Abstract
BackgroundLymphatic filariasis (LF) is a major public health problem in the Pacific. As the global prevalence of infection was not known in New Caledonia (NC), a serosurvey study was conducted by determining the prevalence of circulating filarial antigens, as recommended by the World Health Organization.FindingsA cross sectional study on a 2 degree stratified sample was carried out from June to November 2013. Inclusion criteria were: individuals aged 2 to 80 y/o, who had been hospitalized or sought medical care for a non-infectious cause and who had been living in NC for more than 6 months. LF antigenic detection was performed using the immunocromatographic BinaxNOW filariasis card test (ICT).Among the 1,035 individuals tested, 7 were antigenic. The overall LF antigenic prevalence was 0.62% (CI 95% [0.60-0.63]).All patients were unrelated to each other; none of them presented clinical symptoms of LF.Four of the 7 ICT positive patients reported having travelled to LF endemic areas, 2 patients had never traveled outside NC and the last one had only traveled in non-endemic areas.For the 7 ICT positive patients, the research of microfilariae in blood smears and filarial DNA by PCR was negative.ConclusionThe prevalence of filarial antigenemia in NC is less than 1%, the threshold that defines the filarial endemic areas for WHO. Nevertheless, as two patients who had never travelled outside NC and one who had only travelled to non-endemic areas were antigenic, we cannot conclude that NC is totally free of LF.
Highlights
Lymphatic filariasis (LF) is a major public health problem in the Pacific
The prevalence of filarial antigenemia in New Caledonia (NC) is less than 1%, the threshold that defines the filarial endemic areas for World Health Organization (WHO)
As two patients who had never travelled outside NC and one who had only travelled to non-endemic areas were antigenic, we cannot conclude that NC is totally free of LF
Summary
In view of the results, we conclude that the LF prevalence in NC is less than 1%, so we assume that LF is not a public health concern in NC and that there is no need to set up the GPELF. As the overall population has not been tested and as three patients had never been exposed in endemic areas, we cannot conclude that NC is totally free of LF, especially in some very remotes areas. Aedes vigilax is the potential vector of LF in NC [12], Ae. polynesiensis, the main vector of LF in the Pacific is not present in NC, suggesting that the potential for filariasis emergence is low in this country. Lymphatic Filariasis; PICTs: Pacific Island Countries and Territories; PCR: Polymerase chain reaction; WHO: World Health Organization. MD, JC, AF, FR, JPG, DM drafted parts of the manuscript. All of the authors have approved the content of the manuscript
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