scholarly journals Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa

2021 ◽  
Vol 6 (2) ◽  
pp. 44
Author(s):  
Patricia M. Graves ◽  
Sarah Sheridan ◽  
Jessica Scott ◽  
Filipina Amosa-Lei Sam ◽  
Take Naseri ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Venous Blood ◽  
Household Survey ◽  
Correct Dose ◽  
Pre Treatment

Following the first triple-drug mass drug administration (MDA) for lymphatic filariasis in Samoa in 2018, unexpected persistence of microfilaria (Mf) positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1–2 months later. Of the 18 Mf positive persons, 14 reported taking the MDA, raising concerns about MDA efficacy. In 2019, 5–6 months after the 2018 survey, a monitored treatment study was done to evaluate directly observed weight-based treatment in these Mf positive individuals. Mf presence and density were assessed before and 7 days after treatment, using 1 mL membrane filtered venous blood, and 60uL thick blood films on slides prepared from venous or fingerprick blood. All 14 participants were still Mf positive on filters from venous blood pre-treatment samples, but two were negative by slide made from the same samples. Mf were cleared completely by day 7 in 12 of 13 participants followed up, and by day 30 in the remaining participant. Filtered blood using EDTA samples (to reduce clumping of Mf) is preferred over slides alone for improving the likelihood of detecting Mf and estimating their density. The triple-drug MDA strategy was effective at clearing Mf when given and taken at the correct dose.

scholarly journals Triple-Drug Mass Drug Administration is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa

2021 ◽  
Author(s):  
Patricia M. Graves ◽  
Sarah Sheridan ◽  
Jessica Scott ◽  
Filipina Amosa-Lei Sam ◽  
Take Naseri ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Venous Blood ◽  
Household Survey ◽  
Correct Dose ◽  
Pre Treatment

Following the first triple-drug MDA for lymphatic filariasis in Samoa in 2018, unexpected persistence of Mf-positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1-2 months later, raising concerns about MDA efficacy. In 2019, a monitored treatment study was done before and 7 days after directly observed weight-based treatment. Mf presence and density were evaluated using 1 mL membrane filtered venous blood, and 60uL thick blood films on slides prepared from venous or fingerprick blood. All 14 participants were still Mf positive on filters from venous blood pre-treatment samples, but two were negative by slide made from the same samples. Mf were cleared completely by day 7 in 12 of 13 participants followed up, and by day 30 in the remaining participant. Filtered blood using EDTA samples (to reduce clumping of Mf) is preferred over slides alone for improving the likelihood of detecting Mf and estimating their density. The triple-drug MDA strategy was effective at clearing Mf by day 30 when given and taken at the correct dose.

scholarly journals A Step Toward Eradication of Human Filariases in Areas Where Loa Is Endemic

mBio ◽  
2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Timothy G. Geary
Keyword(s):  
Adverse Events ◽  
Drug Treatment ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Diagnostic Method ◽  
Parasitic Infections ◽  
Loa Loa ◽  
Risk Threshold ◽  
Rapid Diagnostic Method

ABSTRACT Mass drug administration (MDA) programs have achieved remarkable success in limiting the pathology and transmission of the human parasitic infections onchocerciasis and lymphatic filariasis. The full implementation of MDA campaigns for filariasis elimination has been stymied by the unacceptable incidence of severe adverse events observed following drug treatment of a subset of individuals who harbor high loads of Loa loa microfilaria. Extending MDA strategies to regions where loiasis is coendemic could be done confidently if a simple, inexpensive, and rapid diagnostic method was available that could accurately identify individuals who have L. loa microfilarial loads above the risk threshold and could thus be excluded from treatment. A recent paper in mBio reports the discovery of an antigen unique to L. loa microfilaria that can be detected in blood and urine and may form the basis for such an assay. Further work will reveal whether this discovery will smooth the path to achieve filariasis eradication.

scholarly journals Risk factors for lymphatic filariasis and mass drug administration non-participation in Mandalay Region, Myanmar

