The Impact of a Filariasis Control Program on Lihir Island, Papua New Guinea | Zendy

Natàlia Casamitjana | Zendy; Raymond Paru | Zendy; Ron D. Hays | Zendy; Lysaght Griffin | Zendy; Nedley Laban | Zendy; Mellie Samson | Zendy; Quique Bassat | Zendy

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The Impact of a Filariasis Control Program on Lihir Island, Papua New Guinea

Author(s) -

Natàlia Casamitjana,

Raymond Paru,

Ron D. Hays,

Lysaght Griffin,

Nedley Laban,

Mellie Samson,

Quique Bassat

Publication year - 2011

Publication title -

plos neglected tropical diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.99

H-Index - 135

eISSN - 1935-2735

pISSN - 1935-2727

DOI - 10.1371/journal.pntd.0001286

Subject(s) - lymphatic filariasis , mass drug administration , new guinea , vector (molecular biology) , filariasis , transmission (telecommunications) , environmental health , multivariate analysis , medicine , epidemiology , baseline (sea) , wuchereria bancrofti , demography , multivariate statistics , geography , biology , immunology , helminths , population , statistics , history , recombinant dna , sociology , engineering , biochemistry , ethnology , electrical engineering , gene , mathematics , fishery

Background Annual mass drug administration (MDA) over five years is the WHO's recommended strategy to eliminate lymphatic filariasis (LF). Some experts, however, consider that longer periods of treatment might be necessary in certain high prevalence and transmission environments based upon past unsuccessful field experience and modelling. Methodology/Principal Findings To evaluate predictors of success in a LF control program we conducted an ecological study during a pre-existing MDA program. We studied 27 villages in Lihir Island, Papua New Guinea, from two areas with different infection rates before MDA. We undertook surveys to collect information on variables potentially having an influence on the outcome of the program, including epidemiological (baseline prevalence of infection, immigration rate), entomological (vector density) and operational (treatment coverage, vector control strategies) variables. The success in a village was defined using variables related to the infection (circulating filarial antigenemia prevalence <1%) and transmission (antigenemia prevalence <1 in 1000 children born since start of MDA). 8709 people were involved in the MDA program and average coverage rates were around 70%. The overall prevalence of filariasis fell from an initial 17.91% to 3.76% at round 5 (p<0.001). Viewed on a village by village basis, 12/27 (44%) villages achieved success. In multivariate analysis, low baseline prevalence was the only factor predicting both success in reducing infection rates (OR 19,26; CI 95% 1,12 to 331,82) and success in preventing new infections (OR 27,44; CI 95% 1,05 to 719,6). Low vector density and the use of an optimal vector control strategy were also associated with success in reducing infection rates, but this did not reach statistical significance. Conclusions/Significance Our results provide the data that supports the recommendation that high endemic areas may require longer duration MDA programs, or alternative control strategies.

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