Lymphatic filariasis control in Tanga Region, Tanzania: status after eight rounds of mass drug administration

Simonsen, Paul E.; Derua, Yahya A.; Magesa, Stephen; Pedersen, Erik Helmer; Stensgaard, Anna‐Sofie; Malecela, Mwelecele N.; Kisinza, William

doi:10.1186/preaccept-1476152043138525

Cited by 19 publications

(31 citation statements)

References 22 publications

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“…The present communication studies and compares both coverage and impact indicator- Mf prevalence simultaneously. We found an overall 68% percent decrease in microfilaria rate from baseline year 2005 to 2015, similar to other studies [17, 23, 24]. (Fig 2 and Table 5) The evidence confirms that after 10 rounds of MDA, the LF transmission is interrupted and microfilaria rate has decreased to less than 1% in all IUs of Gujarat; threshold level recommended by WHO to provisionally stop MDA [17, 23, 24].…”

Section: Discussionsupporting

confidence: 89%

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Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India

et al. 2017

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BackgroundFollowing the World Health Assembly resolution on Elimination of lymphatic filariasis (ELF) as a public health problem by the year 2020, a Global Program (GPELF) was launched in 1997 to help endemic countries to initiate national programs. The current strategy to interrupt transmission of LF, is administration of once-yearly, single-dose, two-drug regimen (Albendazole with Diethylcarbamazine (DEC) to be used in endemic areas with the goal of reaching 65% epidemiological coverage for 4–6 years. We report findings of independent assessment from year 2010 to 2015 for last six rounds, after initial five rounds of Mass Drug Administration (MDA) since 2005 for ELF in endemic area of Gujarat.MethodsIndependent assessment of MDA was performed to find coverage and compliance indicators, reasons for non-coverage and non-compliance in five Implementation Units (IUs). Pre, during and post MDA evaluations were done in three phases. The impact of MDA was measured by microfilaraemia survey. A total of eight sites, four random and four fixed sentinel sites were selected to calculate microfilaria rate (MF) per IUs per year. In years 2010 to 2015, we report results from 125,936 nocturnal blood smears and 17551 population in 120 selected clusters. Four clusters were selected per year in each of the five IUs for assessment of MDA round.ResultPost MDA survey showed drug coverage between 81%-88% and epidemiological coverage 77%-89% across years. Main reasons for non-coverage were drug administrator related (the team did not visit or missed people) while non-compliance was population related (fear of side effects, sickness, people forgot or absent). During MDA findings show that the directly observed consumption is considerably improved from 58% in 2010 to 82% in 2015. The knowledge about benefits of drug provided also increased from 59% to 90% over the years. The current MF rate is less than one in all IUs with an overall 68% percent decrease from baseline year 2005 to year 2015. The average MF rate of Gujarat is 0.44 for year 2015.ConclusionsThe findings show that achieving adequate epidemiological and drug coverage is possible by actual field level operation of the program in large endemic areas. The results and feedback from independent assessment, performed regularly, could guide the policymakers and program managers for mid-term corrections and to frame strategies to enhance program. Monitoring of coverage and impact indicator together informs decisions for reaching end-point of MDA. The impact indicator- microfilaria rate in all IUs of South Gujarat Region has reached and remained less than one percent signaling end-points of MDA. Post MDA stringent monitoring in form of TAS is recommended to keep vigil on maintenance of elimination achieved.

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Section: Discussionsupporting

confidence: 89%

“…Further research and verification in form of surveillance is essential to assure national government that national program have achieved their elimination goals [3, 17, 24]. …”

Section: Discussionmentioning

confidence: 99%

Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India

et al. 2017

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“…The findings of the 2015 survey indicate a remarkable reduction in W. bancrofti CFA prevalence in young children after 12 rounds of MDA. Based on other studies that have reported a reduction in CFA as a result of MDA (Simonsen et al, 2011, Simonsen et al, 2014), the findings suggest a decrease in acquisition of new infections by young school children as a result of MDA.…”

