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Persistent 'hotspots' of lymphatic filariasis microfilaraemia despite 14 years of mass drug administration in Ghana.

Biritwum, Nana-Kwadwo, Yikpotey, Paul, Marfo, Benjamin K, Odoom, Samuel, Mensah, Ernest O, Asiedu, Odame, Alomatu, Bright, Hervie, Edward T, Yeboah, Abednego, Ade, Serge, Hinderaker, Sven G, Reid, Anthony, Takarinda, Kudakwashe C, Koudou, Benjamin and Koroma, Joseph B (2017) 'Persistent 'hotspots' of lymphatic filariasis microfilaraemia despite 14 years of mass drug administration in Ghana.'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 110, Issue 12, pp. 690-695.

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Abstract

Among the 216 districts in Ghana, 98 were declared endemic for lymphatic filariasis in 1999 after mapping. Pursuing the goal of elimination, WHO recommends annual treatment using mass drugs administration (MDA) for at least 5 years. MDA was started in the country in 2001 and reached national coverage in 2006. By 2014, 69 districts had 'stopped-MDA' (after passing the transmission assessment survey) while 29 others remained with persistent microfilaraemia (mf) prevalence (≥1%) despite more than 11 years of MDA and were classified as 'hotspots'. An ecological study was carried out to compare baseline mf prevalence and anti-microfilaria interventions between hotspot and stopped-MDA districts. Baseline mf prevalence was significantly higher in hotspots than stopped-MDA districts (p<0.001). After three years of MDA, there was a significant decrease in mf prevalence in hotspot districts, but it was still higher than in stopped-MDA districts. The number of MDA rounds was slightly higher in hotspot districts (p<0.001), but there were no differences in coverage of MDA or long-lasting-insecticide-treated nets. The main difference in hotspots and stopped-MDA districts was a high baseline mf prevalence. This finding indicates that the recommended 5-6 rounds annual treatment may not achieve interruption of transmission.

Item Type: Article
Uncontrolled Keywords: Ghana, Hotspots, Lymphatic filariasis, MDA, Mass drug administration
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WB Practice of Medicine > Therapeutics > WB 340 Drug Administration
WC Communicable Diseases > WC 20 Research (General)
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/10.1093/trstmh/trx007
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 23 Oct 2017 15:47
Last Modified: 27 Sep 2018 10:36
URI: http://archive.lstmed.ac.uk/id/eprint/7665

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