The Impact of a Filariasis Control Program on Lihir Island, Papua New Guinea
Identifieur interne : 002C97 ( Pmc/Checkpoint ); précédent : 002C96; suivant : 002C98The Impact of a Filariasis Control Program on Lihir Island, Papua New Guinea
Auteurs : Oriol Mitjà [Papouasie-Nouvelle-Guinée] ; Raymond Paru [Papouasie-Nouvelle-Guinée] ; Russell Hays [Papouasie-Nouvelle-Guinée] ; Lysaght Griffin [Papouasie-Nouvelle-Guinée] ; Nedley Laban [Papouasie-Nouvelle-Guinée] ; Mellie Samson [Papouasie-Nouvelle-Guinée] ; Quique Bassat [Espagne]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2011.
Abstract
Annual mass drug administration (MDA) over five years is the WHO's recommended strategy to eliminate lymphatic filariasis (LF). Some experts, however, consider that longer periods of treatment might be necessary in certain high prevalence and transmission environments based upon past unsuccessful field experience and modelling.
To evaluate predictors of success in a LF control program we conducted an ecological study during a pre-existing MDA program. We studied 27 villages in Lihir Island, Papua New Guinea, from two areas with different infection rates before MDA. We undertook surveys to collect information on variables potentially having an influence on the outcome of the program, including epidemiological (baseline prevalence of infection, immigration rate), entomological (vector density) and operational (treatment coverage, vector control strategies) variables. The success in a village was defined using variables related to the infection (circulating filarial antigenemia prevalence <1%) and transmission (antigenemia prevalence <1 in 1000 children born since start of MDA). 8709 people were involved in the MDA program and average coverage rates were around 70%. The overall prevalence of filariasis fell from an initial 17.91% to 3.76% at round 5 (p<0.001). Viewed on a village by village basis, 12/27 (44%) villages achieved success. In multivariate analysis, low baseline prevalence was the only factor predicting both success in reducing infection rates (OR 19,26; CI 95% 1,12 to 331,82) and success in preventing new infections (OR 27,44; CI 95% 1,05 to 719,6). Low vector density and the use of an optimal vector control strategy were also associated with success in reducing infection rates, but this did not reach statistical significance.
Our results provide the data that supports the recommendation that high endemic areas may require longer duration MDA programs, or alternative control strategies.
Url:
DOI: 10.1371/journal.pntd.0001286
PubMed: 21886851
PubMed Central: 3160343
Affiliations:
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Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Hays, Russell" sort="Hays, Russell" uniqKey="Hays R" first="Russell" last="Hays">Russell Hays</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Griffin, Lysaght" sort="Griffin, Lysaght" uniqKey="Griffin L" first="Lysaght" last="Griffin">Lysaght Griffin</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Laban, Nedley" sort="Laban, Nedley" uniqKey="Laban N" first="Nedley" last="Laban">Nedley Laban</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Department of Microbiology, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Microbiology, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Samson, Mellie" sort="Samson, Mellie" uniqKey="Samson M" first="Mellie" last="Samson">Mellie Samson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Bassat, Quique" sort="Bassat, Quique" uniqKey="Bassat Q" first="Quique" last="Bassat">Quique Bassat</name><affiliation wicri:level="3"><nlm:aff id="aff4"><addr-line>Barcelona Centre for International Health Research, Hospital Clínic, University of Barcelona, Barcelona, Spain</addr-line></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Centre for International Health Research, Hospital Clínic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21886851</idno><idno type="pmc">3160343</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160343</idno><idno type="RBID">PMC:3160343</idno><idno type="doi">10.1371/journal.pntd.0001286</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">004390</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004390</idno><idno type="wicri:Area/Pmc/Curation">004389</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004389</idno><idno type="wicri:Area/Pmc/Checkpoint">002C97</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002C97</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Impact of a Filariasis Control Program on Lihir Island, Papua New Guinea</title><author><name sortKey="Mitja, Oriol" sort="Mitja, Oriol" uniqKey="Mitja O" first="Oriol" last="Mitjà">Oriol Mitjà</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Paru, Raymond" sort="Paru, Raymond" uniqKey="Paru R" first="Raymond" last="Paru">Raymond Paru</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Hays, Russell" sort="Hays, Russell" uniqKey="Hays R" first="Russell" last="Hays">Russell Hays</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Griffin, Lysaght" sort="Griffin, Lysaght" uniqKey="Griffin L" first="Lysaght" last="Griffin">Lysaght Griffin</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Laban, Nedley" sort="Laban, Nedley" uniqKey="Laban N" first="Nedley" last="Laban">Nedley Laban</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Department of Microbiology, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Microbiology, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Samson, Mellie" sort="Samson, Mellie" uniqKey="Samson