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Elimination of lymphatic filariasis in the Gambia.

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Rebollo, Maria, Sambou, Sana Malang, Thomas, Brent ORCID: https://orcid.org/0000-0003-1118-5429, Biritwum, Nana-Kwadwo, Jaye, Momodou C, Kelly-Hope, Louise ORCID: https://orcid.org/0000-0002-3330-7629, Escalada, Alba Gonzalez, Molyneux, David ORCID: https://orcid.org/0000-0001-8537-7947 and Bockarie, Moses (2015) 'Elimination of lymphatic filariasis in the Gambia.'. PLoS Neglected Tropical Diseases, Vol 9, Issue 3, e0003642.

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Abstract

BACKGROUND

The prevalence of Wuchereria bancrofti, which causes lymphatic filariasis (LF) in The Gambia was among the highest in Africa in the 1950s. However, surveys conducted in 1975 and 1976 revealed a dramatic decline in LF endemicity in the absence of mass drug administration (MDA). The decline in prevalence was partly attributed to a significant reduction in mosquito density through the widespread use of insecticidal nets. Based on findings elsewhere that vector control alone can interrupt LF, we asked the question in 2013 whether the rapid scale up in the use of insecticidal nets in The Gambia had interrupted LF transmission.

METHODOLOGY/PRINCIPAL FINDING

We present here the results of three independently designed filariasis surveys conducted over a period of 17 years (1997-2013), and involving over 6000 subjects in 21 districts across all administrative divisions in The Gambia. An immunochromatographic (ICT) test was used to detect W. bancrofti antigen during all three surveys. In 2001, tests performed on stored samples collected between 1997 and 2000, in three divisions, failed to show positive individuals from two divisions that were previously highly endemic for LF, suggesting a decline towards extinction in some areas. Results of the second survey conducted in 2003 showed that LF was no longer endemic in 16 of 21 districts surveyed. The 2013 survey used a WHO recommended LF transmission verification tool involving 3180 6-7 year-olds attending 60 schools across the country. We demonstrated that transmission of W. bancrofti has been interrupted in all 21 districts.

CONCLUSIONS

We conclude that LF transmission may have been interrupted in The Gambia through the extensive use of insecticidal nets for malaria control for decades. The growing evidence for the impact of malaria vector control activities on parasite transmission has been endorsed by WHO through a position statement in 2011 on integrated vector management to control malaria and LF.

Item Type: Article
Subjects: QX Parasitology > Helminths. Annelida > QX 301 Filarioidea
QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0003642
Depositing User: Mary Creegan
Date Deposited: 17 Dec 2015 11:33
Last Modified: 31 May 2018 12:46
URI: http://archive.lstmed.ac.uk/id/eprint/5446

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