Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria
The current strategy for interrupting transmission of lymphatic filariasis (LF) is annual mass drug administration (MDA), at good coverage, for 6 or more years. We describe our programmatic experience delivering the MDA combination of ivermectin and albendazole in Plateau and Nasarawa states in cent...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2011-10, Vol.5 (10), p.e1346-e1346 |
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| creator | Richards, Frank O Eigege, Abel Miri, Emmanuel S Kal, Alphonsus Umaru, John Pam, Davou Rakers, Lindsay J Sambo, Yohanna Danboyi, Jacob Ibrahim, Bako Adelamo, Solomon E Ogah, Gladys Goshit, Danjuma Oyenekan, O Kehinde Mathieu, Els Withers, P Craig Saka, Yisa A Jiya, Jonathan Hopkins, Donald R |
| description | The current strategy for interrupting transmission of lymphatic filariasis (LF) is annual mass drug administration (MDA), at good coverage, for 6 or more years. We describe our programmatic experience delivering the MDA combination of ivermectin and albendazole in Plateau and Nasarawa states in central Nigeria, where LF is caused by anopheline transmitted Wuchereria bancrofti. Baseline LF mapping using rapid blood antigen detection tests showed mean local government area (LGA) prevalence of 23% (range 4-62%). MDA was launched in 2000 and by 2003 had been scaled up to full geographic coverage in all 30 LGAs in the two states; over 26 million cumulative directly observed treatments were provided by community drug distributors over the intervention period. Reported treatment coverage for each round was ≥85% of the treatment eligible population of 3.7 million, although a population-based coverage survey in 2003 showed lower coverage (72.2%; 95% CI 65.5-79.0%). To determine impact on transmission, we monitored three LF infection parameters (microfilaremia, antigenemia, and mosquito infection) in 10 sentinel villages (SVs) serially. The last monitoring was done in 2009, when SVs had been treated for 7-10 years. Microfilaremia in 2009 decreased by 83% from baseline (from 4.9% to 0.8%); antigenemia by 67% (from 21.6% to 7.2%); mosquito infection rate (all larval stages) by 86% (from 3.1% to 0.4%); and mosquito infectivity rate (L3 stages) by 76% (from 1.3% to 0.3%). All changes were statistically significant. Results suggest that LF transmission has been interrupted in 5 of the 10 SVs, based on 2009 finding of microfilaremia ≥1% and/or L3 stages in mosquitoes. Four of the five SVs where transmission persists had baseline antigenemia prevalence of >25%. Longer or additional interventions (e.g., more frequent MDA treatments, insecticidal bed nets) should be considered for 'hot spots' where transmission is ongoing. |
| doi_str_mv | 10.1371/journal.pntd.0001346 |
| format | Article |
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We describe our programmatic experience delivering the MDA combination of ivermectin and albendazole in Plateau and Nasarawa states in central Nigeria, where LF is caused by anopheline transmitted Wuchereria bancrofti. Baseline LF mapping using rapid blood antigen detection tests showed mean local government area (LGA) prevalence of 23% (range 4-62%). MDA was launched in 2000 and by 2003 had been scaled up to full geographic coverage in all 30 LGAs in the two states; over 26 million cumulative directly observed treatments were provided by community drug distributors over the intervention period. Reported treatment coverage for each round was ≥85% of the treatment eligible population of 3.7 million, although a population-based coverage survey in 2003 showed lower coverage (72.2%; 95% CI 65.5-79.0%). To determine impact on transmission, we monitored three LF infection parameters (microfilaremia, antigenemia, and mosquito infection) in 10 sentinel villages (SVs) serially. The last monitoring was done in 2009, when SVs had been treated for 7-10 years. Microfilaremia in 2009 decreased by 83% from baseline (from 4.9% to 0.8%); antigenemia by 67% (from 21.6% to 7.2%); mosquito infection rate (all larval stages) by 86% (from 3.1% to 0.4%); and mosquito infectivity rate (L3 stages) by 76% (from 1.3% to 0.3%). All changes were statistically significant. Results suggest that LF transmission has been interrupted in 5 of the 10 SVs, based on 2009 finding of microfilaremia ≥1% and/or L3 stages in mosquitoes. Four of the five SVs where transmission persists had baseline antigenemia prevalence of >25%. Longer or additional interventions (e.g., more frequent MDA treatments, insecticidal bed nets) should be considered for 'hot spots' where transmission is ongoing.