SYSTEMATIC REVIEW ON IMPACT OF MASS DRUG ADMINISTRATION ON LYMPHATIC FILARIASIS PREVENTION

introduction: Lymphatic filariasis (LF) is a disease caused by filarial parasites transmitted to human by mosquitoes and infecting 120 million people worldwide. Mass drug administration (MDA) involves delivering treatment to every person living in a defined geographical area, is the current practice in place and has shown to be very useful in reducing the global transmission of LF. This review aims to explore into the effectiveness of MDA in interrupting the transmission of LF in terms of the types of MDA, number of cycles, coverage, and percentage of transmission reduction. Methods: A systematic search via Scopus, PubMed, and Cochrane was done for articles published from 2015 to 2019 by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The articles identified from the databases searched and any that appeared to relate to the research questions were included. A total number of 14 articles fulfilled the criteria for review. Results: Overall, the review showed a reduction in LF indices of more than 50% and up to 100% post-MDA in endemic communities with high prevalence. The entomological assessment revealed a reduction in LF transmission post-MDA, which strongly supported the reduction of LF indices. Biannual MDA conducted further showed a marked reduction in LF indices compared to annual MDA. Double therapy of MDA significantly reduced the transmission indices to almost nil compared to single therapy. Conclusion: Review of MDA showed promising effects in which it reduced the prevalence microfilaraemia (mf) and Circulating Filarial Antigen (CFA) from baseline, as well as the clinical prevalence and entomological indices. Combination therapy showed better outcome compared to single therapy. Therefore, complementary vector control is suggested in addition to MDA, as well as education delivery to the endemic communities.

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Impact of Mass Drug Administration on Prevalence of Schistosomiasis in Eight Riverine Communities in the Asuogyaman District of the Eastern Region, Ghana

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1530355 ◽

2020 ◽

pp. 18-32

Author(s):

Quartey Abass ◽

John Yao Bedzo ◽

Stephen Manortey

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Geographical Area ◽

Bivariate Analysis ◽

Disease Rate ◽

Significant Variable ◽

Eastern Region ◽

Cross Sectional ◽

High Prevalence ◽

The Impact

Background: The incidence of schistosomiasis in Ghana and more specifically in the Asuogyaman District had become a noticeable record following the creation of the Akosombo Dam in the early 1960s. This has inevitably since placed an enormous burden on the health service delivery systems in the geographical area. Mass Drug Administration (MDA) of Praziquantel has been used worldwide as a preventive and treatment intervention measure for the disease, and the study area is no exception. The study, therefore, aimed to assess the impact of MDA on the prevalence and associated risk factors of schistosomiasis in eight (8) selected riverine communities within the district. Methods: A descriptive retrospective cross-sectional study was conducted involving 896 respondents with ages ranging from 2 to 82 years and a mean age of 17±13.78 years. Data were obtained from the Volta River Authority (VRA) Public Health and Environmental Department. Pearson’s chi-square tests and logistic regression models were used to assess the association and predict the relationship between variables. Findings: Out of the 896 respondents, 93 (10.4 %) tested positive for Schistosoma haematobium. Proportionally, the Nyameben community had a high prevalence of 25.8% while Mami-Waterkope, and Mangoase both had a low prevalence of 3.2 %. The average uptake of Praziquantel was 41% across the study area. From the bivariate analysis, the respondents’ community of residence was noted as the only statistically significant variable contributing to infection. Respondents aged 13-39 were 1.68 times more likely to be infected compared to their younger counterparts after controlling for all other covariates in the predictive model. Conclusion: Mass Drug Administration had a tremendous effect on reducing the prevalence of urinary schistosomiasis to the present level of 10.4%. However, some “hotspots” like the Nyameben community will require special attention to reduce the high prevalence disease rate. Communities with low uptake of Praziquantel had a relatively high prevalence of schistosomiasis.

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

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666190206210808 ◽

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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Evaluating context-specific evidence-based quality improvement intervention on lymphatic filariasis mass drug administration in Northern Ghana using the RE-AIM framework

Tropical Medicine and Health ◽

10.1186/s41182-021-00305-3 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Alfred Kwesi Manyeh ◽

Tobias Chirwa ◽

Rohit Ramaswamy ◽

Frank Baiden ◽

Latifat Ibisomi

Keyword(s):

Quality Improvement ◽

Needs Assessment ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Northern Ghana ◽

