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LETTER TO EDITOR
Year : 2016  |  Volume : 1  |  Issue : 2  |  Page : 83-84

Mid-term assessment of the lymphatic filariasis elimination program


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication4-Jul-2016

Correspondence Address:
Saurabh Rambiharilal Shrivastava
Third Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur-Guduvancherry Main Road, Sembakkam, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2468-5690.185306

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Mid-term assessment of the lymphatic filariasis elimination program. Environ Dis 2016;1:83-4

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Mid-term assessment of the lymphatic filariasis elimination program. Environ Dis [serial online] 2016 [cited 2018 May 21];1:83-4. Available from: http://www.environmentmed.org/text.asp?2016/1/2/83/185306

Dear Editor,

Lymphatic filariasis is a neglected tropical disease caused by three types of filarial worms, with Wuchereria bancrofti alone accounting for 90% cases, resulting in an altered lymphatic system, and an abnormal enlargement of body parts, causing pain and permanent disability. [1],[2] The recent global estimates suggest that almost 1.1 billion people are in the need for prophylactic chemotherapy to stop the disease transmission, of which four-fifth are from the African region, Southeast Asia, and India. [1] Though, a major proportion of cases are asymptomatic, even acute and chronic manifestations of the disease have been reported. [1]

Further, the majority of the patients are not only physically disabled but also even had to face mental, social, and financial losses, eventually precipitating social stigma and poverty. [1] Acknowledging the public health concern associated with the disease, distribution across different geographical regions, and the associated impairment in the quality of life/disability, the World Health Organization has initiated the global program to eliminate lymphatic filariasis in 2000. [1],[2],[3] The international stakeholders have realized this initiative as one of the fastest growing disease elimination programs in the world, and subsequent to the considerable gains achieved (viz. 5.5 billion people received preventive chemotherapy), it was decided to target elimination of the disease by the year 2020. [1],[3]

The proposed target of elimination is based on two strategies, namely preventive chemotherapy (large scale administration of a single dose of two drugs [albendazole + ivermectin/diethylcarbamazine] annually for 4-6 successive years in regions where infection is prevalent to interrupt the transmission), and appropriate treatment of morbidities and prevention of disabilities. [2],[3] Variable morbidities can be managed by either surgical intervention for hydrocele or treatment of lymphedema, promotion of general cleanliness/skin care/limb elevation, and management of adenolymphangitis. [2],[3],[4] In addition, measures to ensure control of the mosquito vector, and adoption of Filariasis Test Strip newer diagnostic test to ascertain when to stop preventive chemotherapy will also play a defining role in accomplishing the target of elimination of the disease. [1],[5]

Furthermore, as migration plays a significant role in the emergence and re-introduction of lymphatic filariasis, some of the nations have adopted the strategy to administer two doses of diethylcarbamazine with an interval of 6 months to prevent imported cases. [2],[3] However, a wide range of challenges like almost 55 nations yet to initiate preventive chemotherapy, the lack of coverage of the entire at-risk population in high-risk areas, shortcomings in the health system, issues with compliance to treatment, contraindications to drugs, and funding constraints have been identified in the global mission of filariasis elimination. [1],[2],[3]

To conclude, the target to globally eliminate lymphatic filariasis by 2020 can be accomplished, provide all the member states and stakeholders work in collaboration to strengthen the prevention and control activities.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Lymphatic Filariasis - Fact sheet; 2016. Available from: . [Last accessed on 2016 Mar 05].  Back to cited text no. 1
    
2.
Kastner RJ, Stone CM, Steinmann P, Tanner M, Tediosi F. What is needed to eradicate lymphatic filariasis? A model-based assessment on the impact of scaling up mass drug administration programs. PLoS Negl Trop Dis 2015;9:e0004147.  Back to cited text no. 2
    
3.
Toothong T, Tipayamongkholgul M, Suwannapong N, Suvannadabba S. Evaluation of mass drug administration in the program to control imported lymphatic filariasis in Thailand. BMC Public Health 2015;15:975.  Back to cited text no. 3
    
4.
Cassidy T, Worrell CM, Little K, Prakash A, Patra I, Rout J, et al. Experiences of a community-based lymphedema management program for lymphatic filariasis in Odisha State, India: An Analysis of Focus Group Discussions with Patients, Families, Community Members and Program Volunteers. PLoS Negl Trop Dis 2016;10:e0004424.  Back to cited text no. 4
    
5.
World Health Organization. Improved Availability of New Test to Enhance Global Lymphatic Filariasis Elimination; 2016. Available from: . [Last accessed on 2016 Mar 05].  Back to cited text no. 5
    




 

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