Evaluation of lymphatic filariasis in endemic area of Brazil where mass drug administration is not required

ABSTRACT

Mass drug administration (MDA) is the main counter-transmission strategy of the Global Programme to Eliminate Lymphatic Filariasis. In endemic countries, there are areas where MDA is not required. However, there is no standard approach in these areas, and studies are important to evaluate the epidemiological status. This study aimed to investigate lymphatic filariasis and strategies developed for its control in an area where MDA is not required. Together with the 2018 morbidity evaluation, a survey was conducted using point-of-care immunochromatographic test-AD12 tests for diagnostic screening in an area where MDA is not required. The methodology also included desk research based on Health Department reports of the control activities for lymphatic filariasis during 2003–2016. Among the 934 cases investigated in 2018, there was a 0.64% prevalence of circulating filarial antigen positive, comprising five adults and one 2-year-old child. Six patients aged 39–63 years had filarial disease. Fourteen surveys have already been conducted as control activities, and since 2009, there have been no positive cases. This study showed that the prevalence of antigenemia decreased from 2.97% in 2003 to 0.64% in 2018. Moreover, the transmission of filariasis infection was under control in this area. Our study provides insights into the surveillance phase by identifying areas of low transmission and where MDA is not required. Although we have not identified cases of filarial infection, there is a need to provide services that will provide assist those already affected with morbidity and help reduce and prevent disability.

KEYWORDS:

• Lymphatic filariasis
• Wuchereria bancrofti
• ICT card
• mass drug administration
• Elimination
• Surveillance

Acknowledgments

We would like to thank Alere Pty Ltd. for providing low-cost kits for this evaluation. The authors are grateful to the National Reference Center of Lymphatic Filariasis (NRCLF/IAM/FIOCRUZ) in Recife for their support in the laboratory procedures and the Health Department of Jaboatão dos Guararapes for the health system and fieldwork information.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary Materials

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Additional information

Funding

This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [001]; Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco [001]; Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco [APQ 0359-4.06/13]- IBPG-0959-4.01/16.