Preventive chemotherapy reverses covert, lymphatic‐associated tissue change in young people with lymphatic filariasis in Myanmar

Background: Lymphatic filariasis is a pervasive and life-threatening disease for human beings. Currently, 893 million people in 49 countries worldwide affected by lymphatic filariasis as per WHO statistics. The concealed aspects of lymphatic diseases such as delayed disease detection, inappropriate disease imaging, the geographical outbreak of infection, and lack of preventive chemotherapy have brought this epidemic to the edge of Neglected Tropical Diseases. Many medications and natural bioactive substances have seen to promote filaricidal activity against the target parasitic species. However, the majority of failures have occurred in pharmaceutical and pharmacokinetic issues. Objective: The purpose of the study is to focus on the challenges and therapeutic issues in the treatment of filariasis. The review brings novel techniques and therapeutic approaches for combating lymphatic filariasis. It also offers significant developments and opportunities for such therapeutic interventions. Conclusion: Through this review, an attempt has made to critically evaluate the avenues of innovative pharmaceuticals and molecular targeting approaches to bring an integrated solution to combat lymphatic filariasis.

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Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed2040050 ◽

2017 ◽

Vol 2 (4) ◽

pp. 50 ◽

Cited By ~ 4

Author(s):

Janet Douglass ◽

Patricia Graves ◽

Daniel Lindsay ◽

Luke Becker ◽

Maureen Roineau ◽

...

Keyword(s):

Young People ◽

Lymphatic Filariasis ◽

Extracellular Fluid ◽

Lower Limbs

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Are current preventive chemotherapy strategies for controlling and eliminating neglected tropical diseases cost-effective?

BMJ Global Health ◽

10.1136/bmjgh-2021-005456 ◽

2021 ◽

Vol 6 (8) ◽

pp. e005456

Author(s):

Hugo C Turner ◽

Wilma A Stolk ◽

Anthony W Solomon ◽

Jonathan D King ◽

Antonio Montresor ◽

...

Keyword(s):

Lymphatic Filariasis ◽

Low Income ◽

Neglected Tropical Diseases ◽

Cost Effective ◽

Healthcare Spending ◽

Tropical Diseases ◽

Preventive Chemotherapy ◽

Middle Income ◽

Disability Adjusted Life ◽

The Cost

Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.

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Current WHO protocols for mass drug administration in helminth control

Microbiology Australia ◽

10.1071/ma16004 ◽

2016 ◽

Vol 37 (1) ◽

pp. 10

Author(s):

Richard S Bradbury ◽

Patricia M Graves

Keyword(s):

Vector Control ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Target Population ◽

Preventive Chemotherapy ◽

Soil Transmitted Helminths ◽

Helminth Infections ◽

The World ◽

Control Criteria

Soil transmitted helminths (STH), comprising Ascaris, Trichuris, Strongyloides and the hookworms remain a significant cause of morbidity amongst people in many parts of the world, including Australia. Other important helminth infections include lymphatic filariasis (LF), schistosomiasis and onchocerciasis. Preventive chemotherapy (mass drug administration [MDA]) campaigns are frequently conducted for these helminth infections in endemic areas, but the target population groups, duration of campaigns, cointerventions (e.g. vector control) criteria for inclusion, drugs used and doses of drugs differ.

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African regional progress and status of the programme to eliminate lymphatic filariasis: 2000–2020

International Health ◽

10.1093/inthealth/ihaa058 ◽

2020 ◽

Vol 13 (Supplement_1) ◽

pp. S22-S27

Author(s):

Kebede Deribe ◽

Didier K Bakajika ◽

Honorat Marie-Gustave Zoure ◽

John O Gyapong ◽

David H Molyneux ◽

...

Keyword(s):

Vector Control ◽

Lymphatic Filariasis ◽

Neglected Tropical Diseases ◽

Public Health Problem ◽

World Health ◽

Malaria Vector Control ◽

Tropical Diseases ◽

Significant Progress ◽

African Region ◽

Preventive Chemotherapy

Abstract To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Africa through the WHO neglected tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme in the region while we identify the key remaining challenges in achieving an Africa free of LF.

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Prevalence of soil-transmitted helminth infections, schistosomiasis, and lymphatic filariasis before and after preventive chemotherapy initiation in the Philippines: A systematic review and meta-analysis

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0010026 ◽

2021 ◽

Vol 15 (12) ◽

pp. e0010026

Author(s):

John Paul Caesar Robles delos Trinos ◽

Luh Putu Lila Wulandari ◽

Naomi Clarke ◽

Vicente Belizario ◽

John Kaldor ◽

...

