Rapid progress towards elimination of lymphatic filariasis in endemic regions of Myanmar as a result of 16 years of anti-filarial activities (2001–2016)

Abstract

BackgroundAs Myanmar progresses towards lymphatic filariasis (LF) elimination, it is important to know how well the anti-filarial activities have performed. The present study was conducted to study the implementation of the key anti-filarial activities and their impact on key indicators of LF transmission.MethodsA secondary analysis of aggregate program data on the anti-filarial activities was conducted in four endemic state/regions of Myanmar receiving at least six mass drug administration (MDA) rounds during 2001–2016.ResultsMDA coverage has been expanded to cover all the endemic implementation units (IUs), i.e., 45 by 2015 and 6 IUs out of them have already stopped MDA. The reported coverage of MDA ranges from 87 to 100% whereas surveyed coverage ranges from 78 to 100% among the eligible population. The prevalence of microfilaria has significantly declined especially in Magway from 4.7 to 0.2% and Sagaing region from 7.9 to 1.3% during 2001–2016. Around 2.5% of estimated cases of hydrocele were reported to the program during 2009–2014.ConclusionMyanmar has achieved significant success in interrupting LF transmission through several MDA rounds with high coverage. However, morbidity reporting and management, being in its initial phase requires an active surveillance system for identifying and managing people with LF-associated morbidities under the program.

The prevalence of lymphatic filariasis infection and disease following six rounds of mass drug administration in Mandalay Region, Myanmar

“…[ 5 , 6 ] Forty-five of the 65 districts in Myanmar were classified as LF-endemic, with 47 million people at-risk (85.5% of the total population). [ 4 , 5 , 7 ] Baseline, pre– mass drug administration (MDA), surveys indicated high levels of antigenaemia (20–30%) in the central and western dry zones, consistent with that seen in Myanmar migrants living in Thailand. [ 3 , 5 , 6 ] Meanwhile, the northern, eastern and southern areas of the country were less endemic or free from filariasis.…”

“…[ 5 , 6 ] In Mandalay Region, the site of this study, the baseline prevalence by microfilaraemia (mf) was 5.2% (range: 0.2 to 14.7%) and by antigenaemia ranged from 2 to >25%. [ 5 – 7 ] The parasite Wuchereria bancrofti is the sole documented cause of LF in Myanmar, where it is transmitted by the mosquito Culex quinquefasciatus . [ 3 , 5 , 7 , 8 ]…”

“…[ 5 – 7 ] The parasite Wuchereria bancrofti is the sole documented cause of LF in Myanmar, where it is transmitted by the mosquito Culex quinquefasciatus . [ 3 , 5 , 7 , 8 ]…”

“…[ 4 , 5 ] Since then, the coverage has been progressively expanded, reaching all endemic districts by 2015. [ 7 ] With the exception of six districts (three in Sagaing Region, two in Mandalay Region and one in Magway Region) that have passed Transmission Assessment Surveys (TAS), all are continuing MDA rounds. [ 5 , 7 ] Whilst the WHO recommends annual MDA rounds for at least five consecutive years, several challenges resulted in two to three year intervals between rounds.…”

Operational Research Capacity Building through the Structured Operational Research and Training Initiative (SORT IT) Model in Myanmar: National Operational Research Course (2016-17)

“…Elimination of lymphatic filariasis in endemic regions of Myanmar as a result of 16 years of antifilarial activities including preventive chemotherapy (2001-2016) 8 This study reported that mass drug administration (MDA) for lymphatic filariasis covered all the endemic districts in Myanmar through several MDA rounds and the reported coverage of MDA rounds according to post-mass drug administration survey ranges from 87 to 100%. The study also found that prevalence of microfilaria has significantly declined and Myanmar has achieved significant success in interrupting lymphatic filariasis.…”