Progress and Impact of 13 Years of the Global Programme to Eliminate Lymphatic Filariasis on Reducing the Burden of Filarial Disease

Abstract

BackgroundA Global Programme to Eliminate Lymphatic Filariasis was launched in 2000, with mass drug administration (MDA) as the core strategy of the programme. After completing 13 years of operations through 2012 and with MDA in place in 55 of 73 endemic countries, the impact of the MDA programme on microfilaraemia, hydrocele and lymphedema is in need of being assessed.Methodology/Principal findingsDuring 2000–2012, the MDA programme made remarkable achievements – a total of 6.37 billion treatments were offered and an estimated 4.45 billion treatments were consumed by the population living in endemic areas. Using a model based on empirical observations of the effects of treatment on clinical manifestations, it is estimated that 96.71 million LF cases, including 79.20 million microfilaria carriers, 18.73 million hydrocele cases and a minimum of 5.49 million lymphedema cases have been prevented or cured during this period. Consequently, the global prevalence of LF is calculated to have fallen by 59%, from 3.55% to 1.47%. The fall was highest for microfilaraemia prevalence (68%), followed by 49% in hydrocele prevalence and 25% in lymphedema prevalence. It is estimated that, currently, i.e. after 13 years of the MDA programme, there are still an estimated 67.88 million LF cases that include 36.45 million microfilaria carriers, 19.43 million hydrocele cases and 16.68 million lymphedema cases.Conclusions/SignificanceThe MDA programme has resulted in significant reduction of the LF burden. Extension of MDA to all at-risk countries and to all regions within those countries where MDA has not yet reached 100% geographic coverage is imperative to further reduce the number of microfilaraemia and chronic disease cases and to reach the global target of interrupting transmission of LF by 2020.

“Unseen” Caregivers: The disproportionate gender balance and role of females in the home- based care of lymphatic filariasis patients in Malawi

“…Globally, recent figures estimate that 36 million people suffer from the clinical manifestations of LF, specifically limb lymphoedema (16.68 million) and hydrocele in men (19.43 million), which accounts for at least 2.8 million disability-adjusted life years (DALYs) [1,2]. These disabling and disfiguring conditions require specific morbidity management and disability prevention (MMDP) measures, as they inflict a complex range of physical, social, psychological and economic hardships on those affected.…”

Evaluating the Burden of Lymphedema Due to Lymphatic Filariasis in 2005 in Khurda District, Odisha State, India

“…MDA campaigns have been occurring in India since 1997 and have progressed well with some areas having demonstrated interruption of transmission [3, 8, 9]. However, it is recognized that MDA does not treat the chronic clinical manifestations, specifically lymphedema, elephantiasis and hydrocele, seen in some LF-infected individuals [2, 10].…”

Absence of IL-17A in Litomosoides sigmodontis-infected mice influences worm development and drives elevated filarial-specific IFN-γ

“…In endemic communities, filarial infections in man remain a public health concern, and currently, 100 million individuals suffer from either lymphatic filariasis (LF), onchocerciasis or loasis, placing filariasis amongst the major causes of global morbidity (Klion and Nutman 2011; Ramaiah and Ottesen 2014; World Health Organization 2016). Filaria-like Wuchereria bancrofti modulate human immune responses so that most individuals carry numerous worms and present a homeostatic regulated state including elevated IL-10, TGF-β, regulatory T cells (Treg) and IgG4.…”