Global Elimination of Lymphatic Filariasis: Addressing the Public Health Problem

Addiss, David G.

doi:10.1371/journal.pntd.0000741

Cited by 25 publications

(20 citation statements)

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“…These are the soil-transmitted helminth infections (hookworm, ascariasis, and trichuriasis); lymphatic filariasis; schistosomiasis; trachoma and onchocerciasis [5]. Globally, 600–800 million people have soil-transmitted helminth infections [5], 200 million people are infected with schistosomiasis, and 120 million with lymphatic filariasis in 83 countries [5,6]. Onchocerciasis affects nearly 37 million people in 34 countries, and is most abundant in Africa, with small foci in southern and Central America [7], while trachoma affects 84 million people globally [4].…”

Section: Reviewmentioning

confidence: 99%

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The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

et al. 2012

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BackgroundNeglected tropical diseases (NTDs) are a group of chronic parasitic diseases and related conditions that are the most common diseases among the 2·7 billion people globally living on less than US$2 per day. In response to the growing challenge of NTDs, Ethiopia is preparing to launch a NTD Master Plan. The purpose of this review is to underscore the burden of NTDs in Ethiopia, highlight the state of current interventions, and suggest ways forward.ResultsThis review indicates that NTDs are significant public health problems in Ethiopia. From the analysis reported here, Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo. Ethiopia is estimated to have the highest burden of trachoma, podoconiosis and cutaneous leishmaniasis in sub-Saharan Africa (SSA), the second highest burden in terms of ascariasis, leprosy and visceral leishmaniasis, and the third highest burden of hookworm. Infections such as schistosomiasis, trichuriasis, lymphatic filariasis and rabies are also common. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. However, despite these high burdens of infection, the control of most NTDs in Ethiopia is in its infancy. In terms of NTD control achievements, Ethiopia reached the leprosy elimination target of 1 case/10,000 population in 1999. No cases of human African trypanosomiasis have been reported since 1984. Guinea worm eradication is in its final phase. The Onchocerciasis Control Program has been making steady progress since 2001. A national blindness survey was conducted in 2006 and the trachoma program has kicked off in some regions. Lymphatic Filariasis, podoconiosis and rabies mapping are underway.ConclusionEthiopia bears a significant burden of NTDs compared to other SSA countries. To achieve success in integrated control of NTDs, integrated mapping, rapid scale up of interventions and operational research into co implementation of intervention packages will be crucial.

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Section: Reviewmentioning

confidence: 99%

“…timori , which are transmitted by anopheline and culicine mosquitoes [6,48,49]. LF is one of the most debilitating and disfiguring diseases in Ethiopia and is caused by W .…”

Section: Reviewmentioning

confidence: 99%

The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

et al. 2012

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“…Although mass treatment with antiparasitic drugs has led to significant reductions in transmission worldwide [ 4 ], scaling up of LF morbidity management and disability prevention (MMDP) activities has lagged behind [ 5 , 6 ]. Consequently, countries that have successfully interrupted transmission may have sizeable numbers of people who continue to suffer from the disabling and stigmatizing effects of lymphedema and elephantiasis [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The reasons for the lagging promotion of MMDP are complex [ 6 , 7 ] and include a lack of funding, inadequate integration of LF elimination into national health services, and the fact that relatively few LF program managers have been clinically trained. In addition, lack of consensus about the degree of effectiveness of WASH interventions on LF-related lymphedema is a contributing factor.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Hygiene-Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis

2015

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BackgroundLymphedema of the leg and its advanced form, known as elephantiasis, are significant causes of disability and morbidity in areas endemic for lymphatic filariasis (LF), with an estimated 14 million persons affected worldwide. The twin goals of the World Health Organization’s Global Program to Eliminate Lymphatic Filariasis include interrupting transmission of the parasitic worms that cause LF and providing care to persons who suffer from its clinical manifestations, including lymphedema—so-called morbidity management and disability prevention (MMDP). Scaling up of MMDP has been slow, in part because of a lack of consensus about the effectiveness of recommended hygiene-based interventions for clinical lymphedema.Methods and FindingsWe conducted a systemic review and meta-analyses to estimate the effectiveness of hygiene-based interventions on LF-related lymphedema. We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through March 23, 2015 with no restriction on year of publication. Studies were eligible for inclusion if they (1) were conducted in an area endemic for LF, (2) involved hygiene-based interventions to manage lymphedema, and (3) assessed lymphedema-related morbidity. For clinical outcomes for which three or more studies assessed comparable interventions for lymphedema, we conducted random-effects meta-analyses. Twenty-two studies met the inclusion criteria and two meta-analyses were possible. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. Participation in hygiene-based lymphedema management was associated with a lower incidence of acute dermatolymphagioadenitis (ADLA), (Odds Ratio 0.32, 95% CI 0.25–0.40), as well as with a decreased percentage of patients reporting at least one episode of ADLA during follow-up (OR 0.29, 95% CI 0.12–0.47). Limitations included high heterogeneity across studies and variation in components of lymphedema management.ConclusionsAvailable evidence strongly supports the effectiveness of hygiene-based lymphedema management in LF-endemic areas. Despite the aforementioned limitations, these findings highlight the potential to significantly reduce LF-associated morbidity and disability as well as the need to develop standardized approaches to MMDP in LF-endemic areas.

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“…Inclusion of a morbidity management pillar distinguished the GPELF from efforts to eradicate smallpox, polio, and Guinea worm disease, which focused primarily, if not exclusively, on interrupting transmission. This two-pronged approach was initially criticized on the basis that efforts to reduce the suffering of those affected would divert attention and resources from the principal goal of stopping LF transmission [2].…”

Section: Introductionmentioning

confidence: 99%

Global Elimination of Lymphatic Filariasis: A “Mass Uprising of Compassion”

Addiss

2013

PLoS Negl Trop Dis

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Global Elimination of Lymphatic Filariasis: Addressing the Public Health Problem

Cited by 25 publications

References 13 publications

The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

The Effect of Hygiene-Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis

Global Elimination of Lymphatic Filariasis: A “Mass Uprising of Compassion”

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