The role of medicine donations in the global programme for the elimination of lymphatic filariasis

Williams, Tijana; Taylor, Russell F.; Iwamoto, Minne; Hida, Takayuki; Gusovsky, Fabián

doi:10.1093/inthealth/ihaa077

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Malawi’s MDA programme included a combination of ivermectin (IVM: 200 μg/kg of body weight) and albendazole (ALB: 400 mg) to treat the entire at-risk population [ 11 , 12 ]. The drugs were donated by the Mectizan Donation Program (IVM) and GlaxoSmithKline (ALB) [ 19 ], and the logistics and transportation of these donated goods were managed by the LF Programme Manager and distributed from the Central Medical Stores in the capital city of Lilongwe, to the district-level headquarters, and onwards to all district health facilities.…”

Section: Methods/principal Findings [Results]mentioning

confidence: 99%

“…Most of the financial support for MDA and MMDP implementation and operational research activities were from the Centre for Neglected Tropical Diseases (CNTD) at the Liverpool School of Tropical Medicine (LSTM) with a grant from the U.K. Foreign Commonwealth and Development Office (FCDO; formerly Department for International Development, DFID) and support from GlaxoSmithKline (GSK). The two drugs used for MDA implementation were donated by the Mectizan Donation Programme (IVM) and by GSK (ALB) [ 19 ].…”

Section: Methods/principal Findings [Results]mentioning

confidence: 99%

“…(LSTM) with a grant from the U.K. Foreign Commonwealth and Development Office (FCDO; formerly Department for International Development, DFID) and support from GlaxoSmithKline (GSK). The two drugs used for MDA implementation were donated by the Mectizan Donation Programme (IVM) and by GSK (ALB) [19].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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Elimination of lymphatic filariasis as a public health problem in Malawi

Chiphwanya,

Mkwanda,

Kabuluzi

et al. 2024

PLoS Negl Trop Dis

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Background Lymphatic filariasis (LF) is a parasitic disease transmitted by mosquitoes, causing severe pain, disfiguring, and disabling clinical conditions such as lymphoedema and hydrocoele. LF is a global public health problem affecting 72 countries, primarily in Africa and Asia. Since 2000, the World Health Organization (WHO) has led the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to support all endemic regions. This paper focuses on the achievements of the Malawi LF Elimination Programme between 2000 and 2020 to eliminate LF as a public health problem, making it the second sub-Saharan country to receive validation from the WHO. Methodology/principal findings The Malawi LF Programme addressed the widespread prevalence of LF infection and disease across the country, using the recommended WHO GPELF strategies and operational research initiatives in collaboration with key national and international partners. First, to stop the spread of infection (i.e., interrupt transmission) and reduce the circulating filarial antigen prevalence from as high as 74.4% to below the critical threshold of 1–2% prevalence, mass drug administration (MDA) using a two-drug regime was implemented at high coverage rates (>65%) of the total population, with supplementary interventions from other programmes (e.g., malaria vector control). The decline in prevalence was monitored and confirmed over time using several impact assessment and post-treatment surveillance tools including the standard sentinel site, spot check, and transmission assessment surveys and alternative integrated, hotspot, and easy-access group surveys. Second, to alleviate suffering of the affected populations (i.e., control morbidity) the morbidity management and disability prevention (MMDP) package of care was implemented. Specifically, clinical case estimates were obtained via house-to-house patient searching activities; health personnel and patients were trained in self-care protocols for lymphoedema and/or referrals to hospitals for hydrocoele surgery; and the readiness and quality of treatment and services were assessed with new survey tools. Conclusions Malawi’s elimination of LF will ensure that future generations are not infected and suffer from the disfiguring and disabling disease. However, it will be critical that the Malawi LF Elimination programme remains vigilant, focussing on post-elimination surveillance and MMDP implementation and integration into routine health systems to support long-term sustainability and ongoing success. Summary Lymphatic filariasis, also known as elephantiasis, is a disabling, disfiguring, and painful disease caused by a parasite that infected mosquitoes transmit to millions of people worldwide. Since 2000, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) has supported endemic countries such as Malawi in south-eastern Africa, to eliminate the disease as a public health problem. The Malawi National LF Elimination Programme has worked tirelessly over the past two decades to implement the GPELF recommended strategies to interrupt the transmission with a two-drug regime, and to alleviate suffering in patients with lymphoedema and/or hydrocoele through morbidity management and disability prevention. Additionally, the LF Programme has collaborated with national and international stakeholders to implement a range of supplementary operational research projects to address outstanding knowledge gaps and programmatic barriers. In 2020, the World Health Organisation validated that Malawi had successfully eliminated LF as a public health problem, making it the second country in sub-Saharan Africa to achieve this, which is remarkable given that Malawi previously had very high infection rates. The LF Programme now remains vigilant, putting its efforts towards post-elimination surveillance and the continued implementation of care for patients with chronic conditions. Malawi’s elimination of LF will ensure that future generations are not affected by this devastating disease.

