A Success Story: Togo Is Moving toward Becoming the First Sub-Saharan African Nation to Eliminate Lymphatic Filariasis through Mass Drug Administration and Countrywide Morbidity Alleviation

Ongoing Surveillance for Lymphatic Filariasis in Togo: Assessment of Alternatives and Nationwide Reassessment of Transmission Status

“…Although the current report focuses on surveillance to ensure interruption of transmission, morbidity control efforts have also been an essential component of the LF control program in Togo and have recently been described elsewhere. 6,24 Because hydrocele and lymphedema are poor indicators of active filarial burden, 25 they are not currently used for surveillance of LF transmission in Togo; incorporation of these indicators of LF-related morbidity into ongoing surveillance should be considered.…”

“…Seven of the country's thirty-five medical districts were LF-endemic before onset of MDA in 2000; the last MDA in Togo was conducted in 2009. 6 A nationwide laboratory-based LF surveillance system, developed in cooperation with the US Centers for Disease Control and Prevention (CDC), covering all 35 districts and designed to be sustainable in resource-poor settings was implemented in 2006 and has been described in detail in the work by Mathieu and others. 7 The technicians in this laboratory-based surveillance system review nocturnal malarial thick blood smears collected from patients at district hospitals (or equivalent inpatient facilities) throughout the country for the presence of microfilariae.…”

The global distribution and transmission limits of lymphatic filariasis: past and present

“…The main intervention strategy is mass drug administration (MDA) with albendazole in combination with diethylcarbamazine (DEC) (or ivermectin in countries where onchocerciasis is endemic) to entire communities in districts where the prevalence of LF is equal or more than 1% [6], supported by vector control to reduce exposure to mosquitoes and morbidity management to alleviate suffering and prevent disability of those affected by the disease [7,8]. During the last half century, several countries have successfully eliminated LF, including Japan, China, South Korea, the Solomon Islands, Egypt and Togo [9][10][11][12][13].…”

This De-Wormed World?

“…This has prompted the accolade that the GPELF is a “best buy” among many global health expenditures. Both China and the Republic of Korea have since declared elimination of lymphatic filariasis, and Togo is probably the first sub-Saharan African nation to have interrupted transmission of lymphatic filariasis (Sodahlon et al, 2013). Haiti is close to eliminating filariasis http://www.cdc.gov/media/releases/2013/p0614-haiti-filariasis.html.…”