M" first="Mellie" last="Samson">Mellie Samson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></nlm:aff><country xml:lang="fr">Papouasie-Nouvelle-Guinée</country><wicri:regionArea>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province</wicri:regionArea><wicri:noRegion>New Ireland Province</wicri:noRegion></affiliation></author><author><name sortKey="Bassat, Quique" sort="Bassat, Quique" uniqKey="Bassat Q" first="Quique" last="Bassat">Quique Bassat</name><affiliation wicri:level="3"><nlm:aff id="aff4"><addr-line>Barcelona Centre for International Health Research, Hospital Clínic, University of Barcelona, Barcelona, Spain</addr-line></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Centre for International Health Research, Hospital Clínic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author></analytic><series><title level="j">PLoS Neglected Tropical Diseases</title><idno type="ISSN">1935-2727</idno><idno type="eISSN">1935-2735</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Annual mass drug administration (MDA) over five years is the WHO's recommended strategy to eliminate lymphatic filariasis (LF). Some experts, however, consider that longer periods of treatment might be necessary in certain high prevalence and transmission environments based upon past unsuccessful field experience and modelling.</p></sec><sec><title>Methodology/Principal Findings</title><p>To evaluate predictors of success in a LF control program we conducted an ecological study during a pre-existing MDA program. We studied 27 villages in Lihir Island, Papua New Guinea, from two areas with different infection rates before MDA. We undertook surveys to collect information on variables potentially having an influence on the outcome of the program, including epidemiological (baseline prevalence of infection, immigration rate), entomological (vector density) and operational (treatment coverage, vector control strategies) variables. The success in a village was defined using variables related to the infection (circulating filarial antigenemia prevalence <1%) and transmission (antigenemia prevalence <1 in 1000 children born since start of MDA). 8709 people were involved in the MDA program and average coverage rates were around 70%. The overall prevalence of filariasis fell from an initial 17.91% to 3.76% at round 5 (p<0.001). Viewed on a village by village basis, 12/27 (44%) villages achieved success. In multivariate analysis, low baseline prevalence was the only factor predicting both success in reducing infection rates (OR 19,26; CI 95% 1,12 to 331,82) and success in preventing new infections (OR 27,44; CI 95% 1,05 to 719,6). Low vector density and the use of an optimal vector control strategy were also associated with success in reducing infection rates, but this did not reach statistical significance.</p></sec><sec><title>Conclusions/Significance</title><p>Our results provide the data that supports the recommendation that high endemic areas may require longer duration MDA programs, or alternative control strategies.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ichimori, K" uniqKey="Ichimori K">K Ichimori</name></author><author><name sortKey="Crump, A" uniqKey="Crump A">A Crump</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bockarie, M" uniqKey="Bockarie M">M Bockarie</name></author><author><name sortKey="Tish, Dj" uniqKey="Tish D">DJ Tish</name></author><author><name sortKey="Kastens, W" uniqKey="Kastens W">W 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS Negl Trop Dis</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosntds</journal-id><journal-title-group><journal-title>PLoS Neglected Tropical Diseases</journal-title></journal-title-group><issn pub-type="ppub">1935-2727</issn><issn pub-type="epub">1935-2735</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21886851</article-id><article-id pub-id-type="pmc">3160343</article-id><article-id pub-id-type="publisher-id">PNTD-D-11-00201</article-id><article-id pub-id-type="doi">10.1371/journal.pntd.0001286</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Neglected Tropical Diseases</subject><subj-group><subject>Lymphatic Filariasis</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>The Impact of a Filariasis Control Program on Lihir Island, Papua New Guinea</article-title><alt-title alt-title-type="running-head">Impact of a Filariasis Control Program</alt-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Mitjà</surname><given-names>Oriol</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Paru</surname><given-names>Raymond</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hays</surname><given-names>Russell</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Griffin</surname><given-names>Lysaght</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Laban</surname><given-names>Nedley</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Samson</surname><given-names>Mellie</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bassat</surname><given-names>Quique</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Department of Medicine, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Department of Public Health, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Department of Microbiology, Lihir Medical Centre, International SOS, Lihir Island, New Ireland Province, Papua New Guinea</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Barcelona Centre for International Health Research, Hospital Clínic, University of Barcelona, Barcelona, Spain</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Lammie</surname><given-names>Patrick J.