Abstract
BackgroundVanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes. After a baseline survey showing 4.8% antigen prevalence in 1998, the country conducted nationwide (in one implementation unit) annual mass drug administration (MDA) with albendazole and diethylcarbamazine citrate from 2000 to 2004 and achieved prevalence of 0.2% by 2006 in a representative nationwide cluster survey among all age groups.MethodsPost MDA surveillance was conducted from 2006 to 2012. After MDA, the country was divided for surveillance into three evaluation units (EUs) formed by grouping provinces according to baseline prevalence: EU1: Torba, Sanma and Malampa; EU2: Penama; EU3: Shefa and Tafea. The study compiled all past data and information on surveys in Vanuatu from the country programme. This paper reviews the surveillance activities done after stopping MDA to validate the interruption of transmission and elimination of LF as a public health problem.ResultsPost-MDA surveillance consisting of at least three transmission assessment surveys (TAS) in each of the three EUs was conducted between 2006 and 2012. Sentinel and spot check surveys identified a few villages with persistent high prevalence; all antigen positive cases in these sites were treated and additional targeted MDA conducted for 3 years in 13 villages in one area of concern. All three EUs passed all TAS in 2007, 2010 and 2012 respectively, with no positives found except in EU2 (Penama province) in 2012 when 2 children tested positive for circulating filariasis antigen. Assessment of the burden of chronic filariasis morbidity found 95 cases in 2003 and 32 remaining cases in 2007, all aged over 60 years.ConclusionsVanuatu has achieved validation of elimination of LF as a public health problem. Post-validation surveillance is still recommended especially in formerly highly endemic areas.
Highlights
Vanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes
Vanuatu is a Pacific Island nation and one of the 16 Pacific Island countries and territories included in the Pacific Programme to Eliminate Lymphatic Filariasis (PacELF) started in 1999 [1, 2]
At the start of the Pacific Programme to Eliminate LF (PacELF) control programme in Vanuatu in 1999, the national LF antigen prevalence measured by immunochromatographic test (ICT) was estimated to be 4.8% in a baseline survey of 51 villages
Summary
Vanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes. After a baseline survey showing 4.8% antigen prevalence in 1998, the country conducted nationwide (in one implementation unit) annual mass drug administration (MDA) with albendazole and diethylcarbamazine citrate from 2000 to 2004 and achieved prevalence of 0.2% by 2006 in a representative nationwide cluster survey among all age groups. Vanuatu is a Pacific Island nation and one of the 16 Pacific Island countries and territories included in the Pacific Programme to Eliminate Lymphatic Filariasis (PacELF) started in 1999 [1, 2]. At the start of the PacELF control programme in Vanuatu in 1999, the national LF antigen prevalence measured by immunochromatographic test (ICT) was estimated to be 4.8% in a baseline survey of 51 villages. Through intense efforts of annual MDA campaigns combining albendazole and diethylcarbamazine citrate (DEC) with vector control, antigen prevalence was reduced to 0.2% by 2006 as estimated in a survey of 90 household clusters. Available information on morbidity is included in the present paper
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