First evidence of lymphatic filariasis transmission interruption in Cameroon: Progress towards elimination
Identifieur interne : 004310 ( Pmc/Curation ); précédent : 004309; suivant : 004311First evidence of lymphatic filariasis transmission interruption in Cameroon: Progress towards elimination
Auteurs : Hugues C. Nana-Djeunga [Cameroun] ; Magellan Tchouakui [Cameroun] ; Guy R. Njitchouang [Cameroun] ; Jules B. Tchatchueng-Mbougua [Cameroun] ; Philippe Nwane [Cameroun] ; André Domche [Cameroun] ; Jean Bopda [Cameroun] ; Stève Mbickmen-Tchana [Cameroun] ; Julie Akame [Cameroun] ; Ann Tarini [Cameroun] ; Emilienne Epée [Cameroun] ; Benjamin D. Biholong [Cameroun] ; Yaobi Zhang [Sénégal] ; Jean J. Tougoue [États-Unis] ; Achille Kabore [États-Unis] ; Flobert Njiokou [Cameroun] ; Joseph Kamgno [Cameroun]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2017.
Abstract
Lymphatic filariasis (LF) is among the 10 neglected tropical diseases targeted for control or elimination by 2020. For LF elimination, the World Health Organization (WHO) has proposed a comprehensive strategy including (i) interruption of LF transmission through large-scale annual treatment (or mass drug administration (MDA)) of all eligible individuals in endemic areas, and (ii) alleviation of LF-associated suffering through morbidity management and disability prevention. In Cameroon, once-yearly mass administration of ivermectin and albendazole has been implemented since 2008. The aim of this study was to assess progress towards the elimination goal, looking specifically at the impact of six rounds of MDA on LF transmission in northern Cameroon.
The study was conducted in the North and Far North Regions of Cameroon. Five health districts that successfully completed six rounds of MDA (defined as achieving a treatment coverage ≥ 65% each year) and reported no positive results for
A total of 5292 children (male/female ratio 1.04) aged 5–8 years old were examined in 97 communities. Positive CFA results were observed in 2, 8 and 11 cases, with a CFA prevalence of 0.13% (95% CI: 0.04–0.46) in EU#1, 0.57% (95% CI: 0.32–1.02) in EU#2, and 0.45% (95% CI: 0.23–0.89) in EU#3.
The positive CFA cases were below WHO defined critical cut-off thresholds for stopping treatment and suggest that transmission can no longer be sustained. Post-MDA surveillance activities should be organized to evaluate whether recrudescence can occur.
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DOI: 10.1371/journal.pntd.0005633
PubMed: 28662054
PubMed Central: 5490934
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Nana-Djeunga</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Tchouakui, Magellan" sort="Tchouakui, Magellan" uniqKey="Tchouakui M" first="Magellan" last="Tchouakui">Magellan Tchouakui</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Njitchouang, Guy R" sort="Njitchouang, Guy R" uniqKey="Njitchouang G" first="Guy R." last="Njitchouang">Guy R. Njitchouang</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Tchatchueng Mbougua, Jules B" sort="Tchatchueng Mbougua, Jules B" uniqKey="Tchatchueng Mbougua J" first="Jules B." last="Tchatchueng-Mbougua">Jules B. Tchatchueng-Mbougua</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Nwane, Philippe" sort="Nwane, Philippe" uniqKey="Nwane P" first="Philippe" last="Nwane">Philippe Nwane</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Domche, Andre" sort="Domche, Andre" uniqKey="Domche A" first="André" last="Domche">André Domche</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Bopda, Jean" sort="Bopda, Jean" uniqKey="Bopda J" first="Jean" last="Bopda">Jean Bopda</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Mbickmen Tchana, Steve" sort="Mbickmen Tchana, Steve" uniqKey="Mbickmen Tchana S" first="Stève" last="Mbickmen-Tchana">Stève Mbickmen-Tchana</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Akame, Julie" sort="Akame, Julie" uniqKey="Akame J" first="Julie" last="Akame">Julie Akame</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Helen Keller International, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Helen Keller International, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Tarini, Ann" sort="Tarini, Ann" uniqKey="Tarini A" first="Ann" last="Tarini">Ann Tarini</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Helen Keller International, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Helen Keller International, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Epee, Emilienne" sort="Epee, Emilienne" uniqKey="Epee