1. Achievements and challenges of lymphatic filariasis elimination in Sierra Leone.
- Author
-
Bah YM, Paye J, Bah MS, Conteh A, Redwood-Sawyerr V, Sonnie M, Veinoglou A, Koroma JB, Hodges MH, and Zhang Y
- Subjects
- Animals, Brugia malayi isolation & purification, Child, Child, Preschool, Disease Eradication methods, Elephantiasis, Filarial diagnosis, Elephantiasis, Filarial drug therapy, Humans, Sierra Leone epidemiology, Wuchereria bancrofti isolation & purification, Albendazole therapeutic use, Elephantiasis, Filarial epidemiology, Elephantiasis, Filarial prevention & control, Filaricides therapeutic use, Ivermectin therapeutic use, Mass Drug Administration
- Abstract
Background: Lymphatic filariasis (LF) is targeted for elimination in Sierra Leone. Epidemiological coverage of mass drug administration (MDA) with ivermectin and albendazole had been reported >65% in all 12 districts annually. Eight districts qualified to implement transmission assessment survey (TAS) in 2013 but were deferred until 2017 due to the Ebola outbreak (2014-2016). In 2017, four districts qualified for conducting a repeat pre-TAS after completing three more rounds of MDA and the final two districts were also eligible to implement a pre-TAS., Methodology/principal Findings: For TAS, eight districts were surveyed as four evaluation units (EU). A school-based survey was conducted in children aged 6-7 years from 30 clusters per EU. For pre-TAS, one sentinel and one spot check site per district (with 2 spot check sites in Bombali) were selected and 300-350 persons aged 5 years and above were selected. For both surveys, finger prick blood samples were tested using the Filariasis Test Strips (FTS). For TAS, 7,143 children aged 6-7 years were surveyed across four EUs, and positives were found in three EUs, all below the critical cut-off value for each EU. For the repeat pre-TAS/pre-TAS, 3,994 persons over five years of age were surveyed. The Western Area Urban had FTS prevalence of 0.7% in two sites and qualified for TAS, while other five districts had sites with antigenemia prevalence >2%: 9.1-25.9% in Bombali, 7.5-19.4% in Koinadugu, 6.1-2.9% in Kailahun, 1.3-2.3% in Kenema and 1.7% - 3.7% in Western Area Rural., Conclusions/significance: Eight districts in Sierra Leone have successfully passed TAS1 and stopped MDA, with one more district qualified for conducting TAS1, a significant progress towards LF elimination. However, great challenges exist in eliminating LF from the whole country with repeated failure of pre-TAS in border districts. Effort needs to be intensified to achieve LF elimination., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
- Full Text
- View/download PDF