Evidence for Stopping Mass Drug Administration for Lymphatic Filariasis in Some, But Not All Local Government Areas of Plateau and Nasarawa States, Nigeria

Abstract

Abstract. An average of six annual rounds of ivermectin and albendazole were distributed in Plateau and Nasarawa States, Nigeria, to eliminate lymphatic filariasis. From 2007 to 2008, population-based surveys were implemented in all 30 local government areas (LGAs) of the two states to determine the prevalence of Wuchereria bancrofti antigenemia to assess which LGA mass drug administration (MDA) could be halted. In total, 36,681 persons from 7,819 households were examined for filarial antigen as determined by immunochromatographic card tests. Overall antigen prevalence was 3.05% (exact upper 95% confidence interval [CI] = 3.41%) with an upper 95% CI range by LGA of 0.50-19.3%. Among 3,233 children 6-7 years of age, overall antigen prevalence was 1.71% (exact upper 95% CI = 2.19%), too high to recommend generally halting MDA in the two-state area. However, based on criteria of 2% antigenemia among persons 2 years of age, stopping MDA was recommended for 10 LGAs.

Lymphatic Filariasis in Nigeria; Micro-stratification Overlap Mapping (MOM) as a Prerequisite for Cost-Effective Resource Utilization in Control and Surveillance

“…The studies indicate that LF is present in 19 States across all six geopolitical zones of the country (Figure 2a). The majority of studies were from the NC geopolitical zone, with the most comprehensive studies carried out in Plateau and Nassarawa States [49] [53] [54] [63] [66].…”

“…The average Mf prevalence in pre-MDA sites was 10.1% (n = 124; range 0% to 47.4%), which was approximately 5 times higher than the average Mf prevalence in post-MDA sites, 2.0% (n = 66, range 0% to 12.1%) (Figure 3c,d). The distribution of post-MDA sites occur in the two States of Plateau and Nassarawa, and are the result of an extensive MDA programme delivering the combination of ivermectin and albendazole as detailed in the study publications [49] [53] [54] [63]. Baseline LF mapping was conducted in 1999 and 2000 in 30 LGAs of the two States, and MDA launched in 2000, and monitored from 2000 to 2009.…”

“…The impact of MDA on LF transmission in most of the States and LGAs is yet to be determined as this intervention has only started to expand. However, detailed studies carried out in the States of Plateau and Nassarawa have highlighted the effectiveness of this intervention and the importance of documenting impact and progress through systematic monitoring and evaluation [53] [63]. These results suggest that Nigeria could significantly reduce W. bancrofti transmission in the next few years with a collective effort and commitment through increased human and financial resources from both national and external donors and stakeholders.…”

Lymphatic filariasis control in Tanzania: effect of six rounds of mass drug administration with ivermectin and albendazole on infection and transmission

“…Many LF endemic countries in sub-Saharan Africa are co-endemic for onchocerciasis, and due to the potential risk of DEC induced side-effects in individuals with Onchocerca volvulus infections, use a combination of ivermectin and albendazole in their MDAs for LF control. The effect of this drug combination in a low-moderate LF endemic area of central Nigeria, West Africa, was recently documented [22,23]. Here we present and analyse the effect of six rounds of MDA with ivermectin and albendazole in a highly endemic area of Tanzania, East Africa.…”

Fifteen years of programme implementation for the elimination of Lymphatic Filariasis in Ghana: Impact of MDA on immunoparasitological indicators

“…An example was in Nadowli, which had a prevalence of 4% and 17% at baseline and midterm evaluations, respectively. Limitations of LF programmes in terms of inadequate or small sample sizes have been reported [13]. Thus, the need for achieving the appropriate sample sizes in evaluating programmes cannot be overemphasized.…”