The rationale and cost-effectiveness of a confirmatory mapping tool for lymphatic filariasis: Examples from Ethiopia and Tanzania

Gass, Katherine; Sime, Heven; Mwingira, Upendo; Nshala, Andreas; Chikawe, Maria; Pelletreau, Sonia; Barbre, Kira; Deming, Michael S.; Rebollo, Maria P.

doi:10.1371/journal.pntd.0005944

Cited by 18 publications

(30 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2015, using a probability-based sampling of school attending children to determine the prevalence of LF antigenemia, the South Ari district was re-mapped for LF. Results showed that 2.1% of immunochromatographic tests (ICTs) were positive, and the district was recommended to undergo MDA [40]. For podoconiosis, it is reported that the SNNPR has a prevalence of 8.63% (Confidence Interval (CI) ± 0.66%) [41].…”

Section: Study Site and Characteristicsmentioning

confidence: 99%

Quantifying the socio-economic impact of leg lymphoedema on patient caregivers in a lymphatic filariasis and podoconiosis co-endemic district of Ethiopia

Caprioli

Martindale

Mengiste³

et al. 2020

PLoS Negl Trop Dis

View full text Add to dashboard Cite

BackgroundLymphoedema caused by lymphatic filariasis (LF) or podoconiosis can result in physical disability and social exclusion, which is exacerbated by painful acute dermatolymphangioadenitis (ADLA) episodes. These conditions have a significant impact on patients, however, little is known about the indirect effects on their caregivers. This study, therefore, aimed to determine the impact on caregivers for patients with leg lymphoedema in a co-endemic district of Ethiopia. Methodology/Principal findingsA cross-sectional survey of lymphoedema patients and their caregivers was conducted using semi-structured questionnaires in the Southern Nation Nationalities Peoples Region (SNNPR) of Ethiopia. Lymphoedema patient information on clinical severity (mild, moderate, severe), frequency of ADLAs, their socio-demographic characteristics and the identity of main caregiver(s) was collected. Caregiver information on socio-demographic characteristics, types of care provided, their quality of life (QoL) measured across nine domains, and productivity was collected, with key indicators compared in the presence and absence of patients' ADLAs.A total of 73 patients and 76 caregivers were included. Patients were grouped by mild/ moderate (n = 42, 57.5%) or severe (n = 31, 42.5%) lymphoedema, and reported an average of 6.1 (CI± 2.18) and 9.8 (CI± 3.17) ADLAs respectively in the last six months. A total of 48 (65.8%) female and 25 (34.2%) male patients were interviewed. Caregivers were predominately male (n = 45, 59.2%), and spouses formed the largest caregiving group for both female and male patients. PLOS NEGLECTED TROPICAL DISEASESPLOS Neglected Tropical Diseases | https://doi.org/10.

show abstract

Section: Study Site and Characteristicsmentioning

confidence: 99%

Quantifying the socio-economic impact of leg lymphoedema on patient caregivers in a lymphatic filariasis and podoconiosis co-endemic district of Ethiopia

Caprioli

Martindale

Mengiste³

et al. 2020

PLoS Negl Trop Dis

View full text Add to dashboard Cite

show abstract

“…The approximate cost of implementing the confirmatory mapping tool in one woreda is $7,910; a detailed description of the cost effectiveness of this survey is presented by Gass et.al. [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…These include restricting the age group to a population that is more likely to be indicative of recent transmission (e.g. 9–14 year olds) and expanding the number of sites sampled per woreda [ 14 ]. This latter improvement was particularly important to Ethiopia.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Results of a confirmatory mapping tool for Lymphatic filariasis endemicity classification in areas where transmission was uncertain in Ethiopia

