Lymphatic filariasis


Global Programme to Eliminate Lymphatic Filariasis

In 1997, as a result of advances in the diagnosis and treatment of lymphatic filariasis (LF), the disease was classed as one of six infectious diseases considered to be “eradicable” or “potentially eradicable”. Consequently, the World Health Assembly adopted resolution 50.29, calling for elimination of the disease as a global public health problem.

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. Following this, during the course of 1999 and 2000, the World Health Organization (WHO) launched the Global Programme to Eliminate Lymphatic Filariasis (GPELF).

Elimination strategy

The strategy proposed by WHO to achieve the goal of elimination comprises two components:

  • interruption of transmission of filarial infection in all endemic countries through drastic reduction of microfilariae prevalence levels;
  • prevention and alleviation of disability and suffering in individuals already affected by LF.

Interruption of transmission of infection can only be achieved if the entire population at risk is covered by mass drug administration (MDA) for a period long enough to ensure a reduction in the level of microfilariae in the blood to a point where transmission can no longer be sustained. The following recommended drug regimens must 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 diethylcarbamazine citrate (DEC) + 400 mg albendazole; or
  • 150 µg/kg ivermectin + 400 mg albendazole (in the case of co-endemicity with onchocerciasis).
  • A third option is to follow a treatment regimen using DEC-fortified cooking salt daily for a period of 12 months.

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