The prevalence of lymphatic filariasis infection and disease following six rounds of mass drug administration in Mandalay Region, Myanmar
| Autor: | Janet Douglass, San San Win, Myint Shwe, Thet Wai Nwe, Ni Ni Aye, Benjamin F. R. Dickson, Patricia M. Graves, Tint Wai, William J. H. McBride, Richard S. Bradbury |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Epidemiology Cross-sectional study Myanmar Pathology and Laboratory Medicine Parasitemia Geographical Locations 0302 clinical medicine Risk Factors Surveys and Questionnaires Medicine and Health Sciences Prevalence Edema Diethylcarbamazine Medicine Public and Occupational Health Lymphedema 030212 general & internal medicine Young adult Child Lymphatic filariasis Aged 80 and over medicine.diagnostic_test Pharmaceutics lcsh:Public aspects of medicine Middle Aged Filariasis Testicular Hydrocele Infectious Diseases Helminth Infections Child Preschool Mass Drug Administration Female Research Article Neglected Tropical Diseases Adult wc_880 Asia Drug Administration lcsh:Arctic medicine. Tropical medicine wc_680 Adolescent lcsh:RC955-962 030231 tropical medicine wa_395 Physical examination Elephantiasis wc_765 Albendazole Disease cluster wa_110 Young Adult 03 medical and health sciences Signs and Symptoms Elephantiasis Filarial Drug Therapy Diagnostic Medicine Parasitic Diseases Animals Humans Wuchereria bancrofti Mass drug administration Aged business.industry Lymphatic Filariasis Public Health Environmental and Occupational Health Infant lcsh:RA1-1270 Tropical Diseases medicine.disease Health Care Cross-Sectional Studies Filaricides Medical Risk Factors People and Places Health Statistics Morbidity business Demography |
| Zdroj: | PLoS Neglected Tropical Diseases, Vol 12, Iss 11, p e0006944 (2018) PLoS Neglected Tropical Diseases |
| ISSN: | 1935-2735 |
| DOI: | 10.1371/journal.pntd.0006944 |
| Popis: | Lymphatic filariasis is widely endemic in Myanmar. Despite the establishment of an elimination program in 2000, knowledge of the remaining burden of disease relies predominantly on programmatic information. To assist the program, we conducted an independent cross-sectional household cluster survey to determine the prevalence of filariasis infection, morbidity and mass-drug administration coverage in four townships of the Mandalay Region: Amarapura, Patheingyi, Tada-U and Wundwin. The survey included 1014 individuals from 430 randomly selected households in 24 villages. Household members one year and older were assessed for antigenaemia using immunochromatographic test cards and if positive, microfilaraemia by night-time thick blood smear. Participants 15 years and older were assessed for filariasis morbidity by ultrasound-assisted clinical examination. The overall prevalence of infection was 2.63% by antigenaemia (95% confidence interval (CI) 1.71–4.04%) and 1.03% by microfilaraemia (95%CI 0.59–1.47%). The prevalence of hydrocoele in adult males was 2.78% (95%CI 1.23–6.15%) and of lymphoedema in both genders was 0% (95%CI 0–0.45%). These results indicate the persistence of filarial infection and transmission despite six rounds of annual mass drug administration and highlight the need for further rounds as well as the implementation of morbidity management programs in the country. Author summary Lymphatic filariasis (LF) is a mosquito-transmitted worm infection that causes chronic and progressive swelling of the limbs (lymphoedema) and testis (hydrocoele). Over time this swelling results in significant disfigurement and disability for sufferers. In 2000, Myanmar commenced a National Program to Eliminate LF through the annual mass drug administration (MDA) of two de-worming medications: albendazole and diethylcarbamazine to all endemic districts. However there remains little reliable information on how well the elimination program is working, and how large the burden of disease is in the country. This study assessed the prevalence of LF and participation in the MDA program in 24 villages across four townships of Mandalay Region in central Myanmar. The study found ongoing filarial infection suggesting that the six rounds of MDA had not been sufficient to stop LF transmission in the area. It also identified a substantial burden of hydrocoele but no cases of lymphoedema. These results suggest that further rounds of effective MDA are required to halt LF transmission and highlight the urgent need for morbidity management programs in the country. |
| Databáze: | OpenAIRE |
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