNs/LLINs) and indoor residual spraying (IRS) for malaria control in Africa may significantly impact LF transmission because the parasite is transmitted mainly by Anopheles mosquitoes. This study examined the magnitude, geographical extent and potential impact of vector control in the 17 African countries that are yet to or have only recently started MDA.MethodsNational data on mosquito bed nets, ITNs/LLINs and IRS were obtained from published literature, national reports, surveys and datasets from public sources such as Demographic Health Surveys, Malaria Indicator Surveys, Multiple Indicator Cluster Surveys, Malaria Report, Roll Back Malaria and President’s Malaria Initiative websites. The type, number and distribution of interventions were summarised and mapped at sub-national level. and compared with known or potential LF distributions, and those which may be co-endemic with Loa loa and MDA is contraindicated.ResultsAnalyses found that vector control activities had increased significantly since 2005, with a three-fold increase in ITN ownership and IRS coverage. However, coverage varied dramatically across the 17 countries; some regions reported >70% ITNs ownership and regular IRS activity, while others had no coverage in remote rural populations where the risk of LF was potentially high and co-endemic with high risk L.loa.ConclusionsDespite many African countries being slow to initiate MDA for LF, the continued commitment and global financial support for NTDs, and the concurrent expansion of vector control activities for malaria, is promising. It is not beyond the capacity of GPELF to reach its target of global LF elimination by 2020, but monitoring and evaluating the impact of these activities over the next decade will be critical to its success.
Highlights
The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000, and most endemic countries in the Americas, Eastern Mediterranean and Asia-Pacific regions have initiated the World Health Organization (WHO) recommended mass drug administration (MDA) campaign to interrupt transmission of the parasite
For all countries to fully benefit from this global effort, it must address the slow progress in Africa where half of the 34 endemic countries have not or have only just started to implement the GPELF intervention strategy for LF elimination, which does not promote vector control, despite the suggestion of the need to link malaria and LF activities for mutual benefit [3,4,5], and the widespread evidence of the value of vector control in the control/ elimination of LF [6,7]
In total 8 countries are considered to be co-endemic with W. bancrofti and L.loa with the greatest risk of L. loa and severe adverse events (SAEs) in Central Africa Republic (CAR), Congo, Democratic Republic of Congo (DRC), Equatorial Guinea, Gabon and the new country of South Sudan (Figure 1d)
Summary
The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000, and most endemic countries in the Americas, Eastern Mediterranean and Asia-Pacific regions have initiated the WHO recommended mass drug administration (MDA) campaign to interrupt transmission of the parasite. Most 39 endemic countries in the Americas, Eastern Mediterranean and Asia-Pacific regions have initiated or finished the World Health Organization (WHO) recommended mass drug administration (MDA) campaign to interrupt transmission of the two main parasites, Wuchereria bancrofti and/or Brugia malayi with significant scale-up in drug distributions and reductions in disease burden being demonstrated [1,2]. This progress is promising for GPELF and its goal of LF elimination by 2020 [1]. These countries included Angola, Central Africa Republic (CAR), Chad, Congo, Democratic Republic of Congo (DRC), Equatorial Guinea, Eritrea, Gabon, The Gambia, Guinea, Guinea-Bissau, Liberia, São Tomé and Príncipe, Zambia, Zimbabwe and the new Sudan/South Sudan [1]
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