The Global Programme to Eliminate Lymphatic Filariasis: Health Impact after 8 Years
Identifieur interne : 002948 ( Pmc/Curation ); précédent : 002947; suivant : 002949The Global Programme to Eliminate Lymphatic Filariasis: Health Impact after 8 Years
Auteurs : Eric A. Ottesen [États-Unis] ; Pamela J. Hooper [États-Unis] ; Mark Bradley [Royaume-Uni] ; Gautam Biswas [Suisse]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2008.
Abstract
In its first 8 years, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) achieved an unprecedentedly rapid scale-up: >1.9 billion treatments with anti-filarial drugs (albendazole, ivermectin, and diethylcarbamazine) were provided via yearly mass drug administration (MDA) to a minimum of 570 million individuals living in 48 of the 83 initially identified LF-endemic countries.
To assess the health impact that this massive global effort has had, we analyzed the benefits accrued first from preventing or stopping the progression of LF disease, and then from the broader anti-parasite effects (‘beyond-LF’ benefits) attributable to the use of albendazole and ivermectin. Projections were based on demographic and disease prevalence data from publications of the Population Reference Bureau, The World Bank, and the World Health Organization.
Between 2000 and 2007, the GPELF prevented LF disease in an estimated 6.6 million newborns who would otherwise have acquired LF, thus averting in their lifetimes nearly 1.4 million cases of hydrocele, 800,000 cases of lymphedema and 4.4 million cases of subclinical disease. Similarly, 9.5 million individuals—previously infected but without overt manifestations of disease—were protected from developing hydrocele (6.0 million) or lymphedema (3.5 million). These LF-related benefits, by themselves, translate into 32 million DALYs (Disability Adjusted Life Years) averted. Ancillary, ‘beyond-LF’ benefits from the >1.9 billion treatments delivered by the GPELF were also enormous, especially because of the >310 million treatments to the children and women of childbearing age who received albendazole with/without ivermectin (effectively treating intestinal helminths, onchocerciasis, lice, scabies, and other conditions). These benefits can be described but remain difficult to quantify, largely because of the poorly defined epidemiology of these latter infections.
The GPELF has earlier been described as a ‘best buy’ in global health; this present tally of attributable health benefits from its first 8 years strengthens this notion considerably.
Url:
DOI: 10.1371/journal.pntd.0000317
PubMed: 18841205
PubMed Central: 2556399
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>In its first 8 years, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) achieved an unprecedentedly rapid scale-up: >1.9 billion treatments with anti-filarial drugs (albendazole, ivermectin, and diethylcarbamazine) were provided via yearly mass drug administration (MDA) to a minimum of 570 million individuals living in 48 of the 83 initially identified LF-endemic countries.</p>
</sec>
<sec sec-type="methods"><title>Methodology</title>
<p>To assess the health impact that this massive global effort has had, we analyzed the benefits accrued first from preventing or stopping the progression of LF disease, and then from the broader anti-parasite effects (‘beyond-LF’ benefits) attributable to the use of albendazole and ivermectin. Projections were based on demographic and disease prevalence data from publications of the Population Reference Bureau, The World Bank, and the World Health Organization.</p>
</sec>
<sec><title>Result</title>
<p>Between 2000 and 2007, the GPELF prevented LF disease in an estimated 6.6 million newborns who would otherwise have acquired LF, thus averting in their lifetimes nearly 1.4 million cases of hydrocele, 800,000 cases of lymphedema and 4.4 million cases of subclinical disease. Similarly, 9.5 million individuals—previously infected but without overt manifestations of disease—were protected from developing hydrocele (6.0 million) or lymphedema (3.5 million). These LF-related benefits, by themselves, translate into 32 million DALYs (Disability Adjusted Life Years) averted. Ancillary, ‘beyond-LF’ benefits from the >1.9 billion treatments delivered by the GPELF were also enormous, especially because of the >310 million treatments to the children and women of childbearing age who received albendazole with/without ivermectin (effectively treating intestinal helminths, onchocerciasis, lice, scabies, and other conditions). These benefits can be described but remain difficult to quantify, largely because of the poorly defined epidemiology of these latter infections.</p>
</sec>
<sec><title>Conclusion</title>
<p>The GPELF has earlier been described as a ‘best buy’ in global health; this present tally of attributable health benefits from its first 8 years strengthens this notion considerably.</p>
</sec>
</div>
</front>
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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>
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<article-id pub-id-type="pmc">2556399</article-id>
<article-id pub-id-type="publisher-id">08-PNTD-RA-0114R3</article-id>
<article-id pub-id-type="doi">10.1371/journal.pntd.0000317</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline"><subject>Infectious Diseases/Helminth Infections</subject>
<subject>Public Health and Epidemiology/Global Health</subject>
</subj-group>
</article-categories>
<title-group><article-title>The Global Programme to Eliminate Lymphatic Filariasis: Health Impact after 8 Years</article-title>
