A practical strategy for responding to a case of lymphatic filariasis post-elimination in Pacific Islands

Particle and Fibre Toxicology

Rick Speare²  David MacLaren³  Wayne Melrose²  Hayley Joseph²  Richard Bradbury¹  Elmer Ribeyro⁴  John Gwalaa⁴  Christopher Jimuru⁴  James Asugeni⁴  Humpress Harrington⁴ 

[1] Medical Research Council International Nutrition Group, MRC, Keneba, The Gambia;WHO Collaborating Centre for the Control of Lymphatic Filariasis and Soil Transmitted Helminths, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia;School of Medicine and Dentistry, James Cook University, Cairns, Australia;Atoifi Adventist Hospital, Malaita, Solomon Islands

关键词: Research capacity building;    Surveillance response;    Wuchereria bancrofti;    Atoifi;    Solomon Islands;    Elimination;    Lymphatic filariasis;   

Others  :  1225303
DOI  :  10.1186/1756-3305-6-218

 received in 2013-03-27, accepted in 2013-05-17,  发布年份 2013

【 摘 要 】

Background

Lymphatic filariasis (LF) due to Wuchereria bancrofti is being eliminated from Oceania under the Pacific Elimination of Lymphatic Filariasis Programme. LF was endemic in Solomon Islands but in the 2010-2020 Strategic Plan of the Global Programme to Eliminate LF, Solomon Islands was listed as non-endemic for LF. In countries now declared free of LF an important question is what monitoring strategy should be used to detect any residual foci of LF?

This paper describes how a new case of elephantiasis in a post-elimination setting may be used as a trigger to initiate a local survey for LF.

Methods

The index case, a 44 year old male, presented to Atoifi Adventist Hospital, Malaita, Solomon Islands in April 2011 with elephantiasis of the lower leg. Persistent swelling had commenced 16 months previously. He was negative for antigen by TropBio Og4C3 ELISA and for microfilaria. A week later a survey of 197 people aged from 1 year to 68 years was conducted at Alasi, the index case’s village, by a research team from Atoifi Adventist Hospital and Atoifi College of Nursing. This represented 66.3% of the village population. Blood was collected between 22:00 and 03:00 by finger-prick and made into thick smears to detect microfilaria and collected onto filter paper for W. bancrofti antigen tests. A second group of 110 specimens was similarly collected from residents of the Hospital campus and inpatients. W. bancrofti antigen was tested for using the Trop-Bio Og4C3 test.

Results

One sample (1/307) from an 18 year old male from Alsai was positive for W. bancrofti antigen. No samples were positive for microfilaria. Although antigen-positivity indicated a live worm, the case was regarded as having been acquired some years previously.

Conclusions

We propose that when LF has been eliminated from a country, a case of elephantiasis should be a trigger to conduct a survey of the case’s community using a decision pathway. W. bancrofti antigen should be tested for with screening for microfilariae in antigen positive cases. The field survey was designed and conducted by local researchers, highlighting the value of local research capacity in remote areas.

【 授权许可】

   
2013 Harrington et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Ottesen EA: The global programme to eliminate lymphatic filariasis. Trop Med Int Health 2000, 5:591-594.
• [2]Burkot T, Ichimori K: The PacELF programme: will mass drug administration be enough? Trends Parasitol 2002, 18(3):109-115.
• [3]Durrheim DN, Nelesone T, Speare R, Melrose W: Certifying lymphatic filariasis elimination in the Pacific - the need for new tools. Pac Health Dialog 2003, 10(2):149-154.
• [4]Ichimori K, Crump A: Pacific collaboration to eliminate lymphatic filariasis. Trends Parasitol 2005, 21(10):441-444.
• [5]World Health Organization: Global Programme to Eliminate Lymphatic Filariasis: Progress Report 2000-2009 and Strategic Plan 2010-2020. Geneva: WHO; 2010.
• [6]Joseph H, Moloney J, Maiava F, McClintock S, Lammie P, Melrose W: First evidence of spatial clustering of lymphatic filariasis in an Aedes polynesiensis endemic area. Acta Trop 2011, 120(Suppl 1):S39-47.
• [7]Joseph H, Maiava F, Naseri T, Silva U, Lammie P, Melrose W: Epidemiological assessment of continuing transmission of lymphatic filariasis in Samoa. Ann Trop Med Parasitol 2011, 105(8):567-578.
• [8]World Health Organization: Report of the Ninth Workshop for Pacific Lymphatic Filariasis Programme Managers. Fiji: WHO; 2007.
• [9]Webber RH, Southgate BA: The maximum density of anopheline mosquitoes that can be permitted in the absence of continuing transmission of filariasis. Tran R Soc Trop Med Hyg 1981, 75(4):499-506.
• [10]Webber R: Eradication of Wuchereria bancrofti through vector control. Trans R Soc Trop Med Hyg 1979, 76:722-724.
• [11]Webber RH: The natural decline of Wuchereria bancrofti infection in a vector control situation in the Solomon Islands. Trans R Soc Trop Med Hyg 1977, 71(5):396-400.
• [12]World Health Organization: Global Programme to Eliminate Lymphatic Filariasis: annual report on lymphatic filariasis 2003. Geneva: WHO; 2005.
• [13]Anonymous: Global Programme to Eliminate Lymphatic Filariasis: progress report on mass drug administration, 2010. WER 2011, 86:377-388.
• [14]World Health Organization: Lymphatic filariasis: A manual for national elimination programmes. Geneva: WHO; 2011.
• [15]Dreyer G, Addiss D, Dreyer P, Noroes J: Basic Lymphoedema Management: Treatment and Prevetion of Problems Associated with Lymphatic Filariasis. New Hampshire: Hollis Publishing; 2002.
• [16]Schlosser RJ: Observations on the incidence of Wuchereria bancrofti larvae in the native population of the Solomon Islands area. Amer J Trop Med Hyg 1945, 25:493-495.
• [17]Redman-MacLaren ML, MacLaren DJ, Humpress H, Asugeni R, Timothy-Harrington R, Kekeubata K, Speare R: Mutual research capacity strengthening: a qualitative study of two-way partnerships in public health research in Solomon Islands. Int J Equity Health 2012, 11:79. BioMed Central Full Text
• [18]Massey P, Massey PD, Wakageni J, Kekeubata E, Maena’adi J, Laete’esafi J, Waneagea J, Fangaria G, Jimuru C, Houaimane M, Talana J, MacLaren D, Speare R: TB questions, East Kwaio answers: community-based participatory research in a remote area of Solomon Islands. Rural Remote Health 2012, 12:2139.
• [19]Hoti SL, Elango A, Radjame K, Yuvaraj J, Pani SP: Detection of day blood filarial antigens by Og4C3 ELISA test using filter paper samples. Nat Med J India 2002, 15(5):263-266.
• [20]El-Moamly AA, El-Sweify MA, Hafez MA: Using the AD12-ICT rapid-format test to detect Wuchereria bancrofti circulating antigens in comparison to Og4C3-ELISA and nucleopore membrane filtration and microscopy techniques. Parasitol Res 2012, 111:1379-1383.
• [21]Gass K, de Rochars MV B, Boakye D, Bradley M, Fischer PU, Gyapong J, Itoh M, Ituaso-Conway N, Joseph H, Kyelem D, Laney SJ, Legrand AM, Liyanage TS, Melrose W, Mohammed K, Pilotte N, Ottesen EA, Plichart C, Ramaiah K, Rao RU, Talbot J, Weil GJ, Williams SA, Won KY, Lammie P: A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis. PLoS Negl Trop Dis 2012, 6(1):e1479-1484.