Keyword(s):

Systematic Review ◽

Lymphatic Filariasis ◽

Meta Analysis ◽

The Philippines ◽

Preschool Age ◽

Infection Prevalence ◽

Preventive Chemotherapy ◽

Before And After ◽

Chemotherapy Initiation ◽

The Impact

Objective To estimate the impact of preventive chemotherapy on the prevalence and intensity of soil-transmitted helminth (STH) infections, schistosomiasis, and lymphatic filariasis in the Philippines, using systematic review and meta-analysis. Methods We included reports reporting prevalence of STH infections, schistosomiasis, or lymphatic filariasis in the Philippines published until 31 March 2021. Peer-reviewed studies were identified in electronic databases. Grey literature reports by the University of the Philippines and the Department of Health were also included. Pooled infection prevalence, before and after the initiation of preventive chemotherapy, stratified by age group, was calculated using the inverse variance heterogeneity model. Findings A total of 109 reports were included in the review and meta-analysis. Overall prevalence of moderate-heavy intensity Ascaris lumbricoides (6.6%) and Trichuris trichiura (2.7%) infection after initiation of preventive chemotherapy were significantly lower than the prevalence prior to initiation (23.6% for A. lumbricoides and 12.2% for T. trichiura). Prevalence reductions were also found in school and preschool-age children for A. lumbricoides and T. trichiura. Studies conducted after preventive chemotherapy initiation had significantly lower overall prevalence of moderate-heavy intensity schistosomiasis (3.1% vs 0.2%) and of schistosomiasis in school-age children (30.5% vs 1%). Pooled prevalence of lymphatic filariasis prior to preventive chemotherapy initiation was 3.2% across 12 provinces, while currently only two provinces still have prevalence of more than 1%. There were no published studies reporting prevalence of lymphatic filariasis after initiation of preventive chemotherapy. Heterogeneity was high with I2 mostly above 90%. Conclusion The burden of STH infections and schistosomiasis in children were significantly lower in studies conducted following the initiation of preventive chemotherapy. Eliminating morbidity and interrupting transmission, however, may require expanded control initiatives including community-wide treatment, and improved water, sanitation, and hygiene. Lymphatic filariasis burden has decreased since the implementation of preventive chemotherapy, with all but two provinces having reached the elimination of lymphatic filariasis as a public health problem.

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Assessing Lymphatic Filariasis Data Quality in Endemic Communities in Ghana, Using the Neglected Tropical Diseases Data Quality Assessment Tool for Preventive Chemotherapy

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0004590 ◽

2016 ◽

Vol 10 (3) ◽

pp. e0004590 ◽

Cited By ~ 12

Author(s):

Dziedzom K. de Souza ◽

Eric Yirenkyi ◽

Joseph Otchere ◽

Nana-Kwadwo Biritwum ◽

Donne K. Ameme ◽

...

Keyword(s):

Data Quality ◽

Quality Assessment ◽

Lymphatic Filariasis ◽

Assessment Tool ◽

Neglected Tropical Diseases ◽

Tropical Diseases ◽

Quality Assessment Tool ◽

Preventive Chemotherapy ◽

Data Quality Assessment

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Safety and Tolerability of Mass Diethylcarbamazine and Albendazole Administration for the Elimination of Lymphatic Filariasis in Kenya: An Active Surveillance Study

Pharmaceuticals ◽

10.3390/ph14030264 ◽

2021 ◽

Vol 14 (3) ◽

pp. 264

Author(s):

Christabel Khaemba ◽

Abbie Barry ◽

Wyckliff P. Omondi ◽

Kefa Bota ◽

Sultani Matendechero ◽

...

Keyword(s):

