Abstract
Introduction: Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for elimination as a public health issue in the world by 2020. To achieve this goal, one of the strategies is interruption of transmission using chemotherapy (mass drug administration). Burkina Faso in west Africa, an endemic country, has endorsed this resolution. In 2000, all Sanitary Districts (SD) in the country were endemic, and then a national elimination program has made it possible to stop mass treatment in 45 out of 70 SD over 12 years. Sixteen years later, 13 other SD were reeligible for Transmission Assessment Surveys (TAS). This study aimed to determine the current level of the Mass drugs Administration (MDA) impact indicators in these 13 targeted SD in order to decide whether we need to continue MDA. Method: It was a descriptive study that took place from June to September 2017 in 13 SD regrouped into 7 Evaluation Units (EU). The population of the study was 6 to 7 years old children. The community-based cluster survey method was used. The diagnostic test used to detect Wuchereria bancrofti’s circulating antigen (W. bancrofti) is the Filariasis Test Strip (FTS). The critical threshold of positivity was set at 18 positive subjects per EU. Results: We sampled a total of 12,060 children, 48.9% were female and 51.1% male. In the 7 EU, 13 children were positive to W. bancrofti test. The average antigenic prevalence was 0.11% (13/12,060). In all EU, the number of positive subjects was below the critical threshold. Conclusion: At the end of this evaluation of the transmission of lymphatic filariasis in 13 SD of Burkina Faso, we can tell the MDA could be stopped in these areas without risk of resurgence of the disease, according to the current recommendations of WHO. This can be possible by setting up post-TMM surveillance, considering migratory flows, and including villages where positive cases were found to search possible residual transmission zones.
Highlights
Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for elimination as a public health issue in the world by 2020
The epidemiological coverage of medicines is the proportion of inhabitants of the evaluation unit (EU) who ingested the drugs on the total population of the evaluation unit. − To have a prevalence of microfilaraemia (Mf) less than 1% or a prevalence of filarial antigenemia (Ag) less than 2% after the last effective Mass drugs Administration (MDA) session for each sentinel site and point control site
The Evaluation Units (EU) were subdivided into 210 community clusters in which 84 interviewers collected the data
Summary
Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for elimination as a public health issue in the world by 2020. To achieve this goal, one of the strategies is interruption of transmission using chemotherapy (mass drug administration). In order to stop transmission, WHO recommends the dispensation of combinated two drugs (ivermectin + albendazole) to all populations at risk in countries where there is co-endemicity with onchocerciasis. This strategy is known as “Mass Drug Administration (MDA)”. MDA is a modality of preventive chemotherapy in which antihelminthic medicines are administered to the entire population of an area (e.g. state, region, province, district, subdistrict, village) at regular intervals, irrespective of the individual infection status
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