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Benjamin F. R. Dickson ◽  
Patricia M. Graves ◽  
Ni Ni Aye ◽  
Thet Wai Nwe ◽  
Tint Wai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Survey Design ◽  
Age Groups ◽  
Household Survey ◽  
Male Gender ◽  
Night Time ◽  
Cross Sectional

Abstract Background Myanmar commenced a lymphatic filariasis (LF) elimination programme in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere; however, there remains little information on the factors that contribute in Myanmar. Methods We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and, if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and, if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for non-participation (never taking MDA). Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results After adjustment for covariates and survey design, being CFA positive was significantly associated with age [odds ratio (OR) 1.03, 95% CI 1.01–1.06), per year], male gender (OR 3.14, 1.27–7.76), elevation (OR 0.96, 0.94–0.99, per metre) and the density of people per household room (OR 1.59, 1.31–1.92). LF-related hydrocoele was associated with age (OR 1.06, 1.03–1.09, per year) and residing in Amarapura Township (OR 8.93, 1.37–58.32). Never taking MDA was associated with male gender [OR 6.89 (2.13–22.28)] and age, particularly in females, with a significant interaction term. Overall, compared to those aged 30–44 years, the proportion never taking MDA was higher in all age groups (OR highest in those < 5 years and > 60 years, ranging from 3.37 to 12.82). Never taking MDA was also associated with residing in Amarapura township (OR 2.48, 1.15–5.31), moving to one’s current village from another (OR 2.62, 1.12–6.11) and ever having declined medication (OR 11.82, 4.25–32.91). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.16, 0.03–0.74) and the number visits by the MDA programme (OR 0.69, 0.48–1.00). Conclusions These results contribute to the understanding of LF and MDA participation-related risk factors and will assist Myanmar to improve its elimination and morbidity management programmes.

scholarly journals Risk factors for Lymphatic Filariasis and Mass Drug Administration non-Participation in Mandalay Region, Myanmar

2020 ◽  
Author(s):  
Benjamin Felix Rothschild Dickson ◽  
Patricia M. Graves ◽  
Ni Ni Aye ◽  
Thet Wai Nwe ◽  
Tint Wai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Survey Design ◽  
Household Survey ◽  
Male Gender ◽  
Night Time ◽  
Cross Sectional ◽  
Separate Step

Abstract Background: Myanmar commenced a lymphatic filariasis (LF) elimination program in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere, however, there remains little information on the factors that contribute in Myanmar. Methods: We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for never-taking MDA. Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results: After adjustment for covariates and survey design, being CFA positive was significantly associated with age (odds ratio (OR) 1.03, 95% CI 1.01 – 1.06), per year), male gender (OR 3.11, 1.23 – 7.87), elevation (OR 0.97, 0.94 – 1.00, per metre) and the density of people per household room (OR 1.56, 1.26 – 1.93). LF-related hydrocoele was associated with age (OR 1.06, 1.02 – 1.09, per year) and residing in Amarapura Township (OR 8.56, 1.33 – 55.22). Never-taking MDA was associated with age (less than 15 years: OR 2.89, 1.11 – 7.51; greater than 60 years: OR 4.00, 1.53 – 10.48), male gender (OR 1.85, 1.05 – 3.25), residing in Amarapura township (OR 2.99, 1.39 – 6.43), moving to one’s current village from another (OR 2.84, 1.15 – 7.02) and ever having declined medication (OR 13.76, 4.79 – 39.58). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.18, 0.04 – 0.96)). Conclusions: These results contribute to the understanding of LF and MDA participation related risk factors, and will assist Myanmar improve its elimination and morbidity management programs.

scholarly journals A triple-drug treatment regimen to accelerate elimination of lymphatic filariasis: From conception to delivery

2020 ◽  
Vol 13 (Supplement_1) ◽  
pp. S60-S64
Author(s):  
Gary J Weil ◽  
Julie A Jacobson ◽  
Jonathan D King
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Single Dose ◽  
Drug Treatment ◽  
Lymphatic Filariasis ◽  
Treatment Regimen ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Drug Combination ◽  
Community Study

