Determinants of Success in National Programs to Eliminate Lymphatic Filariasis: a Perspective Identifying Essential Elements and Research Needs

Authors

Dominique Kyelem, The Task Force for Global Health, Decatur, Georgia
Gautam Biswas
Moses J. Bockarie, Case Western Reserve University School of Medicine
Mark Bradley, Global Community Partnerships
Maged El-Setouhy
Peter U. Fischer, Washington University School of Medicine
Ralph H. Henderson, Neglected Tropical Diseases Support Center
James W. Kazura, Case Western Reserve University School of Medicine
Patrick J. Lammie, Centers for Disease Control and Prevention, Atlanta, Georgia
Sammy M. Njenga
Eric A. Ottesen, The Task Force for Global Health, Decatur, Georgia
Kapa Ramaiah, Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India
Frank O. Richardson
Gary J. Weil, Washington University School of Medicine
Steven A. Williams, Smith CollegeFollow

Document Type

Article

Publication Date

10-2008

Publication Title

The American Society of Tropical Medicine and Hygiene

Abstract

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000. To understand why some national programs have been more successful than others, a panel of individuals with expertise in LF elimination efforts met to assess available data from programs in 8 countries. The goal was to identify: 1) the factors determining success for national LF elimination programs (defined as the rapid, sustained reduction in microfilaremia/ antigenemia after repeated mass drug administration [MDA]); 2) the priorities for operational research to enhance LF elimination efforts.

Of more than 40 factors identified, the most prominent were 1) initial level of LF endemicity; 2) effectiveness of vector mosquitoes; 3) MDA drug regimen; 4) population compliance.

Research important for facilitating program success was identified as either biologic (i.e., [1] quantifying differences in vectorial capacity; [2] identifying seasonal variations affecting LF transmission) or programmatic (i.e., [1] identifying quantitative thresholds, especially the population compliance levels necessary for success, and the antigenemia or microfilaremia prevalence at which MDA programs can stop with minimal risk of resumption of transmission; [2] defining optimal drug distribution strategies and timing; [3] identifying those individuals who are “persistently non- compliant” during MDAs, the reasons for this non-compliance and approaches to overcoming it).

While addressing these challenges is important, many key determinants of program success are already clearly understood; operationalizing these as soon as possible will greatly increase the potential for national program success.

Volume

79

Issue

4

First Page

480

Last Page

484

DOI

doi.org/10.4269/ajtmh.2008.79.480

Rights

Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

Comments

Archived as published.

Recommended Citation

Kyelem, Dominique; Biswas, Gautam; Bockarie, Moses J.; Bradley, Mark; El-Setouhy, Maged; Fischer, Peter U.; Henderson, Ralph H.; Kazura, James W.; Lammie, Patrick J.; Njenga, Sammy M.; Ottesen, Eric A.; Ramaiah, Kapa; Richardson, Frank O.; Weil, Gary J.; and Williams, Steven A., "Determinants of Success in National Programs to Eliminate Lymphatic Filariasis: a Perspective Identifying Essential Elements and Research Needs" (2008). Biological Sciences: Faculty Publications, Smith College, Northampton, MA.
https://scholarworks.smith.edu/bio_facpubs/17