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Section: Methods/principal Findings [Results]mentioning

confidence: 99%

Section: Methods/principal Findings [Results]mentioning

confidence: 99%

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Elimination of lymphatic filariasis as a public health problem in Malawi

Chiphwanya,

Mkwanda,

Kabuluzi

et al. 2024

PLoS Negl Trop Dis

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“…In Mozambique, lymphatic filariasis, schistosomiasis and soil-transmitted helminths are widely prevalent with various levels of co-endemicity requiring coordinated integrated MDA campaigns including the donated drugs ivermectin (for lymphatic filariasis), albendazole (for lymphatic filariasis and soil-transmitted helminths) and praziquantel (for schistosomiasis). Lymphatic filariasis is endemic in 114 (71%) districts, while schistosomiasis and soil-transmitted helminths endemicity extends to all 161 (100%) districts [ 4 , 8 ]. The endemicity status of onchocerciasis is still unknown in 135 (84%) districts while the rest are classified as non-endemic.…”

Section: Introductionmentioning

confidence: 99%

Impact of conflict on the elimination targets of lymphatic filariasis, schistosomiasis and soil-transmitted helminths in Cabo Delgado province, Mozambique

Badia-Rius,

Sitoe,

Lopes

et al. 2024

PLoS Negl Trop Dis

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Background Mozambique has one of the highest burdens of neglected tropical diseases in Africa. Lymphatic filariasis, schistosomiasis and soil-transmitted helminths are being targeted for elimination as part of integrated mass drug administration campaigns. The progress made towards interruption of transmission has been affected by recent conflict in Cabo Delgado province. The aim of this paper was to determine the potential impact of this crisis on the neglected tropical diseases programme and the challenges in reaching the elimination goals of 2030. Methodology A desk-based secondary data analysis was conducted on publicly available sources of neglected tropical diseases, conflict incidents, internally displaced persons and geographical access between 2020 and 2022. Data were summarised and mapped using GIS software. A combined risk stratified assessment at district level was developed with five classifications i) Very high-risk; ii) High-risk; iii) Medium to high-risk; iv) Medium risk; and v) Not at risk due to conflict absence but co-endemic. Results Lymphatic filariasis, schistosomiasis and soil-transmitted helminths were co-endemic in 115 out of 156 (74%) districts. Between 2020 and 2022 a total of 1,653 conflict-related incidents were reported, most of them in Cabo Delgado province (n = 1,397, 85%). A five-fold increase of internally displaced persons was recorded from April 2020 (n = 172,186) to November 2022 (n = 935,130). Geographical accessibility also deteriorated across the province with an increase from five (29%) in 2021 to seven (41%) districts in 2022 classified as hard-to-reach. The combined risk stratification identified that most districts (n = 7; 41%) in Cabo Delgado province had medium to high-risk; very high-risk (n = 5, 29%); medium risk (n = 3, 18%); high-risk (n = 2, 12%). Conclusion Most of the districts of Cabo Delgado were considered to be at risk of not meeting the neglected tropical diseases road map 2021–2030 targets due to the humanitarian crisis ongoing. There is the need for practical strategies and funding to overcome these hostile challenges.

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