E" first="Emilienne" last="Epée">Emilienne Epée</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Ministry of Public Health, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Ministry of Public Health, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Biholong, Benjamin D" sort="Biholong, Benjamin D" uniqKey="Biholong B" first="Benjamin D." last="Biholong">Benjamin D. Biholong</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Ministry of Public Health, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Ministry of Public Health, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Yaobi" sort="Zhang, Yaobi" uniqKey="Zhang Y" first="Yaobi" last="Zhang">Yaobi Zhang</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Helen Keller International, Regional Office for Africa, Dakar, Senegal</addr-line></nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Helen Keller International, Regional Office for Africa, Dakar</wicri:regionArea></affiliation></author><author><name sortKey="Tougoue, Jean J" sort="Tougoue, Jean J" uniqKey="Tougoue J" first="Jean J." last="Tougoue">Jean J. Tougoue</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>RTI International, Washington, D.C., United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>RTI International, Washington, D.C.</wicri:regionArea></affiliation></author><author><name sortKey="Kabore, Achille" sort="Kabore, Achille" uniqKey="Kabore A" first="Achille" last="Kabore">Achille Kabore</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>RTI International, Washington, D.C., United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>RTI International, Washington, D.C.</wicri:regionArea></affiliation></author><author><name sortKey="Njiokou, Flobert" sort="Njiokou, Flobert" uniqKey="Njiokou F" first="Flobert" last="Njiokou">Flobert Njiokou</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé</wicri:regionArea></affiliation></author><author><name sortKey="Kamgno, Joseph" sort="Kamgno, Joseph" uniqKey="Kamgno J" first="Joseph" last="Kamgno">Joseph Kamgno</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff007"><addr-line>Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé</wicri:regionArea></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="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Lymphatic filariasis (LF) is among the 10 neglected tropical diseases targeted for control or elimination by 2020. For LF elimination, the World Health Organization (WHO) has proposed a comprehensive strategy including (i) interruption of LF transmission through large-scale annual treatment (or mass drug administration (MDA)) of all eligible individuals in endemic areas, and (ii) alleviation of LF-associated suffering through morbidity management and disability prevention. In Cameroon, once-yearly mass administration of ivermectin and albendazole has been implemented since 2008. The aim of this study was to assess progress towards the elimination goal, looking specifically at the impact of six rounds of MDA on LF transmission in northern Cameroon.</p></sec><sec id="sec002"><title>Methodology</title><p>The study was conducted in the North and Far North Regions of Cameroon. Five health districts that successfully completed six rounds of MDA (defined as achieving a treatment coverage ≥ 65% each year) and reported no positive results for <italic>Wuchereria bancrofti</italic> microfilariaemia during routine surveys following the fifth MDA were grouped into three evaluation units (EU) according to WHO criteria. LF transmission was assessed through a community-based transmission assessment survey (TAS) using an immunochromatographic test (ICT) for the detection of circulating filarial antigen (CFA) in children aged 5–8 years old.</p></sec><sec id="sec003"><title>Principal findings</title><p>A total of 5292 children (male/female ratio 1.04) aged 5–8 years old were examined in 97 communities. Positive CFA results were observed in 2, 8 and 11 cases, with a CFA prevalence of 0.13% (95% CI: 0.04–0.46) in EU#1, 0.57% (95% CI: 0.32–1.02) in EU#2, and 0.45% (95% CI: 0.23–0.89) in EU#3.</p></sec><sec id="sec004"><title>Conclusion/Significance</title><p>The positive CFA cases were below WHO defined critical cut-off thresholds for stopping treatment and suggest that transmission can no longer be sustained. Post-MDA surveillance activities should be organized to evaluate whether recrudescence can occur.