Elimination within reach: A cross-sectional study highlighting the factors that contribute to persistent lymphatic filariasis in eight communities in rural Ghana.
Albendazole
/ therapeutic use
Animals
Anopheles
/ parasitology
Antigens, Helminth
/ blood
Brugia malayi
/ drug effects
Child
Child, Preschool
Cross-Sectional Studies
Diethylcarbamazine
/ therapeutic use
Elephantiasis, Filarial
/ drug therapy
Female
Filaricides
/ therapeutic use
Ghana
/ epidemiology
Humans
Ivermectin
/ therapeutic use
Male
Mass Drug Administration
Microfilariae
/ drug effects
Parasite Load
Risk Factors
Rural Population
Wuchereria bancrofti
/ drug effects
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
18
01
2018
accepted:
13
11
2018
revised:
22
01
2019
pubmed:
5
1
2019
medline:
15
2
2019
entrez:
5
1
2019
Statut:
epublish
Résumé
Despite the progress achieved in scaling-up mass drug administration (MDA) for lymphatic filariasis (LF) in Ghana, communities with persistent LF still exist even after 10 years of community treatment. To understand the reasons for persistence, we conducted a study to assess the status of disease elimination and understand the adherence to interventions including MDA and insecticide treated nets. We conducted a parasitological and epidemiological cross-sectional study in adults from eight villages still under MDA in the Northern Region savannah and the coastal Western Region of the country. Prevalence of filarial antigen ranged 0 to 32.4% and in five villages the prevalence of night blood microfilaria (mf) was above 1%, ranging from 0 to 5.7%. Median mf density was 67 mf/ml (range: 10-3,560). LF antigen positivity was positively associated with male sex but negatively associated with participating in MDA the previous year. Male sex was also associated with a decreased probability of participating in MDA. A stochastic model (TRANSFIL) was used to assess the expected microfilaria prevalence under different MDA coverage scenarios using historical data on one community in the Western Region. In this example, the model simulations suggested that the slow decline in mf prevalence is what we would expect given high baseline prevalence and a high correlation between MDA adherence from year to year, despite high MDA coverage. There is a need for an integrated quantitative and qualitative research approach to identify the variations in prevalence, associated risk factors and intervention coverage and use levels between and within regions and districts. Such knowledge will help target resources and enhance surveillance to the communities most at risk and to reach the 2020 LF elimination goals in Ghana.
Sections du résumé
BACKGROUND
Despite the progress achieved in scaling-up mass drug administration (MDA) for lymphatic filariasis (LF) in Ghana, communities with persistent LF still exist even after 10 years of community treatment. To understand the reasons for persistence, we conducted a study to assess the status of disease elimination and understand the adherence to interventions including MDA and insecticide treated nets.
METHODOLOGY AND PRINCIPAL FINDINGS
We conducted a parasitological and epidemiological cross-sectional study in adults from eight villages still under MDA in the Northern Region savannah and the coastal Western Region of the country. Prevalence of filarial antigen ranged 0 to 32.4% and in five villages the prevalence of night blood microfilaria (mf) was above 1%, ranging from 0 to 5.7%. Median mf density was 67 mf/ml (range: 10-3,560). LF antigen positivity was positively associated with male sex but negatively associated with participating in MDA the previous year. Male sex was also associated with a decreased probability of participating in MDA. A stochastic model (TRANSFIL) was used to assess the expected microfilaria prevalence under different MDA coverage scenarios using historical data on one community in the Western Region. In this example, the model simulations suggested that the slow decline in mf prevalence is what we would expect given high baseline prevalence and a high correlation between MDA adherence from year to year, despite high MDA coverage.
CONCLUSIONS
There is a need for an integrated quantitative and qualitative research approach to identify the variations in prevalence, associated risk factors and intervention coverage and use levels between and within regions and districts. Such knowledge will help target resources and enhance surveillance to the communities most at risk and to reach the 2020 LF elimination goals in Ghana.
Identifiants
pubmed: 30608931
doi: 10.1371/journal.pntd.0006994
pii: PNTD-D-18-00048
pmc: PMC6342320
doi:
Substances chimiques
Antigens, Helminth
0
Filaricides
0
Ivermectin
70288-86-7
Albendazole
F4216019LN
Diethylcarbamazine
V867Q8X3ZD
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0006994Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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