Abstract The Global Programme to Eliminate Lymphatic Filariasis (LF) is using mass drug administration (MDA) of antifilarial medications to treat filarial infections, prevent disease and interrupt transmission. Almost 500 million people receive these medications each year. Clinical trials have recently shown that a single dose of a triple-drug combination comprised of ivermectin, diethylcarbamazine and albendazole (IDA) is dramatically superior to widely used two-drug combinations for clearing larval filarial parasites from the blood of infected persons. A large multicenter community study showed that IDA was well-tolerated when it was provided as MDA. IDA was rapidly advanced from clinical trial to policy and implementation; it has the potential to accelerate LF elimination in many endemic countries.

scholarly journals Filariasis elimination in Egypt: impact of low micro-filaraemics as sources of infection for mosquitoes

2003 ◽  
Vol 9 (4) ◽  
pp. 863-872
Author(s):  
H. A. Farid ◽  
S. A. Kamal ◽  
G. J. Weil ◽  
F. K. Adham ◽  
R. M. R. Ramzy
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Wuchereria Bancrofti ◽  
Vector Transmission ◽  
Transmission Cycle ◽  
Sources Of Infection ◽  
Pre Treatment ◽  
One Year

The elimination strategy for lymphatic filariasis aims at reducing blood microfilaraemia to levels at which vector transmission cannot be sustained. We aimed to determine whether patients with pre-treatment low or ultra-low microfilaria [MF] counts could be a reservoir of infection after mass drug administration [MDA] with a combined regimen. Laboratory-reared mosquitoes were fed on 30 volunteers after 2 rounds of MDA. Microfilaria uptake, infectivity rates and number of Wuchereria bancrofti L3 per mosquito were assessed. One year after MDA-1, 6 subjects transmitted MF, but up to 9 months after MDA-2 transmission failed. Six months after MDA-2 > 90% had clear MF smears and either failed to transmit MF or transmitted MF that did not develop to L3. We conclude that the transmission cycle is seriously weakened after MDA-2

scholarly journals Evaluation of coverage and compliance to mass drug administration for lymphatic filariasis elimination in two endemic districts of Karnataka

2019 ◽  
Vol 6 (8) ◽  
pp. 3583
Author(s):  
Anwith H. Shivalingaiah ◽  
Ravikumar K. ◽  
Sunil M. Gurupadaswamy
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Compliance Rate ◽  
Household Survey ◽  
Cross Sectional Study ◽  
Coverage Rate ◽  
Cross Sectional ◽  
Effective Coverage ◽  
Multi Stage

Background: Lymphatic filariasis is a debilitating and disfiguring disease causing significant socioeconomic burden. India is endemic for filariasis which includes Kalaburagi and Yadgir districts in Karnataka. India has the target for filariasis elimination by 2020 and mass drug administration [MDA] is a strategy for elimination. The objective of the study was to evaluate the coverage and compliance of mass drug administration against lymphatic filariasis.Methods: The study was a cross sectional study conducted during the month of October 2018 in Kalaburagi and Yadgir districts. The study subjects included all the residents of cluster except subjects aged below 2 years and pregnant women. Multi stage sampling was used and three clusters from rural area and one cluster from urban area from each district. Data collection was done by household survey after informed consent using a standard questionnaire.Results: A total population of 1,963 subjects residing in 399 houses of two districts was included. Majority of the study subjects 1517 (77.27%) were in the age group of more than 15 years with predominantly males 984(50.12%). The coverage rate and compliance rate of MDA was 83.17% and 92.46% in Kalaburagi district and 86.71% and 86.98% in Yadgir district respectively. The effective coverage rate and coverage compliance gap was 76.89% and 7.53% in Kalaburagi district, 75.42% and 13.01% in Yadgir district. Incomplete dose of MDA was consumed by 17 subjects in Kalaburagi district and 21 subjects in Yadgir district.Conclusions: The effective MDA coverage in both the study districts is below 85% which is not satisfactory.

