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

Molyneux, David, Hopkins, Adrian, Bradley, Mark H and Kelly-Hope, Louise (2014) 'Multidimensional complexities of filariasis control in an era of large-scale mass drug administration programmes: a can of worms'. Parasites & Vectors, Vol 7, e363.

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Abstract

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.

Item Type: Article
Additional Information: The electronic version of this article is the complete one and can be found online at: http://www.parasitesandvectors.com/content/7/1/363
Subjects: QX Parasitology > Helminths. Annelida > QX 200 Helminths
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 885 Onchocerciasis
Faculty: Department: Biological Sciences > Parasitology Department
Digital Object Identifer (DOI): https://doi.org/10.1186/1756-3305-7-363
Depositing User: Lynn Roberts-Maloney
Date Deposited: 09 Jan 2015 15:20
Last Modified: 06 Feb 2018 13:08
URI: http://archive.lstmed.ac.uk/id/eprint/4719

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