Multidimensional complexities of filariasis control in an era of large-scale mass drug administration programmes: a can of worms

Particle and Fibre Toxicology

Louise A Kelly-Hope¹  Mark H Bradley³  Adrian Hopkins²  David H Molyneux¹ 

[1] Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK;Mectizan Donation Program, Task Force for Global Health, Decatur, Atlanta, GA, USA;GlaxoSmithKline, Global Health Programme, Brentford, UK

关键词: Bed nets;    Ivermectin;    Albendazole;    Mass drug administration;    Malaria;    STHs;    Soil transmitted helminths;    Loiasis;    Loa loa;    LF;    Lymphatic filariasis;    Onchocerciasis;   

Others  :  1181873
DOI  :  10.1186/1756-3305-7-363

 received in 2014-07-11, accepted in 2014-07-30,  发布年份 2014

【 摘 要 】

The impact of control and elimination programmes by mass drug administration (MDA) targeting onchocerciasis and lymphatic filariasis (LF) in sub-Saharan Africa over the last two decades has resulted in significantly reduced prevalence and intensity of infection, with some areas interrupting transmission. However, given that these infections are often co-endemic and the drugs (either ivermectin alone or combined with albendazole) also impact on soil transmitted helminths (STH), the importance of this, in terms of reaching the global goals has not been assessed. The additional problem posed by Loa loa, where ivermectin cannot be safely administered due to the risk of serious adverse events compounds this situation and has left populations drug naïve and an alternative strategy to eliminate LF is yet to be initiated at scale. Here, we present a series of operational research questions, which must be addressed if the effectiveness of integrated control of filarial and helminth infections is to be understood for the endgame. This is particularly important in the diverse and dynamic epidemiological landscape, which has emerged as a result of the long-term large-scale mass drug administration (or not). There is a need for a more holistic approach to address these questions. Different programmes should examine this increased complexity, given that MDA has multiple impacts, drugs are given over different periods, and programmes have different individual targets.

【 授权许可】

   
2014 Molyneux et al.; licensee BioMed Central Ltd.

【 图 表 】

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