Lymphatic filariasis in Papua New Guinea: distribution at district level and impact of mass drug administration, 1980 to 2011

Abstract

BackgroundLymphatic filariasis (LF) caused by Wuchereria bancrofti is present at high prevalence in some parts of Papua New Guinea. However, there has been no rigorous data-based representative assessment of nationwide prevalence of LF. The LF programme has been daunted by the scope of the problem, and progress on mass drug administration (MDA) has been slow and lacking in resources.MethodsA systematic literature review identified LF surveys in Papua New Guinea between 1980 and 2011. Results were extracted by location, time period and test used (blood slide, immunochromatographic test (ICT) or Og4C3 ELISA) and combined by district. Three criteria schemes based on the Global Programme to Eliminate Lymphatic Filariasis guidelines, with modifications, were developed to classify and prioritize districts by prevalence level. Results of repeated surveys in the same sites were used to investigate the impact of MDA on LF prevalence over the time period.ResultsThere were 312 distinct survey sites identified in 80 of the 89 districts over the 31-year period. The overall LF prevalence in the sites tested was estimated at 18.5 to 27.5% by blood slide for microfilariae (Mf), 10.1% to 12.9% by ICT and 45.4% to 48.8% by Og4C3. Biases in site selection towards areas with LF, and change in type of assay used, affected the prevalence estimates, but overall decline in prevalence over the time period was observed. Depending on the criteria used, 34 to 36 districts (population 2.7 to 2.9 million) were classed as high endemic (≥5% prevalence), 15 to 25 districts (1.7 to 1.9 million) as low endemic (<5%) and 20 to 31 (1.3 to 2.2 million) as non-endemic. Nine districts (0.7 million) had no information. The strong impact of MDA, especially on microfilaria (Mf) prevalence, was noted in sites with repeat surveys.ConclusionsThis analytical review of past surveys of LF in Papua New Guinea enables better estimation of the national burden, identifies gaps in knowledge, quantifies and locates the population at risk, and can be used to predict the likely impact of MDA and/or vector control. Better targeting of districts by level of prevalence will strengthen the control programme, facilitate monitoring of the disease trend and increase the likelihood of reaching the target of LF elimination by 2020.

Lymphatic filariasis in Peninsular Malaysia: a cross-sectional survey of the knowledge, attitudes, and practices of residents

“…As evidenced from the findings of a previous survey, the knowledge gap regarding LF, as well as general attitudes towards and perceptions of the eradication program, was the basis of the major causes of lower compliance [ 28 ], this could have likely resulted in the continued endemicity of LF in the endemic areas of Malaysia. This has been shown to occur in Kenya [ 29 , 30 ], Papua New Guinea [ 31 ], and in India [ 25 , 32 ], where it was reported that there was low compliance for an MDA program due to poor knowledge of LF by the target population. On one hand there is sometimes the problem of poor drug delivery.…”

Re-Transmission Assessment Survey Filariasis Pasca Pengobatan Massal di Kabupaten Agam, Provinsi Sumatera Barat Tahun 2016

“…Hasil analisis review di Papua New Guinea mendapatkan bahwa identifikasi pengetahuan, lokasi populasi berisiko dapat digunakan untuk memprediksi pengaruh dari pengobatan massal filariasis sehingga dapat dilakukan penguatan program dan monitoring kegiatan eliminasi filariasis. 18 Faktor lain yang berpengaruh terhadap cakupan pengobatan filariasis adalah jarak ke sarana kesehatan, keberadaan kader, efek samping pengobatan dan monitoring pengobatan.…”

The History of Bancroftian Lymphatic Filariasis in Australasia and Oceania: Is There a Threat of Re-Occurrence in Mainland Australia?

“…There are an estimated 2.7 million cases of LF in Oceania, accounting for 2% of the global disease burden due to this disease, although this figure comes from only one report of national data in PNG [ 10 ]. However, this may be an overestimate as prevalence varies greatly by village and province [ 11 ]. Utilising the Global Program for Elimination of Lymphatic Filariasis (GPELF) criteria, 4.81 million individuals in PNG live in endemic districts [ 11 ].…”