Lymphatic filariasis in Brazil: epidemiological situation and outlook for elimination

Abstract

Since the World Health Assembly’s (Resolution WHA 50.29, 1997) call for the elimination of lymphatic filariasis by the year 2020, most of the endemic countries identified have established programmes to meet this objective. In 1997, a National Lymphatic Filariasis Elimination Plan was drawn up by the Ministry of Health of Brazil, creating local programs for the elimination of Bancroftian filariasis in areas with active transmission. Based on a comprehensive bibliographic search for available studies and reports of filariasis epidemiology in Brazil, current status of this parasitic infection and the outlook for its elimination in the country were analysed. From 1951 to 1958 a nationwide epidemiological study conducted in Brazil confirmed autochthonous transmission of Bancroftian filariasis in 11 cities of the country. Control measures led to a decline in parasite rates, and in the 1980s only the cities of Belém in the Amazonian region (Northern region) and Recife (Northeastern region) were considered to be endemic. In the 1990s, foci of active transmission of LF were also described in the cities of Maceió, Olinda, Jaboatão dos Guararapes, and Paulista, all in the Northeastern coast of Brazil. Data provide evidence for the absence of microfilaremic subjects and infected mosquitoes in Belém, Salvador and Maceió in the past few years, attesting to the effectiveness of the measures adopted in these cities. Currently, lymphatic filariasis is a public health problem in Brazil only in four cities of the metropolitan Recife region (Northeastern coast). Efforts are being concentrated in these areas, with a view to eliminating the disease in the country.

Terapia complexa descongestiva com uso de material alternativo na redução e controle do linfedema em pacientes de área endêmica de filariose: um ensaio clínico

“…Lymphedema is a chronic condition that, although not curable, can be treated and followed up, with actions that can prevent its complications. Once installed and untreated, this can progress and interfere in a negative way in the quality of life of the affected people, causing, in addition to physical sequels, psychological and social changes, especially when affecting the lower limbs, which are directly related to mobility and activities of daily living 5,[8][9][10][11][12][13] . Treating lymphedema goes beyond aesthetic reasons, since, according to the International Society of Lymphology, although it is not possible to achieve the cure, reducing limb volume minimizes joint overload and reduces the presence of pain, facilitating the activities of daily living 9 .…”

Wuchereria bancrofti infection in Haitian immigrants and the risk of re-emergence of lymphatic filariasis in the Brazilian Amazon

“…This individual also tested positive on ICT and PMF, and had a microfilaremia of 9mf/mL blood ( Table 1) The Brazilian Amazon has favorable environmental conditions for the re-emergence of W. bancrofti because of the high concentrations of C. quinquefasciatus and because there is a lack of basic sanitation in many regions. Furthermore, this region was endemic for W. bancrofti in the past 1 . Since the last study on LF in the City of Manaus 4 , almost 60 years ago, in 1956, no research concerning the incidence or prevalence of this disease has been conducted in the City.…”

“…In the north of the country, the Cities of Belém (Pará State) and Manaus (Amazonas State) were endemic for LF in the past, but are currently considered non-endemic 1 .…”

“…In Brazil, the active focus of LF transmission is concentrated in the City of Recife and some cities in its metropolitan region (Olinda, Paulista, and Jaboatão dos Guararapes) on the Northeastern coast 1 . In the north of the country, the Cities of Belém (Pará State) and Manaus (Amazonas State) were endemic for LF in the past, but are currently considered non-endemic 1 .…”

“…Lymphatic filariasis (LF) is a neglected disease that affects millions of people in endemic regions of Asia, Africa, and the Americas 1 . In the Americas, the active foci are located in Guyana, Dominican Republic, Haiti, and Brazil 2 .…”