Many countries have reached the goal of eliminating the disease. But progress is slow, with some countries having not yet completed mapping and MDA. There are differences among the various WHO areas and regions, and additional efforts are needed in endemic areas. The Global Programme to Eliminate Lymphatic Filariasis has been established to help achieve this goal. This report summarizes the current status of the program.
While the global results from the TAS are encouraging, additional work needs to be done to ensure that the global elimination target is reached. In Sri Lanka, the government recently reassessed progress. They confirmed the achievement of LF elimination and reaffirmed the deadline of 2020. The resulting data will provide important guidance for national and international interventions. It will also help identify gaps and challenges, as well as assess progress made to date.
The WHO has recommended a mass drug administration (MDA) strategy to achieve global lymphatic filariasis elimination. This strategy involves giving a large dose of medicine to people living in endemic areas. The aim of this program is to reduce the density of microfilariae in the blood and prevent the spread of the parasite to mosquitoes. However, this method requires at least 10 years to show a significant impact. The success rate for MDA may be overstated because of the spatial distribution of the parasite. In this study, the prevalence of the disease was recorded for a large geographic area to reduce surveillance costs. By contrast, the smaller units compensate for the spatial prevalence of the infection and are more sensitive to its persistence.
The study reported that the prevalence of lymphatic filariasis in both Sri Lanka and the Maldives was higher than the threshold. This is attributed to a high baseline prevalence, which may have contributed to the higher than expected results. Further, the TAS showed that all formerly endemic EUs in Sri Lanka passed the TAS, which led WHO to validate elimination in all regions by 2020.
In addition to the mass drug administrations, the WHO recommended that countries should adopt alternative strategies. In areas that have endemic Loa or onchocerciasis, the triple drug strategy has been used successfully. In these cases, the elimination target for lymphatic filariasis was attained by 17 countries in 2019. For the rest of the world, this achievement is even more impressive.
In addition to the mass drug administration, the WHO recommended that all countries should strengthen their surveillance programs. The elimination of lymphatic filariasis is an important public health issue that is of high importance. In addition to identifying countries with high incidence of the disease, the WHO also urged countries to conduct annual screenings for the parasite that causes the disease. This will help the country achieve its elimination target for lymphatic filariasis.