Research and Reports in Tropical Medicine (Mar 2018)
Elimination of lymphatic filariasis: current perspectives on mass drug administration
Abstract
John O Gyapong,1 Irene O Owusu,2 Frances B da-Costa Vroom,3 Ernest O Mensah,4 Margaret Gyapong5 1Centre for Neglected Tropical Diseases Research, Institute of Health Research, University of Health and Allied Sciences, Ho, 2Department of Epidemiology, Noguchi Memorial Institute for Medical Research, 3Department of Biostatistics, School of Public Health, 4Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Accra, 5Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana Abstract: Following the London declaration on neglected tropical diseases (NTDs) in 2012 and inspired by the WHO 2020 roadmap to control or eliminate NTDs, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) intensified preventive chemotherapy and management of morbidity as the two main strategies to enhance progress towards the elimination of lymphatic filariasis (LF). This paper focuses on current perspectives of mass drug administration (MDA) towards the elimination of LF. The goal of MDA is to reduce the density of parasites circulating in the blood of infected persons and the intensity of infection in communities to levels where transmission is no longer sustainable by the mosquito vector. Three drugs, diethylcarbamazine, albendazole, and ivermectin are currently available for LF treatment, and their effectiveness and relative safety have opened the possibility of treating the entire population at risk. Currently, almost all LF endemic countries rely on the single-dose two-drug regimen recommended by the GPELF to achieve elimination. The 4th WHO report on NTDs has indicated that considerable progress has been made towards elimination of LF in some countries while acknowledging some challenges. In this review, we conclude that the 2020 elimination goal can be achieved if issues pertaining to the drug distribution, health system and implementation challenges are addressed. Keywords: mass drug administration, disease elimination, lymphatic filariasis, neglected tropical diseases, community health worker, treatment compliance