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0001346</identifier><identifier>PMID: 22022627</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Albendazole - administration & dosage ; Animals ; Antigens, Helminth - blood ; Child ; Child, Preschool ; Control ; Distribution ; Drug Therapy, Combination - methods ; Elephantiasis, Filarial - drug therapy ; Elephantiasis, Filarial - epidemiology ; Elephantiasis, Filarial - prevention & control ; Elephantiasis, Filarial - transmission ; Female ; Females ; Filariasis ; Filaricides - administration & dosage ; Humans ; Incidence ; Infection control ; Infections ; Initiatives ; Ivermectin - administration & dosage ; Local government ; Male ; Medicine ; Middle Aged ; Mosquitoes ; Nigeria - epidemiology ; Tropical diseases ; Worms ; Wuchereria bancrofti - isolation & purification ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2011-10, Vol.5 (10), p.e1346-e1346</ispartof><rights>COPYRIGHT 2011 Public Library of Science</rights><rights>2011 Public Library of Science. 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: Citation: Richards FO, Eigege A, Miri ES, Kal A, Umaru J, et al. (2011) Epidemiological and Entomological Evaluations after Six Years or More of Mass Drug Administration for Lymphatic Filariasis Elimination in Nigeria. PLoS Negl Trop Dis 5(10): e1346. doi:10.1371/journal.pntd.0001346</rights><rights>This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. 2011</rights><rights>2011 Public Library of Science. 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: Citation: Richards FO, Eigege A, Miri ES, Kal A, Umaru J, et al. (2011) Epidemiological and Entomological Evaluations after Six Years or More of Mass Drug Administration for Lymphatic Filariasis Elimination in Nigeria. PLoS Negl Trop Dis 5(10): e1346. doi:10.1371/journal.pntd.0001346</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c623t-97ef80d7579ff113feb65599562f4b56e9752126c970e2b8598b671feb21e9fa3</citedby><cites>FETCH-LOGICAL-c623t-97ef80d7579ff113feb65599562f4b56e9752126c970e2b8598b671feb21e9fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191131/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191131/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22022627$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Richards, Frank O</creatorcontrib><creatorcontrib>Eigege, Abel</creatorcontrib><creatorcontrib>Miri, Emmanuel S</creatorcontrib><creatorcontrib>Kal, Alphonsus</creatorcontrib><creatorcontrib>Umaru, John</creatorcontrib><creatorcontrib>Pam, Davou</creatorcontrib><creatorcontrib>Rakers, Lindsay J</creatorcontrib><creatorcontrib>Sambo, Yohanna</creatorcontrib><creatorcontrib>Danboyi, Jacob</creatorcontrib><creatorcontrib>Ibrahim, Bako</creatorcontrib><creatorcontrib>Adelamo, Solomon E</creatorcontrib><creatorcontrib>Ogah, Gladys</creatorcontrib><creatorcontrib>Goshit, Danjuma</creatorcontrib><creatorcontrib>Oyenekan, O Kehinde</creatorcontrib><creatorcontrib>Mathieu, Els</creatorcontrib><creatorcontrib>Withers, P Craig</creatorcontrib><creatorcontrib>Saka, Yisa A</creatorcontrib><creatorcontrib>Jiya, Jonathan</creatorcontrib><creatorcontrib>Hopkins, Donald R</creatorcontrib><title>Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>The current strategy for interrupting transmission of lymphatic filariasis (LF) is annual mass drug administration (MDA), at good coverage, for 6 or more years. We describe our programmatic experience delivering the MDA combination of ivermectin and albendazole in Plateau and Nasarawa states in central Nigeria, where LF is caused by anopheline transmitted Wuchereria bancrofti. Baseline LF mapping using rapid blood antigen detection tests showed mean local government area (LGA) prevalence of 23% (range 4-62%). MDA was launched in 2000 and by 2003 had been