Abstract
BackgroundLymphatic Filariasis (LF) is an important Neglected Tropical Disease, being a major cause of disability worldwide. The Global Programme to Eliminate Lymphatic Filariasis aims to eliminate LF as a public health problem by the year 2020, primarily through repeated Mass Drug Administration (MDA). The Pacific region programme commenced in 1999. By June 2007, five of the eleven countries classified as endemic had completed five MDA campaigns and post-MDA prevalence surveys to assess their progress. We review available programme data and discuss their implications for other LF elimination programs in developing countries.MethodsReported MDA coverage and results from initial surveys and post-MDA surveys of LF using the immunochromatographic test (ICT) from these five Pacific Island countries (Tonga, Niue, Vanuatu, Samoa and Cook Islands) were analysed to provide an understanding of their quality and programme progress towards LF elimination. Denominator data reported by each country programme for 2001 was compared to official sources to assess the accuracy of MDA coverage data.ResultsInitial survey results from these five countries revealed an ICT prevalence of between 2.7 and 8.6 percent in individuals tested prior to commencement of the programme. Country MDA coverage results varied depending on the source of denominator data. Of the five countries in this case study, three countries (Tonga, Niue and Vanuatu) reached the target prevalence of <1% antigenaemia following five rounds of MDA. However, endpoint data could not be reliably compared to baseline data as survey methodology varied.ConclusionAccurate and representative baseline and post-campaign prevalence data is crucial for determining program effectiveness and the factors contributing to effectiveness. This is emphasised by the findings of this case study. While three of the five Pacific countries reported achieving the target prevalence of <1% antigenaemia, limitations in the data preclude identification of key determinants of this achievement.
Highlights
Lymphatic Filariasis (LF) is an important Neglected Tropical Disease, being a major cause of disability worldwide
Estimates of LF antigenaemia prevalence were made from these surveys using immunochromatographic test (ICT), calculated as the number of ICT positive individuals divided by the number of individuals on whom ICT tests were performed
For example for 2001, a year in which each of the case study countries conducted a census, the comparable Mass Drug Administration (MDA) coverage using LF program reported population denominators compared to official government statistics, respectively, were: Cook Islands – 64% vs. 77%; Niue – 99% vs. 95%; Samoa – 68% vs. 67%; Tonga – 79% vs. 77%; and Vanuatu – 84% vs. 80%)
Summary
Lymphatic Filariasis (LF) is an important Neglected Tropical Disease, being a major cause of disability worldwide. The Global Programme to Eliminate Lymphatic Filariasis aims to eliminate LF as a public health problem by the year 2020, primarily through repeated Mass Drug Administration (MDA). Lymphatic filariasis (LF), an infection caused by a mosquito borne parasite, is the second leading cause of disability worldwide, affecting more than 120 million people in 80 countries [1,2,3]. It is a major cause of physical and emotional suffering, as well as economic loss [4,5]. Follow-up surveys are the principle surveillance mechanism employed to assess the effectiveness of the MDA in decreasing the prevalence of LF in affected populations
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