Lymphatic filariasis control in Tanzania: effect of six rounds of mass drug administration with ivermectin and albendazole on infection and transmission
Identifieur interne : 003467 ( Main/Exploration ); précédent : 003466; suivant : 003468Lymphatic filariasis control in Tanzania: effect of six rounds of mass drug administration with ivermectin and albendazole on infection and transmission
Auteurs : Paul E. Simonsen [Danemark] ; Yahya A. Derua [Tanzanie] ; William N. Kisinza [Tanzanie] ; Stephen M. Magesa [Kenya] ; Mwele N. Malecela [Tanzanie] ; Erling M. Pedersen [Danemark]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2013.
Descripteurs français
- KwdFr :
- Adolescent, Albendazole (administration et posologie), Animaux, Culicidae (parasitologie), Enfant, Enfant d'âge préscolaire, Filaricides (administration et posologie), Filariose lymphatique (), Filariose lymphatique (traitement médicamenteux), Filariose lymphatique (transmission), Filariose lymphatique (épidémiologie), Humains, Ivermectine (administration et posologie), Prévalence, Tanzanie (épidémiologie), Vecteurs insectes.
- MESH :
- administration et posologie : Albendazole, Filaricides, Ivermectine.
- parasitologie : Culicidae.
- traitement médicamenteux : Filariose lymphatique.
- épidémiologie : Filariose lymphatique, Tanzanie.
- Adolescent, Animaux, Enfant, Enfant d'âge préscolaire, Filariose lymphatique, Humains, Prévalence, Vecteurs insectes.
English descriptors
- KwdEn :
- Adolescent, Albendazole (administration & dosage), Animals, Child, Child, Preschool, Culicidae (parasitology), Elephantiasis, Filarial (drug therapy), Elephantiasis, Filarial (epidemiology), Elephantiasis, Filarial (prevention & control), Elephantiasis, Filarial (transmission), Filaricides (administration & dosage), Humans, Insect Vectors, Ivermectin (administration & dosage), Prevalence, Tanzania (epidemiology).
- MESH :
- chemical , administration & dosage : Albendazole, Filaricides, Ivermectin.
- geographic , epidemiology : Tanzania.
- drug therapy : Elephantiasis, Filarial.
- epidemiology : Elephantiasis, Filarial.
- parasitology : Culicidae.
- prevention & control : Elephantiasis, Filarial.
- transmission : Elephantiasis, Filarial.
- Adolescent, Animals, Child, Child, Preschool, Humans, Insect Vectors, Prevalence.
Abstract
Control of lymphatic filariasis (LF) in most countries of sub-Saharan Africa is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole, in order to interrupt transmission. We present findings from a detailed study on the effect of six rounds of MDA with this drug combination as implemented by the National Lymphatic Filariasis Elimination Programme (NLFEP) in a highly endemic rural area of north-eastern Tanzania.
The effect of treatment on transmission and human infection was monitored in a community- and a school-based study during an 8-year period (one pre-intervention and 7 post-intervention years) from 2003 to 2011.
Before intervention, 24.5% of the community population had microfilariae (mf) in the blood, 53.3% had circulating filarial antigens (CFA) and 78.9% had specific antibodies to the recombinant filarial antigen Bm14. One year after the sixth MDA, these values had decreased considerably to 2.7%, 19.6% and 27.5%, respectively. During the same period, the CFA prevalence among new intakes of Standard 1 pupils in 10 primary schools decreased from 25.2% to 5.6%. In line with this, transmission by the three vectors (
Six MDAs caused considerable decrease in all the measured indices for transmission and human infection. In spite of this, indices were still relatively high in the late period of the study, and it may take a long time to reach the recommended cut-off levels for interruption of transmission unless extra efforts are made. These should include increased engagement of the target population in the control activities, to ensure higher treatment coverage. It is expected that the recent initiative to distribute insecticide impregnated bed nets to every household in the area will also contribute towards reaching the goal of successful LF elimination.
