Lymphatic filariasis (LF), already recognized as a widespread, seriously handicapping disease of adults, was generally thought to occur only sporadically in children. New, highly sensitive diagnostic tests (antigen detection, ultrasound examination) now reveal, however, that LF is first acquired in childhood, often with as many as one‐third of children infected before age 5. Initial damage to the lymphatic system by the parasites generally remains subclinical for years or gives rise only to non‐specific presentations of adenitis/adenopathy; however, especially after puberty the characteristic clinical features of the adult disease syndromes (lymphoedema, hydrocoele) manifest themselves. Recognizing that LF disease starts its development in childhood has immediate practical implications both for management and prevention of the disease in individual patients and for the broader public health efforts to overcome all childhood illnesses. For the new World Health Organization (WHO)‐supported, public‐/private‐sector collaboration (Global Alliance) to eliminate LF through once‐yearly drug treatment, this recognition means that children will be not only the principal beneficiaries of LF elimination but also a population particularly important to target in order for the programme to achieve its twin goals of interrupting transmission and preventing disease.

A protocol for the collection of resting, blood-engorged Culex quinquefasciatus Say and their examination for microfilariae has been developed as a way of detecting whether lymphatic filariasis (LF) occurs in a particular locality. The protocol was first implemented in a pilot study in Trinidad, West Indies. For gathering prevalence data, such xenomonitoring is a suitable alternative to the use of human bait, which is ethically questionable. The resting mosquitoes were collected, either indoors or outdoors, using electrical and mouth aspirators. A 'cocoeya broom', made from a bunch of the midribs of coconut-palm leaves, was found to be useful in flushing out the mosquitoes resting in hard-to-reach areas within bedrooms. The rationale behind the strategy and the five-step methodology, of householder notification, mapping, preparation of equipment, mosquito collecting and laboratory processing, are described. Data from the pilot study indicate that this xenomonitoring protocol may be applicable worldwide, albeit with modifications to take account of variations in the vector species involved and their ecology and resting behaviour.

No abstract

No abstract

No abstract