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundThe goal of the global lymphatic filariasis (LF) program is to eliminate the disease as a public health problem by the year 2020. The WHO mapping protocol that is used to identify endemic areas in need of mass drug administration (MDA) uses convenience-based sampling. This rapid mapping has allowed the global program to dramatically scale up treatment, but as the program approaches its elimination goal, it is important to ensure that all endemic areas have been identified and have received MDA. In low transmission settings, the WHO mapping protocol for LF mapping has several limitations. To correctly identify the LF endemicity of woredas, a new confirmatory mapping tool was developed to test older school children for circulating filarial antigen (CFA) in settings where it is uncertain. Ethiopia is the first country to implement this new tool. In this paper, we present the Ethiopian experience of implementing the new confirmatory mapping tool and discuss the implications of the results for the LF program in Ethiopia and globally.MethodsConfirmatory LF mapping was conducted in 1,191 schools in 45 woredas, the implementation unit in Ethiopia, in the regions of Tigray, Amhara, Oromia, SNNP, Afar and Harari, where the results of previous mapping for LF using the current WHO protocol indicated that LF endemicity was uncertain. Within each woreda schools were selected using either cluster or systematic sampling. From selected schools, a total of 18,254 children were tested for circulating filarial antigen (CFA) using the immuno-chromatographic test (ICT).ResultsOf the 18,254 children in 45 woredas who participated in the survey, 28 (0.16%) in 9 woredas tested CFA positive. According to the confirmatory mapping threshold, which is ≥2% CFA in children 9–14 years of age, only 3 woredas out of the total 45 had more CFA positive results than the threshold and thus were confirmed to be endemic; the remaining 42 woredas were declared non-endemic. These results drastically decreased the estimated total population living in LF-endemic woredas in Ethiopia and in need of MDA by 49.1%, from 11,580,010 to 5,893,309.ConclusionThis study demonstrated that the new confirmatory mapping tool for LF can benefit national LF programs by generating information that not only can confirm where LF is endemic, but also can save time and resources by preventing MDA where there is no evidence of ongoing LF transmission.

show abstract

“…Alongside adapting a confirmatory mapping protocol based on serological surveys [10,11], xenomonitoring (detecting L3, the infective larval stage of W. bancrofti), is being considered as an option for assessing transmission in urban settings [7,9] as it has the advantage of providing specific transmission information on time and place [8][9][10][11]. At present, there is no recommended protocol adapted to the scale of mosquito collection required for this purpose [9,10].…”

Section: Introductionmentioning

confidence: 99%

Testing a method of sampling for entomological determination of transmission of Wuchereria bancrofti to inform lymphatic filariasis treatment strategy in urban settings

Nditanchou¹,

Dixon

Pam

et al. 2020

Parasites Vectors

View full text Add to dashboard Cite

Background: There is ongoing debate about scale-up of lymphatic filariasis treatment to include urban areas. Determining Wuchereria bancrofti transmission is more complex in these settings and entomological methodologies suggested as a solution as yet have no clear guidance. Methods: The study was conducted in six communities in Minna and Kaduna cities in Nigeria selected based on pre-disposing risk factors for mosquitoes and Transmission Assessment Survey (TAS) results in 2016 indicating need for treatment (> 1% prevalence). In each community, 4 gravid traps (GT), 15 exit traps (ET) and 21 pyrethrum spray catches (PSC) were used for 5 months targeting a sample size of 10,000 mosquitoes inclusive of at least 1500 Anopheles. Community researchers were selected and trained to facilitate community acceptability and carry out collection. We have evaluated the mosquito sampling and trapping methodology in terms of success at reaching targeted sample size, cost effectiveness, and applicability. Results: Community researchers were influential in enabling high acceptability of the methods of collection and were able to conduct collections independently. Overall, 12.1% of trapping events (one trapping event corresponds to one visit to one trap to collect mosquitoes) were affected by householder actions, weather conditions or trap malfunction leading to lower than optimal catches. Exit traps were the most cost-effective way to catch Anopheles (6.4 USD per trapping event and 12.8 USD per Anopheles caught). Sample size of 10,000 mosquitoes overall in each city was met though Anopheles catch was insufficient in one city. However, sample size was met only in one implementation unit out of the four. Conclusions: Methods need adapting to maximise Anopheles catch: we propose planning 250 gravid trap and 3724 exit trap trapping events in similar settings in West African urban areas where Culex is dominant, not using pyrethrum spray catches, and weighting trapping events later in the rainy season. Planning should increase involvement of

show abstract

The rationale and cost-effectiveness of a confirmatory mapping tool for lymphatic filariasis: Examples from Ethiopia and Tanzania

Cited by 18 publications

References 9 publications

Quantifying the socio-economic impact of leg lymphoedema on patient caregivers in a lymphatic filariasis and podoconiosis co-endemic district of Ethiopia

Quantifying the socio-economic impact of leg lymphoedema on patient caregivers in a lymphatic filariasis and podoconiosis co-endemic district of Ethiopia

Results of a confirmatory mapping tool for Lymphatic filariasis endemicity classification in areas where transmission was uncertain in Ethiopia

Testing a method of sampling for entomological determination of transmission of Wuchereria bancrofti to inform lymphatic filariasis treatment strategy in urban settings

Contact Info

Product

Resources

About