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Plaisier, Ap" uniqKey="Plaisier A">AP Plaisier</name></author><author><name sortKey="Stolk, Wa" uniqKey="Stolk W">WA Stolk</name></author><author><name sortKey="Van Oortmarssen, Gj" uniqKey="Van Oortmarssen G">GJ van Oortmarssen</name></author><author><name sortKey="Habbema, Jd" uniqKey="Habbema J">JD Habbema</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Michael, E" uniqKey="Michael E">E Michael</name></author><author><name sortKey="Malecela Lazaro, Mn" uniqKey="Malecela Lazaro M">MN Malecela-Lazaro</name></author><author><name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE Simonsen</name></author><author><name sortKey="Pedersen, Em" uniqKey="Pedersen E">EM Pedersen</name></author><author><name 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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="iso-abbrev">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, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28662054</article-id><article-id pub-id-type="pmc">5490934</article-id><article-id pub-id-type="doi">10.1371/journal.pntd.0005633</article-id><article-id pub-id-type="publisher-id">PNTD-D-16-01872</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject><subj-group><subject>Geographical Locations</subject><subj-group><subject>Africa</subject><subj-group><subject>Cameroon</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Parasitic Diseases</subject><subj-group><subject>Helminth Infections</subject><subj-group><subject>Onchocerciasis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Tropical Diseases</subject><subj-group><subject>Neglected Tropical Diseases</subject><subj-group><subject>Onchocerciasis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Parasitic Diseases</subject><subj-group><subject>Helminth Infections</subject><subj-group><subject>Filariasis</subject><subj-group><subject>Lymphatic Filariasis</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Tropical Diseases</subject><subj-group><subject>Neglected Tropical Diseases</subject><subj-group><subject>Lymphatic Filariasis</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Animals</subject><subj-group><subject>Invertebrates</subject><subj-group><subject>Nematoda</subject><subj-group><subject>Wuchereria</subject><subj-group><subject>Wuchereria Bancrofti</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pharmaceutics</subject><subj-group><subject>Drug Therapy</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Public and Occupational Health</subject><subj-group><subject>Global Health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Disease Vectors</subject><subj-group><subject>Insect Vectors</subject><subj-group><subject>Mosquitoes</subject><subj-group><subject>Anopheles Gambiae</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Species Interactions</subject><subj-group><subject>Disease Vectors</subject><subj-group><subject>Insect Vectors</subject><subj-group><subject>Mosquitoes</subject><subj-group><subject>Anopheles Gambiae</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Organisms</subject><subj-group><subject>Animals</subject><subj-group><subject>Invertebrates</subject><subj-group><subject>Arthropoda</subject><subj-group><subject>Insects</subject><subj-group><subject>Mosquitoes</subject><subj-group><subject>Anopheles Gambiae</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Infectious Disease Control</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>First evidence of lymphatic filariasis transmission interruption in Cameroon: Progress towards elimination</article-title><alt-title alt-title-type="running-head">LF transmission interruption in northern Cameroon</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nana-Djeunga</surname><given-names>Hugues C.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tchouakui</surname><given-names>Magellan</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Njitchouang</surname><given-names>Guy R.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tchatchueng-Mbougua</surname><given-names>Jules B.</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nwane</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Domche</surname><given-names>André</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bopda</surname><given-names>Jean</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mbickmen-Tchana</surname><given-names>Stève</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Akame</surname><given-names>Julie</given-names></name><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tarini</surname><given-names>Ann</given-names></name><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Epée</surname><given-names>Emilienne</given-names></name><xref ref-type="aff" rid="aff004"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Biholong</surname><given-names>Benjamin D.