The impact of residual infections on Anopheles-transmitted Wuchereria bancrofti after multiple rounds of mass drug administration
Identifieur interne : 000E03 ( Pmc/Curation ); précédent : 000E02; suivant : 000E04The impact of residual infections on Anopheles-transmitted Wuchereria bancrofti after multiple rounds of mass drug administration
Auteurs : Dziedzom K. De Souza [Ghana] ; Rashid Ansumana [Royaume-Uni, Sierra Leone] ; Santigie Sessay [Sierra Leone] ; Abu Conteh [Sierra Leone] ; Benjamin Koudou [Royaume-Uni] ; Maria P. Rebollo [États-Unis] ; Joseph Koroma [Royaume-Uni] ; Daniel A. Boakye [Ghana] ; Moses J. Bockarie [Royaume-Uni]Source :
- Parasites & Vectors [ 1756-3305 ] ; 2015.
Abstract
Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.
This study was undertaken in Bo and Pujehun, two LF endemic districts of Sierra Leone, with baseline MF prevalence of 2 % and 0 % respectively in sentinel sites for monitoring impact of the national programme. Study communities in the districts were purposefully selected and an assessment of LF infection prevalence was conducted together with entomological investigations undertaken to determine the existence of areas with residual MF that could enable transmission by local vectors. The transmission Assessment Survey (TAS) protocol described by WHO was applied in the two districts to determine infection of LF in 6–7 year old children who were born before MDA against LF started.
The results indicated the presence of MF infected children in Pujehun district.
Residual infection was detected after three rounds of MDA in Pujehun – a district of 0 % Mf prevalence at the sentinel site. Nevertheless, our results showed that the transmission was contained in a small area. With the scale up of vector control in
Url:
DOI: 10.1186/s13071-015-1091-z
PubMed: 26399968
PubMed Central: 4581406
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-transmitted <italic>Wuchereria bancrofti</italic>
after multiple rounds of mass drug administration</title>
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<author><name sortKey="Rebollo, Maria P" sort="Rebollo, Maria P" uniqKey="Rebollo M" first="Maria P." last="Rebollo">Maria P. Rebollo</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The impact of residual infections on <italic>Anopheles</italic>
-transmitted <italic>Wuchereria bancrofti</italic>
after multiple rounds of mass drug administration</title>
<author><name sortKey="De Souza, Dziedzom K" sort="De Souza, Dziedzom K" uniqKey="De Souza D" first="Dziedzom K." last="De Souza">Dziedzom K. De Souza</name>
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<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon</wicri:regionArea>
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<author><name sortKey="Ansumana, Rashid" sort="Ansumana, Rashid" uniqKey="Ansumana R" first="Rashid" last="Ansumana">Rashid Ansumana</name>
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<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea>
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<country xml:lang="fr">Sierra Leone</country>
<wicri:regionArea>Mercy Hospital Research Laboratory, Bo</wicri:regionArea>
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<author><name sortKey="Sessay, Santigie" sort="Sessay, Santigie" uniqKey="Sessay S" first="Santigie" last="Sessay">Santigie Sessay</name>
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<author><name sortKey="Conteh, Abu" sort="Conteh, Abu" uniqKey="Conteh A" first="Abu" last="Conteh">Abu Conteh</name>
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<country xml:lang="fr">Sierra Leone</country>
<wicri:regionArea>Ministry of Health and Sanitation, Freetown</wicri:regionArea>
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<author><name sortKey="Koudou, Benjamin" sort="Koudou, Benjamin" uniqKey="Koudou B" first="Benjamin" last="Koudou">Benjamin Koudou</name>
<affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea>
</affiliation>
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<author><name sortKey="Rebollo, Maria P" sort="Rebollo, Maria P" uniqKey="Rebollo M" first="Maria P." last="Rebollo">Maria P. Rebollo</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Task Force for Global health, Atlanta</wicri:regionArea>
</affiliation>
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<author><name sortKey="Koroma, Joseph" sort="Koroma, Joseph" uniqKey="Koroma J" first="Joseph" last="Koroma">Joseph Koroma</name>
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<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool</wicri:regionArea>
</affiliation>
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<author><name sortKey="Boakye, Daniel A" sort="Boakye, Daniel A" uniqKey="Boakye D" first="Daniel A." last="Boakye">Daniel A. Boakye</name>
<affiliation wicri:level="1"><nlm:aff id="Aff1">Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana</nlm:aff>
<country xml:lang="fr">Ghana</country>
<wicri:regionArea>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon</wicri:regionArea>
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<author><name sortKey="Bockarie, Moses J" sort="Bockarie, Moses J" uniqKey="Bockarie M" first="Moses J." last="Bockarie">Moses J. Bockarie</name>
<affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
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<series><title level="j">Parasites & Vectors</title>
<idno type="eISSN">1756-3305</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.</p>
</sec>
<sec><title>Methods</title>
<p>This study was undertaken in Bo and Pujehun, two LF endemic districts of Sierra Leone, with baseline MF prevalence of 2 % and 0 % respectively in sentinel sites for monitoring impact of the national programme. Study communities in the districts were purposefully selected and an assessment of LF infection prevalence was conducted together with entomological investigations undertaken to determine the existence of areas with residual MF that could enable transmission by local vectors. The transmission Assessment Survey (TAS) protocol described by WHO was applied in the two districts to determine infection of LF in 6–7 year old children who were born before MDA against LF started.</p>
</sec>
<sec><title>Results</title>
<p>The results indicated the presence of MF infected children in Pujehun district. <italic>An. gambiae</italic>
collected in the district were also positive for <italic>W. bancrofti</italic>
, even though the prevalence of infection was below the threshold associated with active transmission.</p>
</sec>
<sec><title>Conclusions</title>
<p>Residual infection was detected after three rounds of MDA in Pujehun – a district of 0 % Mf prevalence at the sentinel site. Nevertheless, our results showed that the transmission was contained in a small area. With the scale up of vector control in <italic>Anopheles</italic>