Lymphatic Filariasis ◽

Large Scale ◽

Intervention Strategy ◽

Surveillance Study ◽

Preventive Chemotherapy ◽

Diethylcarbamazine Citrate ◽

Severity Grading ◽

Loss Of Appetite ◽

Study Participants

Preventive chemotherapy with diethylcarbamazine citrate (DEC) and albendazole (ALB) is the core intervention strategy to eliminate lymphatic filariasis (LF). We conducted a large-scale prospective active safety surveillance study to identify the incidence, type, severity, and risk factors for adverse events (AEs) following mass drug administration (MDA) of single-dose DEC and ALB in 10,010 participants from Kilifi County, Kenya. AEs were actively monitored and graded at 24 h, 48 h, and on day 7 Post-MDA. Out of 10,010 enrolled study participants, 1621 participants reported a total of 3102 AEs during a seven-day follow-up. The cumulative incidence of AEs was 16.2% (95% CI, 15.5–16.9%). The proportion of participants who experienced one, two, or ≥ three types of AEs was 9.2%, 4.6%, 2.4%, respectively. AEs were mild (87.3%), moderate (12.4%), and severe (0.3%) and resolved within 72 h. The five most common AEs were dizziness (5.9%), headache (5.6%), loss of appetite (3.3%), fever (2.9%), and drowsiness (2.6%). Older age, taking concurrent medications, ≥ three tablets of DEC, and type of meal taken before MDA were significant predictors of AEs. One in six participants experienced systemic mild-to-moderate severity grading and transient AEs. DEC and ALB co-administration for the elimination of LF is generally safe and well-tolerated.

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A study on assessment of mass drug administration for elimination of lymphatic filariasis in Datia district, Madhya Pradesh

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20180748 ◽

2018 ◽

Vol 5 (3) ◽

pp. 944

Author(s):

Ginisha Gupta ◽

Priyesh Marskole ◽

Praveen Yuwane

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Rural Areas ◽

Madhya Pradesh ◽

Control Measures ◽

Programme Implementation ◽

Preventive Chemotherapy ◽

District Health ◽

Study Participants

Background: Currently 947 million people globally live in areas having endemic lymphatic filariasis and require preventive chemotherapy to stop the spread of infection. LF is transmitted by many mosquitoes particularly Culex and in some areas by Anopheles and Aedes too. This study was conducted to assess the programme implementation with respect to process and outcome indicators and to assess the reasons for non-compliance among population.Methods: We conducted a cross sectional study in Datia district, Madhya Pradesh during September 2014. We determined the sample size for survey based on standard guidelines for MDA coverage assessment. We identified four separate clusters, each with thirty households, for the survey. We selected three clusters from rural areas and one cluster from urban area to ensure adequate representation. We used stratified sampling technique for selection of three rural clusters.Results: We surveyed 859 study participants of Indergarh block, Datia district, residing in 120 households across four clusters. Among 859 study participants, the eligible population (excluding less than two year child and pregnant females) was 92% (790/859). District health authorities reported coverage of MDA across entire district to be 91%. We determined the distribution rate of DEC across all four clusters to be 84% (±9%). We identified highest drug distribution rate in Uchad (97%; 193/200) and lowest in Bargai (75%; 133/178).Conclusions: Non-compliant individuals are potential reservoir for the parasite which may serve as source of infection and transmission even after the mass drug administration ceases. As the prevalence of lymphatic filariasis continues to decrease with the implementation of control measures, addressing the issue of non-compliance holds primary importance to further substantiate the effect of our efforts.

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Lymphatic filariasis in the Southeast Asian region; status and control options.

CAB Reviews Perspectives in Agriculture Veterinary Science Nutrition and Natural Resources ◽

10.1079/pavsnnr202015059 ◽

2020 ◽

Vol 15 (059) ◽

Author(s):

Nilmini T. G. A. Chandrasena

Keyword(s):

Sri Lanka ◽

Lymphatic Filariasis ◽

Disease Burden ◽

Public Health Problem ◽

Southeast Asian ◽

World Health ◽

Selective Treatment ◽

Preventive Chemotherapy ◽

Asian Region ◽

Health Organization

Abstract The Global Program to Eliminate Lymphatic Filariasis (GPELF) was launched in year 2000 by the World Health Organization (WHO) with the goal set for elimination by 2020. Over half the global disease burden lies in the Southeast Asian region (SEAR). The preventive chemotherapy (PC) programme has been initiated in all the WHO SEAR member states with varying levels of progress. Maldives, Sri Lanka and Thailand have achieved the goal of elimination as a public health problem (EPHP) within the stipulated period with Bangladesh working towards validation in 2021. Both Sri Lanka and Thailand are continuing with post-validation surveillance combined with selective treatment, striving for zero transmission in-parallel with the morbidity management and disability prevention program (MMDP). Timor-Leste appears close to reaching critical transmission thresholds with 100% coverage and triple therapy in the last round of PC. Data on MMDP activities are insufficient to comment on reaching EPHP status. PC coverage and country reports indicate ongoing transmission in Nepal, Myanmar, Indonesia and India requiring further rounds of PC. The PELF has made considerable progress in the SEAR towards elimination but there still remain significant transmission and disease burden in the highly populated countries in SEAR.

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