</given-names></name><xref ref-type="aff" rid="aff004"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Yaobi</given-names></name><xref ref-type="aff" rid="aff005"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tougoue</surname><given-names>Jean J.</given-names></name><xref ref-type="aff" rid="aff006"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kabore</surname><given-names>Achille</given-names></name><xref ref-type="aff" rid="aff006"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Njiokou</surname><given-names>Flobert</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0003-1572-3490</contrib-id><name><surname>Kamgno</surname><given-names>Joseph</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="aff" rid="aff007"><sup>7</sup></xref><xref ref-type="corresp" rid="cor001">*</xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon</addr-line></aff><aff id="aff002"><label>2</label><addr-line>Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></aff><aff id="aff003"><label>3</label><addr-line>Helen Keller International, Yaoundé, Cameroon</addr-line></aff><aff id="aff004"><label>4</label><addr-line>Ministry of Public Health, Yaoundé, Cameroon</addr-line></aff><aff id="aff005"><label>5</label><addr-line>Helen Keller International, Regional Office for Africa, Dakar, Senegal</addr-line></aff><aff id="aff006"><label>6</label><addr-line>RTI International, Washington, D.C., United States of America</addr-line></aff><aff id="aff007"><label>7</label><addr-line>Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Santiago</surname><given-names>Helton da Costa</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Universidade Federal de Minas Gerais, BRAZIL</addr-line></aff><author-notes><fn fn-type="COI-statement" id="coi001"><p>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p><list list-type="simple"><list-item><p><bold>Conceptualization:</bold> HCND JK YZ.</p></list-item><list-item><p><bold>Data curation:</bold> HCND JBTM JK.</p></list-item><list-item><p><bold>Formal analysis:</bold> HCND JBTM JK.</p></list-item><list-item><p><bold>Funding acquisition:</bold> JK.</p></list-item><list-item><p><bold>Investigation:</bold> HCND MT GRN JBTM PN AD JB SMT JK.</p></list-item><list-item><p><bold>Methodology:</bold> HCND JK YZ.</p></list-item><list-item><p><bold>Project administration:</bold> JK.</p></list-item><list-item><p><bold>Resources:</bold> HCND JK YZ JJT AK.</p></list-item><list-item><p><bold>Supervision:</bold> JK.</p></list-item><list-item><p><bold>Writing – original draft:</bold> HCND JK.</p></list-item><list-item><p><bold>Writing – review & editing:</bold> HCND MT GRN JBTM PN AD JB SMT JA AT BDB EE YZ JJT AK FN JK.</p></list-item></list></p></fn><corresp id="cor001">* E-mail: <email>kamgno@crfilmt.org</email></corresp></author-notes><pub-date pub-type="epub"><day>29</day><month>6</month><year>2017</year></pub-date><pub-date pub-type="collection"><month>6</month><year>2017</year></pub-date><volume>11</volume><issue>6</issue><elocation-id>e0005633</elocation-id><history><date date-type="received"><day>13</day><month>10</month><year>2016</year></date><date date-type="accepted"><day>10</day><month>5</month><year>2017</year></date></history><permissions><license xlink:href="https://creativecommons.org/publicdomain/zero/1.0/"><license-p>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 <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/publicdomain/zero/1.0/">Creative Commons CC0</ext-link> public domain dedication.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="pntd.0005633.pdf"></self-uri><abstract><sec id="sec001"><title>Background</title><p>Lymphatic filariasis (LF) is among the 10 neglected tropical diseases targeted for control or elimination by 2020. For LF elimination, the World Health Organization (WHO) has proposed a comprehensive strategy including (i) interruption of LF transmission through large-scale annual treatment (or mass drug administration (MDA)) of all eligible individuals in endemic areas, and (ii) alleviation of LF-associated suffering through morbidity management and disability prevention. In Cameroon, once-yearly mass administration of ivermectin and albendazole has been implemented since 2008. The aim of this study was to assess progress towards the elimination goal, looking specifically at the impact of six rounds of MDA on LF transmission in northern Cameroon.