Section: Discussionmentioning

confidence: 51%

Lymphatic filariasis elimination efforts in Rufiji, southeastern Tanzania: decline in circulating filarial antigen prevalence in young school children after twelve rounds of mass drug administration and utilization of long-lasting insecticide-treated nets

Jones

Ngasalla

Derua

et al. 2017

International Journal of Infectious Diseases

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“…funestus and Cx. quinquefasciatus were the main vectors of lymphatic filariasis [5, 35, 36] while An. gambiae ( s.l.…”

Section: Discussionmentioning

confidence: 99%

“…Malaria is transmitted by anopheline mosquitoes, while lymphatic filariasis is transmitted by both Anopheles and Culex mosquitoes [2, 4, 5] . These vectors breed in various habitats [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Effect of physicochemical parameters on Anopheles and Culex mosquito larvae abundance in different breeding sites in a rural setting of Muheza, Tanzania

et al. 2017

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BackgroundMalaria and lymphatic filariasis (LF) are diseases of great public health important in East Africa. Malaria is transmitted by Anopheles while LF is transmitted by both Anopheles and Culex mosquitoes. There is limited evidence on the effects of physicochemical parameters on these mosquitoes in rural settings of Tanzania. This study aimed at assessing the effects of physicochemical parameters on Anopheles and Culex larvae abundance in different breeding sites in a rural setting of Muheza district. MethodsA cross-sectional study was conducted in 13 villages in Muheza district, between December 2015 and May 2016. Mosquito larvae were sampled using standard dipping techniques. Physicochemical parameters were measured by a Multi-parameter pH meter in different mosquito breeding sites. Mosquito larvae and pupa densities were compared between the ≤33th (lower) and ≥67th (upper) percentiles of physicochemical parameters. An. gambiae (s.l.) and An. funestus were identified by polymerase chain reaction (PCR) to reveal their sibling species.ResultsAbundance of Anopheles larvae was significantly higher (76.6%) than Culex (66.9%) χ 2 = 5.73, df = 1, P = 0.017). The presence of late instars of Anopheles was significantly higher (78.2%) than that of Culex (64.5%) (χ 2 = 0.984, df = 1, P = 0.017). A model adjusted for larval stage showed that the likelihood of finding Culex larvae was lower by 38.2% (95% CI: 16.9–54.1, df = 1, P = 0.001) compared to Anopheles. Upper percentiles of salinity (OR = 7.05; 95% CI: 1.19–41.88, P = 0.032) and conductivity (OR = 5.47; 95% CI: 1.01–29.67, P = 0.056) were significantly associated with the presence and with increased density of Anopheles larvae. PCR results showed that, within the gambiae complex, 53.3% (n = 136) were An. gambiae (s.s.) and 46.7% (n = 119) were An. arabiensis. In An. funestus group, 91.1% (n = 41) were An. funestus (s.s.), 4.4% (n = 2) were An. rivulorum, 2.2% (n = 1) were An. leesoni and 2.2% (n = 1) were An. parensis. ConclusionHigh salinity and conductivity were significantly associated with increased density of Anopheles larvae. To our knowledge, this is the first study to demonstrate the occurrence of Anopheles larvae in polluted breeding sites in rural settings of Tanzania. The study has found both Anopheles and Culex mosquito larvae co-existed in breeding sites. The possible reasons for tolerance to a higher level of physicochemical parameters among Anopheles mosquitoes need to be ascertained.

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Lymphatic filariasis control in Tanga Region, Tanzania: status after eight rounds of mass drug administration

Cited by 19 publications

References 22 publications

Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India

Reaching endpoints for lymphatic filariasis elimination- results from mass drug administration and nocturnal blood surveys, South Gujarat, India

Lymphatic filariasis elimination efforts in Rufiji, southeastern Tanzania: decline in circulating filarial antigen prevalence in young school children after twelve rounds of mass drug administration and utilization of long-lasting insecticide-treated nets

Effect of physicochemical parameters on Anopheles and Culex mosquito larvae abundance in different breeding sites in a rural setting of Muheza, Tanzania

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