scholarly journals Mass Drug Administration for Lymphatic Filariasis Elimination in Two Districts of North Karnataka: Coverage and Compliance Assessment

Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 94-99
Author(s):  
Huluvadi Shivalingaiah Anwith ◽  
S R Suhas ◽  
Seema K S ◽  
Karishma P S ◽  
K Ravi Kumar ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Compliance Rate ◽  
Household Survey ◽  
Control Programme ◽  
Coverage Rate ◽  
Cross Sectional ◽  
Effective Coverage ◽  
All Diseases

Introduction: Lymphatic filariasis or elephantiasis is the most debilitating and disfiguring scourge among all diseases which imposes severe social and economic burden. Currently an estimated 63crores people are at a risk of filariasis in 256 endemic districts across 16 states and 5 union territories in India. National filarial control programme is operational since 1955 in India and the current goal is achieving elimination of filariasis by 2020through Mass Drug Administration (MDA). Objective: To assess the coverage, compliance and causes for noncompliance of MDA in the study districts. Method: A cross sectional descriptive study was conducted in October 2019 and January 2020 in Koppal and Bidar districts respectively. Randomly four clusters were selected, three from rural area and one from urban area. All the residents of a cluster were included except subjects aged below 2 years and pregnant women. Data collection was done by household survey using a standard questionnaire. Results: Total populations of 2043 subjects residing in 480 houses were included. The coverage rate was95.44 &94.73% with compliance rate of 91.61% &93.12% in Koppal & Bidar districts, respectively. The effective coverage rate was 87.44 %& 88.2% in Koppal & Bidar districts respectively. Drug consumption by DOT was 95.1% in Koppal&85.8% in Bidar district. Conclusions: The coverage& compliance of MDA was found to be satisfactoryas it was >65%.Consumption of MDA by DOT to be more emphasized to reduce coverage compliance gap and increase the effective coverage rate.

scholarly journals Risk factors for lymphatic filariasis and mass drug administration non-participation in Mandalay Region, Myanmar

2020 ◽  
Author(s):  
Benjamin Felix Rothschild Dickson ◽  
Patricia M Graves ◽  
Ni Ni Aye ◽  
Thet Wai Nwe ◽  
Tint Wai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Survey Design ◽  
Household Survey ◽  
Male Gender ◽  
Night Time ◽  
Cross Sectional ◽  
Separate Step

Abstract Background: Myanmar commenced a lymphatic filariasis (LF) elimination program in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere, however, there remains little information on the factors that contribute in Myanmar. Methods: We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for never-taking MDA. Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results: After adjustment for covariates and survey design, being CFA positive was significantly associated with age (odds ratio (OR) 1.03, 95% CI 1.01 – 1.06), per year), male gender (OR 3.11, 1.23 – 7.87), elevation (OR 0.97, 0.94 – 1.00, per metre) and the density of people per household room (OR 1.56, 1.26 – 1.93). LF-related hydrocoele was associated with age (OR 1.06, 1.02 – 1.09, per year) and residing in Amarapura Township (OR 8.56, 1.33 – 55.22). Never-taking MDA was associated with age (less than 15 years: OR 2.89, 1.11 – 7.51; greater than 60 years: OR 4.00, 1.53 – 10.48), male gender (OR 1.85, 1.05 – 3.25), residing in Amarapura township (OR 2.99, 1.39 – 6.43), moving to one’s current village from another (OR 2.84, 1.15 – 7.02) and ever having declined medication (OR 13.76, 4.79 – 39.58). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.18, 0.04 – 0.96)).Conclusions: These results contribute to the understanding of LF and MDA participation related risk factors, and will assist Myanmar improve its elimination and morbidity management programs.

Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

2020 ◽  
Vol 20 (2) ◽  
pp. 167-174
Author(s):  
Ilo Dicko ◽  
Yaya Ibrahim Coulibaly ◽  
Modibo Sangaré ◽  
Bismark Sarfo ◽  
Priscillia Awo Nortey
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Health Workers ◽  
Compliance Rate ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Improve Compliance ◽  
Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

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