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Surveillance efforts after mass drug administration to validate elimination of lymphatic filariasis as a public health problem in Vanuatu.

Taleo, Fasihah, Taleo, George, Graves, Patricia M, Wood, Peter, Kim, Sung Hye, Ozaki, Masayo, Joseph, Hayley, Chu, Brian, Pavluck, Alex, Yajima, Aya, Melrose, Wayne, Ichimori, Kazuyo and Capuano, Corinne (2017) 'Surveillance efforts after mass drug administration to validate elimination of lymphatic filariasis as a public health problem in Vanuatu.'. Tropical medicine and health, Vol 45, p. 18.

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Abstract

Background
Vanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes. After a baseline survey showing 4.8% antigen prevalence in 1998, the country conducted nationwide (in one implementation unit) annual mass drug administration (MDA) with albendazole and diethylcarbamazine citrate from 2000 to 2004 and achieved prevalence of 0.2% by 2006 in a representative nationwide cluster survey among all age groups.

Methods
Post MDA surveillance was conducted from 2006 to 2012. After MDA, the country was divided for surveillance into three evaluation units (EUs) formed by grouping provinces according to baseline prevalence: EU1: Torba, Sanma and Malampa; EU2: Penama; EU3: Shefa and Tafea. The study compiled all past data and information on surveys in Vanuatu from the country programme. This paper reviews the surveillance activities done after stopping MDA to validate the interruption of transmission and elimination of LF as a public health problem.

Results
Post-MDA surveillance consisting of at least three transmission assessment surveys (TAS) in each of the three EUs was conducted between 2006 and 2012. Sentinel and spot check surveys identified a few villages with persistent high prevalence; all antigen positive cases in these sites were treated and additional targeted MDA conducted for 3 years in 13 villages in one area of concern. All three EUs passed all TAS in 2007, 2010 and 2012 respectively, with no positives found except in EU2 (Penama province) in 2012 when 2 children tested positive for circulating filariasis antigen. Assessment of the burden of chronic filariasis morbidity found 95 cases in 2003 and 32 remaining cases in 2007, all aged over 60 years.

Conclusions
Vanuatu has achieved validation of elimination of LF as a public health problem. Post-validation surveillance is still recommended especially in formerly highly endemic areas.

Item Type: Article
Subjects: QV Pharmacology > QV 38 Drug action.
WA Public Health > WA 100 General works
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WB Practice of Medicine > Therapeutics > WB 340 Drug Administration
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s41182-017-0057-6
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 04 Jul 2017 10:17
Last Modified: 06 Feb 2018 13:15
URI: http://archive.lstmed.ac.uk/id/eprint/7327

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