scaled up to full geographic coverage in all 30 LGAs in the two states; over 26 million cumulative directly observed treatments were provided by community drug distributors over the intervention period. Reported treatment coverage for each round was ≥85% of the treatment eligible population of 3.7 million, although a population-based coverage survey in 2003 showed lower coverage (72.2%; 95% CI 65.5-79.0%). To determine impact on transmission, we monitored three LF infection parameters (microfilaremia, antigenemia, and mosquito infection) in 10 sentinel villages (SVs) serially. The last monitoring was done in 2009, when SVs had been treated for 7-10 years. Microfilaremia in 2009 decreased by 83% from baseline (from 4.9% to 0.8%); antigenemia by 67% (from 21.6% to 7.2%); mosquito infection rate (all larval stages) by 86% (from 3.1% to 0.4%); and mosquito infectivity rate (L3 stages) by 76% (from 1.3% to 0.3%). All changes were statistically significant. Results suggest that LF transmission has been interrupted in 5 of the 10 SVs, based on 2009 finding of microfilaremia ≥1% and/or L3 stages in mosquitoes. Four of the five SVs where transmission persists had baseline antigenemia prevalence of >25%. Longer or additional interventions (e.g., more frequent MDA treatments, insecticidal bed nets) should be considered for 'hot spots' where transmission is ongoing.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Albendazole - administration & dosage</subject><subject>Animals</subject><subject>Antigens, Helminth - blood</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Control</subject><subject>Distribution</subject><subject>Drug Therapy, Combination - methods</subject><subject>Elephantiasis, Filarial - drug therapy</subject><subject>Elephantiasis, Filarial - epidemiology</subject><subject>Elephantiasis, Filarial - prevention & control</subject><subject>Elephantiasis, Filarial - transmission</subject><subject>Female</subject><subject>Females</subject><subject>Filariasis</subject><subject>Filaricides - administration & dosage</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infection control</subject><subject>Infections</subject><subject>Initiatives</subject><subject>Ivermectin - administration & dosage</subject><subject>Local government</subject><subject>Male</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Mosquitoes</subject><subject>Nigeria - epidemiology</subject><subject>Tropical diseases</subject><subject>Worms</subject><subject>Wuchereria bancrofti - isolation & purification</subject><subject>Young Adult</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptktFu0zAUhiMEYmPwBggsIcFVi-3EcXwzaZoGTJrgBq6tk-Q4deXExU4m9hi8MW6bVS2afBHH_v7fPsd_lr1ldMlyyT6v_RQGcMvNMLZLSinLi_JZds5ULhZc5uL50fwsexXjmlKhRMVeZmecU85LLs-zvzcb22JvvfOdbcARGFqCw-j7wwreg5tgtH6IBMyIgUT7hzwghEh8IL0PSLwhPcRI2jB1BNreDjaOYSciJkHuod-s0m9DjHUQLEQbCTqbwD1kB_Lddph2XmcvDLiIb-bvRfbry83P62-Lux9fb6-v7hZNyfNxoSSairZSSGUMY7nBuhRCKVFyU9SiRCUFZ7xslKTI60qoqi4lSxhnqAzkF9n7ve_G-ajnbkbNeFUxmhpcJuJ2T7Qe1noTbA_hQXuwerfgQ6chpJocatVWdQENy5kShcilqgBrVoOpc1bLaut1OZ821T22TWpxAHdieroz2JXu_L1Ojqk6lgw-zQbB_54wjrq3sUHnYEA_Ra0oLYv0rjKRH_4jny5upjpI97eD8enYZuupr7jkrJSyKhK1fIJKY5uZxg-YnhNPBR-PBCsEN66id9MuPqdgsQeb4GMMaA69YFRvA_54a70NuJ4DnmTvjvt4ED0mOv8HNC_6Rg</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Richards, Frank O</creator><creator>Eigege, Abel</creator><creator>Miri, Emmanuel S</creator><creator>Kal, Alphonsus</creator><creator>Umaru, John</creator><creator>Pam, Davou</creator><creator>Rakers, Lindsay J</creator><creator>Sambo, Yohanna</creator><creator>Danboyi, Jacob</creator><creator>Ibrahim, Bako</creator><creator>Adelamo, Solomon E</creator><creator>Ogah, Gladys</creator><creator>Goshit, Danjuma</creator><creator>Oyenekan, O Kehinde</creator><creator>Mathieu, Els</creator><creator>Withers, P Craig</creator><creator>Saka, Yisa A</creator><creator>Jiya, Jonathan</creator><creator>Hopkins, Donald R</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20111001</creationdate><title>Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria</title><author>Richards, Frank O ; Eigege, Abel ; Miri, Emmanuel S ; Kal, Alphonsus ; Umaru, John ; Pam, Davou ; Rakers, Lindsay J ; Sambo, Yohanna ; Danboyi, Jacob ; Ibrahim, Bako ; Adelamo, Solomon E ; Ogah, Gladys ; Goshit, Danjuma ; Oyenekan, O Kehinde ; Mathieu, Els ; Withers, P Craig ; Saka, Yisa A ; Jiya, Jonathan ; Hopkins, Donald R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c623t-97ef80d7579ff113feb65599562f4b56e9752126c970e2b8598b671feb21e9fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Albendazole - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Richards, Frank O</au><au>Eigege, Abel</au><au>Miri, Emmanuel S</au><au>Kal, Alphonsus</au><au>Umaru, John</au><au>Pam, Davou</au><au>Rakers, Lindsay J</au><au>Sambo, Yohanna</au><au>Danboyi, Jacob</au><au>Ibrahim, Bako</au><au>Adelamo, Solomon E</au><au>Ogah, Gladys</au><au>Goshit, Danjuma</au><au>Oyenekan, O Kehinde</au><au>Mathieu, Els</au><au>Withers, P Craig</au><au>Saka, Yisa A</au><au>Jiya, Jonathan</au><au>Hopkins, Donald R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>5</volume><issue>10</issue><spage>e1346</spage><epage>e1346</epage><pages>e1346-e1346</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>The current strategy for interrupting transmission of lymphatic filariasis (LF) is annual mass drug administration (MDA), at good coverage, for 6 or more years. We describe our programmatic experience delivering the MDA combination of ivermectin and albendazole in Plateau and Nasarawa states in central Nigeria, where LF is caused by anopheline transmitted Wuchereria bancrofti. Baseline LF mapping using rapid blood antigen detection tests showed mean local government area (LGA) prevalence of 23% (range 4-62%). MDA was launched in 2000 and by 2003 had been scaled up to full geographic coverage in all 30 LGAs in the two states; over 26 million cumulative directly observed treatments were provided by community drug distributors over the intervention period. Reported treatment coverage for each round was ≥85% of the treatment eligible population of 3.7 million, although a population-based coverage survey in 2003 showed lower coverage (72.2%; 95% CI 65.5-79.0%). To determine impact on transmission, we monitored three LF infection parameters (microfilaremia, antigenemia, and mosquito infection) in 10 sentinel villages (SVs) serially. The last monitoring was done in 2009, when SVs had been treated for 7-10 years. Microfilaremia in 2009 decreased by 83% from baseline (from 4.9% to 0.8%); antigenemia by 67% (from 21.6% to 7.2%); mosquito infection rate (all larval stages) by 86% (from 3.1% to 0.4%); and mosquito infectivity rate (L3 stages) by 76% (from 1.3% to 0.3%). All changes were statistically significant. Results suggest that LF transmission has been interrupted in 5 of the 10 SVs, based on 2009 finding of microfilaremia ≥1% and/or L3 stages in mosquitoes. Four of the five SVs where transmission persists had baseline antigenemia prevalence of >25%. Longer or additional interventions (e.g., more frequent MDA treatments, insecticidal bed nets) should be considered for 'hot spots' where transmission is ongoing.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22022627</pmid><doi>10.1371/journal.pntd.0001346</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2011-10, Vol.5 (10), p.e1346-e1346 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_1288103716 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Public Library of Science (PLoS) |
| subjects | Adolescent Adult Aged Aged, 80 and over Albendazole - administration & dosage Animals Antigens, Helminth - blood Child Child, Preschool Control Distribution Drug Therapy, Combination - methods Elephantiasis, Filarial - drug therapy Elephantiasis, Filarial - epidemiology Elephantiasis, Filarial - prevention & control Elephantiasis, Filarial - transmission Female Females Filariasis Filaricides - administration & dosage Humans Incidence Infection control Infections Initiatives Ivermectin - administration & dosage Local government Male Medicine Middle Aged Mosquitoes Nigeria - epidemiology Tropical diseases Worms Wuchereria bancrofti - isolation & purification Young Adult |
| title | Epidemiological and entomological evaluations after six years or more of mass drug administration for lymphatic filariasis elimination in Nigeria |
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