transmission zones, some areas of residual infection may not pose a serious threat for the resurgence of LF if the prevalence of infections observed during TAS are below the threshold required for active transmission of the parasite. However, robust surveillance strategies capable of detecting residual infections must be implemented, together with entomological assessments to determine if ongoing vector control activities, biting rates and infection rates of the vectors can support the transmission of the disease. Furthermore, in areas where mid-term assessments reveal MF prevalence below 1 % or 2 % antigen level, in <italic>Anopheles</italic>
transmission areas with active and effective malaria vector control efforts, the minimum 5 rounds of MDA may not be required before implementing TAS. Thus, we propose a modification of the WHO recommendation for the timing of sentinel and spot-check site assessments in national programs.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Parasit Vectors</journal-id>
<journal-id journal-id-type="iso-abbrev">Parasit Vectors</journal-id>
<journal-title-group><journal-title>Parasites & Vectors</journal-title>
</journal-title-group>
<issn pub-type="epub">1756-3305</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26399968</article-id>
<article-id pub-id-type="pmc">4581406</article-id>
<article-id pub-id-type="publisher-id">1091</article-id>
<article-id pub-id-type="doi">10.1186/s13071-015-1091-z</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>The impact of residual infections on <italic>Anopheles</italic>
-transmitted <italic>Wuchereria bancrofti</italic>
after multiple rounds of mass drug administration</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>de Souza</surname>
<given-names>Dziedzom K.</given-names>
</name>
<address><email>ddesouza@noguchi.ug.edu.gh</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ansumana</surname>
<given-names>Rashid</given-names>
</name>
<address><email>rashidansumana@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sessay</surname>
<given-names>Santigie</given-names>
</name>
<address><email>sanniesay@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Conteh</surname>
<given-names>Abu</given-names>
</name>
<address><email>abu_conteh21@yahoo.co.uk</email>
</address>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Koudou</surname>
<given-names>Benjamin</given-names>
</name>
<address><email>Benjamin.Koudou@lstmed.ac.uk</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rebollo</surname>
<given-names>Maria P.</given-names>
</name>
<address><email>mrebollo@taskforce.org</email>
</address>
<xref ref-type="aff" rid="Aff5"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Koroma</surname>
<given-names>Joseph</given-names>
</name>
<address><email>jkoroma@fhi360.org</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Boakye</surname>
<given-names>Daniel A.</given-names>
</name>
<address><email>dboakye@noguchi.ug.edu.gh</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Bockarie</surname>
<given-names>Moses J.</given-names>
</name>
<address><email>Moses.Bockarie@lstmed.as.uk</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<aff id="Aff1"><label></label>
Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana</aff>
<aff id="Aff2"><label></label>
Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</aff>
<aff id="Aff3"><label></label>
Mercy Hospital Research Laboratory, Bo, Sierra Leone</aff>
<aff id="Aff4"><label></label>
Ministry of Health and Sanitation, Freetown, Sierra Leone</aff>
<aff id="Aff5"><label></label>
Task Force for Global health, Atlanta, USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>24</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>24</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>8</volume>
<elocation-id>488</elocation-id>
<history><date date-type="received"><day>28</day>
<month>7</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>11</day>
<month>9</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© de Souza et al. 2015</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.</p>
</sec>
<sec><title>Methods</title>
<p>This study was undertaken in Bo and Pujehun, two LF endemic districts of Sierra Leone, with baseline MF prevalence of 2 % and 0 % respectively in sentinel sites for monitoring impact of the national programme. Study communities in the districts were purposefully selected and an assessment of LF infection prevalence was conducted together with entomological investigations undertaken to determine the existence of areas with residual MF that could enable transmission by local vectors. The transmission Assessment Survey (TAS) protocol described by WHO was applied in the two districts to determine infection of LF in 6–7 year old children who were born before MDA against LF started.</p>
</sec>
<sec><title>Results</title>
<p>The results indicated the presence of MF infected children in Pujehun district. <italic>An. gambiae</italic>
collected in the district were also positive for <italic>W. bancrofti</italic>
, even though the prevalence of infection was below the threshold associated with active transmission.</p>
</sec>
<sec><title>Conclusions</title>
<p>Residual infection was detected after three rounds of MDA in Pujehun – a district of 0 % Mf prevalence at the sentinel site. Nevertheless, our results showed that the transmission was contained in a small area. With the scale up of vector control in <italic>Anopheles</italic>
transmission zones, some areas of residual infection may not pose a serious threat for the resurgence of LF if the prevalence of infections observed during TAS are below the threshold required for active transmission of the parasite. However, robust surveillance strategies capable of detecting residual infections must be implemented, together with entomological assessments to determine if ongoing vector control activities, biting rates and infection rates of the vectors can support the transmission of the disease. Furthermore, in areas where mid-term assessments reveal MF prevalence below 1 % or 2 % antigen level, in <italic>Anopheles</italic>
transmission areas with active and effective malaria vector control efforts, the minimum 5 rounds of MDA may not be required before implementing TAS. Thus, we propose a modification of the WHO recommendation for the timing of sentinel and spot-check site assessments in national programs.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Lymphatic filariasis</kwd>
<kwd><italic>Wuchereria bancrofti</italic>
</kwd>
<kwd>Residual transmission</kwd>
<kwd>Hotspots</kwd>
<kwd>Sierra Leone</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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