What is it about?
Lymphatic filariasis (LF) is one of the 20 NTDs that the WHO has designated as being targeted for elimination. It affects over 120 million people worldwide. It has close ties to poverty and is linked to significant clinical morbidity, which places a heavy socio-psychological and financial burden on those who are affected. Mass drug administration (MDA) is a strategy that the Global Programme to Eliminate Lymphatic Filariasis (GPELF) uses to stop LF transmission. The GPELF's original 2020 target year for global elimination could not be achieved, so 2030 is the new suggested year. The study assessed how 15 years of MDA had affected the management of LF in two high-risk districts in Ghana. The findings of this study point to a halt in LF transmission in the districts, with microfilaria found in less than 1% of those sampled. However, the prevalence of antigenemia remains above the recommended level. MDA should be increased, particularly in border towns, or alternative treatment strategies should be used to finally eliminate the disease, as some people who are still infected can serve as reservoirs for recrudescence and transmission in previously "LF-free" areas.
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Why is it important?
The paper advocates for a revision/adjustment of the long-standing stringent 2% antigenemia threshold established by the WHO through the Global Programme to Eliminate Lymphatic Filariasis (GPELF), particularly now that more sensitive diagnostic kits, such as the FTS, have been introduced for post-treatment surveillance. The revision and subsequent validation of the 2% antigenemia threshold by WHO may help prevent unnecessary lymphatic filariasis treatment rounds, resulting in a waste of resources.
Perspectives
The co-authors felt I was being too controversial about the WHO-endorsed lymphatic filariasis testing kit, the Filarial Test Kit, and also asking for a revision/adjustment in the longstanding antigenemia threshold. However, that was what the data and Science indicated, so we had to "argue" our way out with the reviewers and editors in order to get the work published.
Mr Derrick Adu Mensah
Kwame Nkrumah University of Science and Technology
Read the Original
This page is a summary of: Occurrence of Lymphatic Filariasis infection after 15 years of mass drug administration in two hotspot districts in the Upper East Region of Ghana, PLoS Neglected Tropical Diseases, August 2022, PLOS,
DOI: 10.1371/journal.pntd.0010129.
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