Lymphatic filariasis

Programme

The Global Programme to Eliminate Lymphatic Filariasis

© Eric Lafforgue


In 1997, following advances in diagnosis and treatment of the disease, WHO classified lymphatic filariasis, along with five other infectious diseases, as eradicable or potentially eradicable. The same year, the World Health Assembly adopted Resolution WHA 50.29, which called on Member States to initiate steps to eliminate lymphatic filariasis as a public health problem. In response to this call, WHO launched the Global Programme to Eliminate Lymphatic Filariasis in 2000.

Two pharmaceutical companies — GlaxoSmithKline (then known as SmithKline Beecham) and Merck & Co. Inc. — made a pledge to donate the much-needed drugs for as long as it would take to eliminate the disease.

The elimination strategy has two components: (i) to stop the spread of infection (interrupting transmission); and (ii) to alleviate the suffering of affected populations (controlling morbidity).

In order to interrupt transmission, districts in which lymphatic filariasis is endemic must be mapped and community-wide mass treatment programmes implemented to treat the entire at-risk population. Most of these programmes are based on once-yearly administration of single doses of two drugs given together. The following recommended drug regimens need to be administered once a year for at least 5 years, with a coverage of at least 65% of the total at-risk population:

  • 6 mg/kg of body weight diethylcarbamazine citrate (DEC) + 400 mg albendazole; or
  • 150 µg/kg of body weight ivermectin + 400 mg albendazole (in areas that are also endemic for onchocerciasis).

An alternative and equally effective community-wide regimen in endemic regions is the use of common table salt or cooking salt fortified with DEC for a period of one year.

The suffering caused by the disease can be alleviated through community education programmes to raise awareness among patients. These programmes promote the benefits of intensive local hygiene practices as well as the prevention of debilitating and painful episodes of inflammation.

Progress


China and the Republic of Korea were declared to have eliminated lymphatic filariasis as a public health problem in 2007 and 2008, respectively. Of 72 countries listed by WHO as being endemic for lymphatic filariasis, 68 countries have completed mapping their endemic foci, 11 countries have made progress and 2 have yet to start the process.

LF in the news

19 December 2013 | Geneva
Training in monitoring and epidemiological assessment of mass drug administration for eliminating lymphatic filariasis.

19 September 2013 | Geneva
New strategies, diagnostic tools and treatment regimens for lymphatic filariasis (LF) have dramatically changed prospects of LF control over the past 20 years. Just published is a new handbook for national programme managers, entomologists and parasitologists.


02 July 2013 | Geneva
Lymphatic filariasis: managing morbidity and preventing disability. An aide-mémoire for national programme managers


PCT Databank (LF)

Public Health Mapping and GIS