</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1">Centers for Disease Control and Prevention, United States of America</aff><author-notes><corresp id="cor1">* E-mail: <email>oriolmitja@hotmail.com</email></corresp><fn fn-type="con"><p>Conceived and designed the experiments: OM RP MS. Performed the experiments: RP LG NL. Analyzed the data: OM QB. Wrote the paper: OM RH QB.</p></fn></author-notes><pub-date pub-type="collection"><month>8</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>23</day><month>8</month><year>2011</year></pub-date><volume>5</volume><issue>8</issue><elocation-id>e1286</elocation-id><history><date date-type="received"><day>9</day><month>3</month><year>2011</year></date><date date-type="accepted"><day>6</day><month>7</month><year>2011</year></date></history><permissions><copyright-statement>Mitjà 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.</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><sec><title>Background</title><p>Annual mass drug administration (MDA) over five years is the WHO's recommended strategy to eliminate lymphatic filariasis (LF). Some experts, however, consider that longer periods of treatment might be necessary in certain high prevalence and transmission environments based upon past unsuccessful field experience and modelling.</p></sec><sec><title>Methodology/Principal Findings</title><p>To evaluate predictors of success in a LF control program we conducted an ecological study during a pre-existing MDA program. We studied 27 villages in Lihir Island, Papua New Guinea, from two areas with different infection rates before MDA. We undertook surveys to collect information on variables potentially having an influence on the outcome of the program, including epidemiological (baseline prevalence of infection, immigration rate), entomological (vector density) and operational (treatment coverage, vector control strategies) variables. The success in a village was defined using variables related to the infection (circulating filarial antigenemia prevalence <1%) and transmission (antigenemia prevalence <1 in 1000 children born since start of MDA). 8709 people were involved in the MDA program and average coverage rates were around 70%. The overall prevalence of filariasis fell from an initial 17.91% to 3.76% at round 5 (p<0.001). Viewed on a village by village basis, 12/27 (44%) villages achieved success. In multivariate analysis, low baseline prevalence was the only factor predicting both success in reducing infection rates (OR 19,26; CI 95% 1,12 to 331,82) and success in preventing new infections (OR 27,44; CI 95% 1,05 to 719,6). Low vector density and the use of an optimal vector control strategy were also associated with success in reducing infection rates, but this did not reach statistical significance.</p></sec><sec><title>Conclusions/Significance</title><p>Our results provide the data that supports the recommendation that high endemic areas may require longer duration MDA programs, or alternative control strategies.</p></sec></abstract><abstract abstract-type="summary"><title>Author Summary</title><p>Large-scale intervention programmes to control filariasis are currently underway worldwide. However, a major unresolved question remains: what is the appropriate duration for these programmes? Recent theoretical work and clinical field experience has highlighted how the ecological diversity between different endemic regions hinders decision making processes of when to stop ongoing MDA programs. The goal of our study was to identify the factors determining success for a five year LF elimination program. We undertook different types of surveys together with a pre-existing MDA program in villages from two regions that had different infection prevalence rates. Our study shows that the five yearly cycles of MDA could neither eliminate the disease nor stop transmission in the high prevalence villages, such that low baseline lymphatic filariasis prevalence has a positive influence on the outcome of a program. Thus, the study provides data supporting the recommendation that in certain high prevalence and transmission environments more sustained efforts may be necessary.</p></abstract><counts><page-count count="8"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Espagne</li><li>Papouasie-Nouvelle-Guinée</li></country><region><li>Catalogne</li></region><settlement><li>Barcelone</li></settlement></list><tree><country name="Papouasie-Nouvelle-Guinée"><noRegion><name sortKey="Mitja, Oriol" sort="Mitja, Oriol" uniqKey="Mitja O" first="Oriol" last="Mitjà">Oriol Mitjà</name></noRegion><name sortKey="Griffin, Lysaght" sort="Griffin, Lysaght" uniqKey="Griffin L" first="Lysaght" last="Griffin">Lysaght Griffin</name><name sortKey="Hays, Russell" sort="Hays, Russell" uniqKey="Hays R" first="Russell" last="Hays">Russell Hays</name><name sortKey="Laban, Nedley" sort="Laban, Nedley" uniqKey="Laban N" first="Nedley" last="Laban">Nedley Laban</name><name sortKey="Paru, Raymond" sort="Paru, Raymond" uniqKey="Paru R" first="Raymond" last="Paru">Raymond Paru</name><name sortKey="Samson, Mellie" sort="Samson, Mellie" uniqKey="Samson M" first="Mellie" last="Samson">Mellie Samson</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Bassat, Quique" sort="Bassat, Quique" uniqKey="Bassat Q" first="Quique" last="Bassat">Quique Bassat</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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