</p></sec><sec id="sec002"><title>Methodology</title><p>The study was conducted in the North and Far North Regions of Cameroon. Five health districts that successfully completed six rounds of MDA (defined as achieving a treatment coverage ≥ 65% each year) and reported no positive results for <italic>Wuchereria bancrofti</italic> microfilariaemia during routine surveys following the fifth MDA were grouped into three evaluation units (EU) according to WHO criteria. LF transmission was assessed through a community-based transmission assessment survey (TAS) using an immunochromatographic test (ICT) for the detection of circulating filarial antigen (CFA) in children aged 5–8 years old.</p></sec><sec id="sec003"><title>Principal findings</title><p>A total of 5292 children (male/female ratio 1.04) aged 5–8 years old were examined in 97 communities. Positive CFA results were observed in 2, 8 and 11 cases, with a CFA prevalence of 0.13% (95% CI: 0.04–0.46) in EU#1, 0.57% (95% CI: 0.32–1.02) in EU#2, and 0.45% (95% CI: 0.23–0.89) in EU#3.</p></sec><sec id="sec004"><title>Conclusion/Significance</title><p>The positive CFA cases were below WHO defined critical cut-off thresholds for stopping treatment and suggest that transmission can no longer be sustained. Post-MDA surveillance activities should be organized to evaluate whether recrudescence can occur.</p></sec></abstract><abstract abstract-type="summary"><title>Author summary</title><p>Lymphatic filariasis (LF) affects more than 120 million people worldwide, and is considered the second leading cause of permanent and long-term disability. In response to the important burden of this disease, the World Health Organization (WHO) elaborated a strategic plan to eliminate LF as a public health problem through annual preventive chemotherapy (PC), repeated for at least six years, and reaching at least 65% of the population at risk. To date, about 5.63 billion cumulative treatments have been delivered since 2000, and more than 300 million people no longer require PC thanks to successful implementation of the WHO strategy. In Cameroon, PC for LF has been implemented since 2008. The aim of this study was to assess whether the transmission of LF has been interrupted. Cross-sectional surveys were conducted in three evaluation units (EU) in northern Cameroon. The LF prevalence observed in each of these EU was lower than the threshold of infection below which transmission is likely no longer sustainable, suggesting that the transmission of LF has been interrupted in the study area.</p></abstract><funding-group><award-group id="award001"><funding-source><institution-wrap><institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/100000200</institution-id><institution>United States Agency for International Development</institution></institution-wrap></funding-source><award-id>AID-OAA-A-11- 00048</award-id><principal-award-recipient><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0003-1572-3490</contrib-id><name><surname>Kamgno</surname><given-names>Joseph</given-names></name></principal-award-recipient></award-group><award-group id="award002"><funding-source><institution>Mectizan Donation Program</institution></funding-source><principal-award-recipient><contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0003-1572-3490</contrib-id><name><surname>Kamgno</surname><given-names>Joseph</given-names></name></principal-award-recipient></award-group><funding-statement>This study was funded by the United States Agency for International Development (USAID) ENVISION Project through Helen Keller International. ENVISION is a global project led by RTI International in partnership with CBM International, The Carter Center, Helen Keller International, IMA World Health, Light for the World, Sightsavers, and World Vision. ENVISION is funded by the US Agency for International Development project under cooperative agreement number AID-OAA-A-11- 00048. The period of performance for ENVISION is September 30, 2011 through September 29, 2019. The Center for Research on Filariasis and other Tropical Diseases (CRFilMT), the platform where biological tests were performed for this study, is funded by Mectizan Donation Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><fig-count count="2"></fig-count><table-count count="1"></table-count><page-count count="12"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>All relevant data are within the paper and its Supporting Information files.</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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