Global programme to eliminate lymphatic filariasis: progress report, 2019

Global programme to eliminate lymphatic filariasis: progress report, 2019. Weekly Epidemiological Record. WHO, 2020


Lymphatic filariasis (LF) is an avoidable, debilitating, disfiguring disease caused by infection  with  the  filarial  parasites Wuchereria  bancrofti,  Brugia  malayi  and B.  timori.  Parasites nest in the lymphatic vessels,  impair  lymphatic  function  and lead  to  lymphoedema  and  hydrocoele. Mosquitos in the genera Culex, Anopheles, Mansonia  and Aedes  transmit  the  para-sites from person to person. In 2000, WHO established  the  Global  Programme  to Eliminate  Lymphatic  Filariasis  (GPELF) to   stop  transmission  of  infection  with mass drug administration (MDA) and to alleviate suffering among people affected by the disease through morbidity management and disability prevention (MMDP).

Achievements in 2019

Validation of elimination as a public health problem

Kiribati,  Malawi  and  Yemen  submitted dossiers  claiming  elimination  of  LF  as  a public health problem. The dossiers from all 3 countries demonstrated reduction of the prevalence of infection in all endemic areas to levels below target thresholds for ≥4 years after MDA had been stopped and documented the availability and provision of essential care for persons with lymphoedema and hydrocoele. Therefore, WHO has acknowledged their achievements.

Scale-up of mass drug administration

WHO  recommends  setting-specific  regimens of  ivermectin, diethylcarbamazine and albendazole in different combinations to stop transmission of the parasites. MDA
involves  treatment of all eligible  people living in all endemic  areas. An implementation  unit  (IU) is the smallest administrative  unit  that  countries  use  as  a basis for making decisions about implementing MDA.

The population in an IU no longer requires MDA when the prevalence of infection has been reduced to such low levels that transmission is considered no longer sustainable.1 Multiple rounds of MDA with effective coverage (≥65% coverage of the total population consuming the medicines) are required to achieve the desired effect. WHO recommends sentinel and spot-check community surveys, followed by a transmission assessment survey (TAS) to measure the impact of MDA and determine whether levels of infection have decreased below target thresholds.

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