Is mass drug administration against lymphatic filariasis required in urban settings? The experience in Kano, Nigeria

Autor: Emmanuel Davies, David H. Molyneux, Moses J. Bockarie, Dziedzom K. de Souza, Millicent Opoku, Ibrahim Nazaradden, Safiya Sanda, Elisabeth Osim Elhassan, Benjamin G. Koudou, Chukwu Okoronkwo, Pam Dd, Susan D’Souza, Ifeoma Anagbogu
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
Nematoda
Anopheles gambiae
Anopheles Gambiae
Helminth genetics
Artificial Gene Amplification and Extension
Disease Vectors
medicine.disease_cause
Polymerase Chain Reaction
Mosquitoes
Geographical Locations
0302 clinical medicine
Medicine and Health Sciences
Child
wb_330
Lymphatic filariasis
Geographic Areas
wa_30
Geography
lcsh:Public aspects of medicine
Eukaryota
Middle Aged
Filariasis
Insects
Culex
Wuchereria bancrofti
Infectious Diseases
Helminth Infections
Female
wb_340
Wuchereria
Research Article
Urban Areas
Neglected Tropical Diseases
Adult
wc_880
lcsh:Arctic medicine. Tropical medicine
Adolescent
Arthropoda
lcsh:RC955-962
030231 tropical medicine
Nigeria
Elephantiasis
Biology
Research and Analysis Methods
Drug Administration Schedule
03 medical and health sciences
Young Adult
Elephantiasis
Filarial
Environmental health
parasitic diseases
Anopheles
medicine
Parasitic Diseases
Animals
Humans
Disease Eradication
Mass drug administration
Molecular Biology Techniques
Molecular Biology
Lymphatic Filariasis
Public Health
Environmental and Occupational Health
Urban Health
Organisms
Biology and Life Sciences
lcsh:RA1-1270
medicine.disease
biology.organism_classification
Tropical Diseases
Invertebrates
Insect Vectors
Species Interactions
030104 developmental biology
Filaricides
Antigens
Helminth
Immunology
People and Places
Africa
Earth Sciences
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 11, Iss 10, p e0006004 (2017)
ISSN: 1935-2735
Popis: Background The Global Programme to Eliminate Lymphatic Filariasis (GPELF), launched in 2000, has the target of eliminating the disease as a public health problem by the year 2020. The strategy adopted is mass drug administration (MDA) to all eligible individuals in endemic communities and the implementation of measures to reduce the morbidity of those suffering from chronic disease. Success has been recorded in many rural endemic communities in which elimination efforts have centered. However, implementation has been challenging in several urban African cities. The large cities of West Africa, exemplified in Nigeria in Kano are challenging for LF elimination program because reaching 65% therapeutic coverage during MDA is difficult. There is therefore a need to define a strategy which could complement MDA. Thus, in Kano State, Nigeria, while LF MDA had reached 33 of the 44 Local Government Areas (LGAs) there remained eleven ‘urban’ LGAs which had not been covered by MDA. Given the challenges of achieving at least 65% coverage during MDA implementation over several years in order to achieve elimination, it may be challenging to eliminate LF in such settings. In order to plan the LF control activities, this study was undertaken to confirm the LF infection prevalence in the human and mosquito populations in three urban LGAs. Methods The prevalence of circulating filarial antigen (CFA) of Wuchereria bancrofti was assessed by an immuno-chromatography test (ICT) in 981 people in three urban LGAs of Kano state, Nigeria. Mosquitoes were collected over a period of 4 months from May to August 2015 using exit traps, gravid traps and pyrethrum knock-down spray sheet collections (PSC) in different households. A proportion of mosquitoes were analyzed for W. bancrofti, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR). Results The results showed that none of the 981 subjects (constituted of
Author summary Mass drug administration (MDA) for the control of elephantiasis in the state of Kano in Nigeria, started in the year 2010. It was estimated that by 2015, the MDA programme will be extended to 11 remaining urban Local Government Areas (LGAs). However, MDA in urban areas faces specific challenges, the most prominent being the need to achieve coverage rates of 65% and above. As such MDA alone may not be sufficient to achieve the required programme impacts of reducing LF transmission to levels below which transmission cannot be sustained, and additional interventions may be required. This study set out to confirm the LF infection prevalence in the human and mosquito populations in three urban LGAs in Kano. Individuals were tested for signs of the disease, and mosquito samples were collected and also tested for the worms that cause the disease. The study revealed that of 981 people tested, none had circulating filarial antigen in the blood. However, the mosquitoes collected revealed the presence of the disease-causing worms, but the level of infection was low. The infection in the mosquitoes was also detected in two different types of mosquitoes. Based on the outcomes of this study, and evidence from other West African cities on the transmission of LF, the Federal Ministry of Health recommended that two rounds of MDA be undertaken in urban areas of Kano. A further reassessment after a couple of years is warranted.
Databáze: OpenAIRE
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