Url:
DOI: 10.1186/1471-2334-13-335
PubMed: 23870103
PubMed Central: 3723586
Affiliations:
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Le document en format XML
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<series><title level="j">BMC Infectious Diseases</title>
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<term>Albendazole (administration & dosage)</term>
<term>Animals</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Culicidae (parasitology)</term>
<term>Elephantiasis, Filarial (drug therapy)</term>
<term>Elephantiasis, Filarial (epidemiology)</term>
<term>Elephantiasis, Filarial (prevention & control)</term>
<term>Elephantiasis, Filarial (transmission)</term>
<term>Filaricides (administration & dosage)</term>
<term>Humans</term>
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<term>Ivermectin (administration & dosage)</term>
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<term>Tanzania (epidemiology)</term>
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<term>Albendazole (administration et posologie)</term>
<term>Animaux</term>
<term>Culicidae (parasitologie)</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Filaricides (administration et posologie)</term>
<term>Filariose lymphatique ()</term>
<term>Filariose lymphatique (traitement médicamenteux)</term>
<term>Filariose lymphatique (transmission)</term>
<term>Filariose lymphatique (épidémiologie)</term>
<term>Humains</term>
<term>Ivermectine (administration et posologie)</term>
<term>Prévalence</term>
<term>Tanzanie (épidémiologie)</term>
<term>Vecteurs insectes</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Albendazole</term>
<term>Filaricides</term>
<term>Ivermectin</term>
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<term>Filaricides</term>
<term>Ivermectine</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="parasitologie" xml:lang="fr"><term>Culicidae</term>
</keywords>
<keywords scheme="MESH" qualifier="parasitology" xml:lang="en"><term>Culicidae</term>
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<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Filariose lymphatique</term>
</keywords>
<keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Elephantiasis, Filarial</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Control of lymphatic filariasis (LF) in most countries of sub-Saharan Africa is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole, in order to interrupt transmission. We present findings from a detailed study on the effect of six rounds of MDA with this drug combination as implemented by the National Lymphatic Filariasis Elimination Programme (NLFEP) in a highly endemic rural area of north-eastern Tanzania.</p>
</sec>
<sec><title>Methods</title>
<p>The effect of treatment on transmission and human infection was monitored in a community- and a school-based study during an 8-year period (one pre-intervention and 7 post-intervention years) from 2003 to 2011.</p>
</sec>
<sec><title>Results</title>
<p>Before intervention, 24.5% of the community population had microfilariae (mf) in the blood, 53.3% had circulating filarial antigens (CFA) and 78.9% had specific antibodies to the recombinant filarial antigen Bm14. One year after the sixth MDA, these values had decreased considerably to 2.7%, 19.6% and 27.5%, respectively. During the same period, the CFA prevalence among new intakes of Standard 1 pupils in 10 primary schools decreased from 25.2% to 5.6%. In line with this, transmission by the three vectors (<italic>Anopheles gambiae</italic>
, <italic>An. funestus</italic>
and <italic>Culex quinquefasciatus</italic>
) as determined by dissection declined sharply (overall vector infectivity rate by 99.3% and mean monthly transmission potential by 99.2% between pre-intervention and fifth post-intervention period). A major shift in vector species composition, from predominantly anopheline to almost exclusively culicine was observed over the years. This may be largely unrelated to the MDAs but may have important implications for the epidemiology of LF in the area.</p>
</sec>
<sec><title>Conclusions</title>
<p>Six MDAs caused considerable decrease in all the measured indices for transmission and human infection. In spite of this, indices were still relatively high in the late period of the study, and it may take a long time to reach the recommended cut-off levels for interruption of transmission unless extra efforts are made. These should include increased engagement of the target population in the control activities, to ensure higher treatment coverage. It is expected that the recent initiative to distribute insecticide impregnated bed nets to every household in the area will also contribute towards reaching the goal of successful LF elimination.</p>
</sec>
</div>
</front>
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<affiliations><list><country><li>Danemark</li>
<li>Kenya</li>
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