Quality Improvement Intervention ◽

Evidence Based ◽

Context Specific ◽

Improvement Intervention

Abstract Background Over a decade of implementing a global strategy to eliminate lymphatic filariasis in Ghana through mass drug administration, the disease is still being transmitted in 11 districts out of an initial 98 endemic districts identified in 2000. A context-specific evidence-based quality improvement intervention was implemented in the Bole District of Northern Ghana after an initial needs assessment to improve the lymphatic filariasis mass drug administration towards eliminating the disease. Therefore, this study aimed to evaluate the process and impact of the lymphatic filariasis context-specific evidence-based quality improvement intervention in the Bole District of Northern Ghana. Method A cross-sectional mixed methods study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the context-specific evidence-based quality improvement intervention was employed. Quantitative secondary data was extracted from the neglected tropical diseases database. A community survey was conducted with 446 randomly selected participants. Qualitative data were collected from 42 purposively selected health workers, chiefs/opinion leaders and community drug distributors in the study area. Results The evaluation findings showed an improvement in social mobilisation and sensitisation, knowledge about lymphatic filariasis and mass drug administration process, willingness to ingest the medication and adherence to the direct observation treatment strategy. We observed an increase in coverage ranging from 0.1 to 12.3% after implementing the intervention at the sub-district level and reducing self-reported adverse drug reaction. The level of reach, effectiveness and adoption at the district, sub-district and individual participants’ level suggest that the context-specific evidence-based quality improvement intervention is feasible to implement in lymphatic filariasis hotspot districts based on initial context-specific needs assessment. Conclusion The study provided the groundwork for future application of the RE-AIM framework to evaluate the implementation of context-specific evidence-based quality improvement intervention to improve lymphatic filariasis mass drug administration towards eliminating the disease as a public health problem.

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Clinical case estimates of lymphatic filariasis in an endemic district of Bangladesh after a decade of mass drug administration

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trv084 ◽

2015 ◽

Vol 109 (11) ◽

pp. 700-709 ◽

Cited By ~ 7

Author(s):

Israt Hafiz ◽

Patricia Graves ◽

Rouseli Haq ◽

Meerjady Sabrina Flora ◽

Louise A. Kelly-Hope

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Clinical Case ◽

Endemic District

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Lymphatic filariasis, infection status in Culex quinquefasciatus and Anopheles species after six rounds of mass drug administration in Masasi District, Tanzania

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00808-5 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Eliza Lupenza ◽

Dinah B. Gasarasi ◽

Omary M. Minzi

Keyword(s):

Vector Control ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Wuchereria Bancrofti ◽

Elimination Phase ◽

Anopheles Species ◽

The Status ◽

Household Environment ◽

Indoor And Outdoor

Abstract Background Lymphatic filariasis (LF) elimination program in Tanzania started in 2000 in response to the Global program for the elimination of LF by 2020. Evidence shows a persistent LF transmission despite more than a decade of mass drug administration (MDA). It is advocated that, regular monitoring should be conducted in endemic areas to evaluate the progress towards elimination and detect resurgence of the disease timely. This study was therefore designed to assess the status of Wuchereria bancrofti infection in Culex quinqefasciatus and Anopheles species after six rounds of MDA in Masasi District, South Eastern Tanzania. Methods Mosquitoes were collected between June and July 2019 using Center for Diseases Control (CDC) light traps and gravid traps for indoor and outdoor respectively. The collected mosquitoes were morphologically identified into respective species. Dissections and PCR were carried out to detect W. bancrofti infection. Questionnaire survey and checklist were used to assess vector control interventions and household environment respectively. A Poisson regression model was run to determine the effects of household environment on filarial vector density. Results Overall, 12 452 mosquitoes were collected of which 10 545 (84.7%) were filarial vectors. Of these, Anopheles gambiae complex, An. funestus group and Cx. quinquefasciatus accounted for 0.1%, 0.7% and 99.2% respectively. A total of 365 pools of Cx. quinquefasciatus (each with 20 mosquitoes) and 46 individual samples of Anopheles species were analyzed by PCR. For Cx. quinquefasciatus pools, 33 were positive for W. bancrofti, giving an infection rate of 0.5%, while the 46 samples of Anopheles species were all negative. All 1859 dissected mosquitoes analyzed by microscopy were also negative. Households with modern latrines had less mosquitoes than those with pit latrines [odds ratio (OR) = 0.407, P < 0.05]. Houses with unscreened windows had more mosquitoes as compared to those with screened windows (OR = 2.125, P < 0.05). More than 80% of the participants own bednets while 16.5% had no protection. Conclusions LF low transmission is still ongoing in Masasi District after six rounds of MDA and vector control interventions. The findings also suggest that molecular tools may be essential for xenomonitoring LF transmission during elimination phase.

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