The impact of the National Programme to Eliminate Lymphatic Filariasis on filariasis morbidity in Sri Lanka: Comparison of current status with retrospective data following the elimination of lymphatic filariasis as a public health problem.

Autor: Gunaratna IE; Anti Filariasis Campaign, Ministry of Health, Colombo, Sri Lanka., Chandrasena NTGA; Department of Parasitology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka., Vallipuranathan M; Anti Filariasis Campaign, Ministry of Health, Colombo, Sri Lanka., Premaratna R; Department of Medicine, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka., Ediriweera D; Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka., de Silva NR; Department of Parasitology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2024 Aug 14; Vol. 18 (8), pp. e0012343. Date of Electronic Publication: 2024 Aug 14 (Print Publication: 2024).
DOI: 10.1371/journal.pntd.0012343
Abstrakt: Introduction: Sri Lanka implemented the National Programme for Elimination of Lymphatic Filariasis (NPELF) in its endemic regions in 2002. Five annual rounds of mass drug administration using the two-drug combination diethylcarbamazine (DEC) and albendazole led to sustained reductions in infection rates below threshold levels. In 2016, WHO validated that Sri Lanka eliminated lymphatic filariasis as a public health problem.
Objective: To explore the impact of the NPELF on lymphatic filariasis morbidity in Sri Lanka.
Methods: Passive Case Detection (PCD) data maintained in filaria clinic registries from 2006-2022 for lymphoedema and hospital admission data for managing hydroceles/spermatoceles from 2007-2022 were analyzed. The morbidity status in 2022 and trends in overall and district-wise PCD rates were assessed. Poisson log-linear models were used to assess the trends in PCD for endemic regions, including district-wise trends and hospital admissions for the management of hydroceles/spermatoceles.
Results: In 2022, there were 566 new lymphoedema case visits. The mean (SD) age was 53.9 (16.0) years. The staging was done for 94% of cases, of which 79% were in the early stages (57.3% and 21.4% in stages two and one, respectively). Western Province had the highest caseload (52%), followed by the Southern (32%) and Northwestern (16%) Provinces, respectively. The reported lymphoedema PCD rate in 2022 was 0.61 per 10,000 endemic population. The overall PCD rate showed a decline of 7.6% (95%CI: 4.9% - 10.3%) per year (P < 0.0001) from 2007 to 2022. A steady decline was observed in Colombo, Gampaha and Kurunegala districts, while Kalutara remained static and other districts showed a decline in recent years. Further, admissions for inpatient management of hydroceles/spermatoceles showed a declining trend after 2015.
Conclusions: The PCD rates of lymphoedema and hydroceles/spermatoceles showed a declining trend in Sri Lanka after the implementation of the NPELF.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Gunaratna et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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