<alt-title alt-title-type="running-head">Global Programme to Eliminate LF: Health Impact</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ottesen</surname>
<given-names>Eric A.</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"><name><surname>Hooper</surname>
<given-names>Pamela J.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bradley</surname>
<given-names>Mark</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Biswas</surname>
<given-names>Gautam</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
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<aff id="aff1"><label>1</label>
<addr-line>Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia, United States of America</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Preventive Chemotherapy and Transmission Control, World Health Organization, Geneva, Switzerland</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>de Silva</surname>
<given-names>Nilanthi</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
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<aff id="edit1">University of Kelaniya, Sri Lanka</aff>
<author-notes><corresp id="cor1">* E-mail: <email>eottesen@taskforce.org</email>
</corresp>
<fn fn-type="con"><p>Conceived and designed the experiments: EAO PJH MB GB. Performed the experiments: EAO PJH MB GB. Analyzed the data: EAO PJH MB GB. Wrote the paper: EAO PJH MB GB.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><month>10</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="epub"><day>8</day>
<month>10</month>
<year>2008</year>
</pub-date>
<volume>2</volume>
<issue>10</issue>
<elocation-id>e317</elocation-id>
<history><date date-type="received"><day>18</day>
<month>4</month>
<year>2008</year>
</date>
<date date-type="accepted"><day>15</day>
<month>9</month>
<year>2008</year>
</date>
</history>
<copyright-statement>Ottesen 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>2008</copyright-year>
<abstract><sec><title>Background</title>
<p>In its first 8 years, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) achieved an unprecedentedly rapid scale-up: >1.9 billion treatments with anti-filarial drugs (albendazole, ivermectin, and diethylcarbamazine) were provided via yearly mass drug administration (MDA) to a minimum of 570 million individuals living in 48 of the 83 initially identified LF-endemic countries.</p>
</sec>
<sec sec-type="methods"><title>Methodology</title>
<p>To assess the health impact that this massive global effort has had, we analyzed the benefits accrued first from preventing or stopping the progression of LF disease, and then from the broader anti-parasite effects (‘beyond-LF’ benefits) attributable to the use of albendazole and ivermectin. Projections were based on demographic and disease prevalence data from publications of the Population Reference Bureau, The World Bank, and the World Health Organization.</p>
</sec>
<sec><title>Result</title>
<p>Between 2000 and 2007, the GPELF prevented LF disease in an estimated 6.6 million newborns who would otherwise have acquired LF, thus averting in their lifetimes nearly 1.4 million cases of hydrocele, 800,000 cases of lymphedema and 4.4 million cases of subclinical disease. Similarly, 9.5 million individuals—previously infected but without overt manifestations of disease—were protected from developing hydrocele (6.0 million) or lymphedema (3.5 million). These LF-related benefits, by themselves, translate into 32 million DALYs (Disability Adjusted Life Years) averted. Ancillary, ‘beyond-LF’ benefits from the >1.9 billion treatments delivered by the GPELF were also enormous, especially because of the >310 million treatments to the children and women of childbearing age who received albendazole with/without ivermectin (effectively treating intestinal helminths, onchocerciasis, lice, scabies, and other conditions). These benefits can be described but remain difficult to quantify, largely because of the poorly defined epidemiology of these latter infections.</p>
</sec>
<sec><title>Conclusion</title>
<p>The GPELF has earlier been described as a ‘best buy’ in global health; this present tally of attributable health benefits from its first 8 years strengthens this notion considerably.</p>
</sec>
</abstract>
<abstract abstract-type="summary"><title>Author Summary</title>
<p>Lymphatic filariasis (LF) is a vector-borne, chronically disabling parasitic infection causing elephantiasis, lymphedema, and hydrocele. The infection is endemic in 83 countries worldwide, with more than 1.2 billion people at risk and 120 million already infected. Since 1998, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) has targeted elimination of LF by 2020. In its first 8 operational years, the program has scaled-up to provide more than 1.9 billion treatments through annual, single-dose mass drug administration (MDA) to ∼570 million individuals living in 48 LF-endemic countries. Not only do the GPELF drugs prevent the spread of LF, they also stop the progression of disease in those already infected. In addition, since two of the three drugs used for LF elimination have broad anti-parasite properties, treated populations are freed from both intestinal worms and from skin infections with onchocerca, lice, and scabies. To better understand the public health benefit of this ongoing global health initiative, we undertook an analysis of Programme data made available to WHO by participating countries. Our conservative estimates show that the GPELF has had an unprecedented public health impact on both LF and other neglected tropical diseases; it justly deserves the accolade of ‘a best buy’ in global health.</p>
</abstract>
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