Ongoing transmission of lymphatic filariasis in Samoa 4.5 years after one round of triple-drug mass drug administration
Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, tr...
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| Published in | PLoS neglected tropical diseases Vol. 18; no. 6; p. e0012236 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
01.06.2024
Public Library of Science (PLoS) |
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| Online Access | Get full text |
| ISSN | 1935-2735 1935-2727 1935-2735 |
| DOI | 10.1371/journal.pntd.0012236 |
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| Abstract | Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA.
In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf.
Ag-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections.
This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. |
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| AbstractList | Background
Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA.
Methodology
In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf.
Principal findings
Ag-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections.
Conclusions/Significance
This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. The World Health Organization (WHO) recommends triple-drug mass drug administration (MDA) for the elimination of lymphatic filariasis (LF) as a public health problem for countries where targets have not been achieved using two-drug MDA, and where onchocerciasis is non-endemic. In 2018, Samoa was the first country to implement a national triple-drug MDA. This study surveyed 623 randomly selected participants across eight primary sampling units (PSUs) in Samoa, 4.5 years after the first round of triple-drug MDA. These results support the current WHO recommendations that multiple rounds of triple-drug MDA are required to interrupt transmission. A gap of 4.5 years between rounds of triple-drug MDA can result in a resurgence, with persistence of LF transmission and burden levels comparable to those observed before the MDA. Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA. In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged [greater than or equal to] 5 years invited to participate. Blood samples were tested for Ag and Mf. This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA.BACKGROUNDLymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA.In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf.METHODOLOGYIn 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf.Ag-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections.PRINCIPAL FINDINGSAg-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections.This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies.CONCLUSIONS/SIGNIFICANCEThis study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. BackgroundLymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA.MethodologyIn 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf.Principal findingsAg-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections.Conclusions/significanceThis study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. Background Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA. Methodology In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged [greater than or equal to] 5 years invited to participate. Blood samples were tested for Ag and Mf. Principal findings Ag-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections. Conclusions/Significance This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. Lymphatic filariasis (LF) remains a significant global issue. To eliminate LF as a public health problem, the World Health Organization (WHO) recommends multiple rounds of mass drug administration (MDA). In certain scenarios, including when elimination targets have not been met with two-drug MDA, triple-drug MDA (using ivermectin, diethylcarbamazine and albendazole) is recommended. In this study, we report on antigen (Ag) and microfilaria (Mf) prevalence in eight primary sampling units (PSUs) in Samoa 4.5 years after one round of triple-drug MDA. In 2023, community surveys were conducted in eight PSUs that had been surveyed previously in 2018 (between 1.5 and 3.5 months post triple-drug MDA) and 2019 (six to eight-months post triple-drug MDA). Fifteen houses were randomly selected in each PSU with household members aged ≥ 5 years invited to participate. Blood samples were tested for Ag and Mf. Ag-positive participants were observed in six of the eight PSUs, and Ag prevalence was significantly above the 1% threshold in four PSUs. The presence of Mf-positive participants in five PSUs confirms the presence of residual active infections. This study provides evidence of persistent LF transmission in Samoa 4.5 years after one round of triple-drug MDA, confirming that one round was insufficient for interruption of transmission in this setting. Our findings highlight the negative impact of delaying MDA rounds, for example, due to public health emergencies. |
| Audience | Academic |
| Author | Martin, Beatris Mario Mayfield, Helen J. Howlett, Maddison Sheridan, Sarah Lau, Colleen L. Sartorius, Benn Thomsen, Robert Viali, Satupaitea Graves, Patricia M. Tofaeono-Pifeleti, Rossana |
| AuthorAffiliation | 5 Oceania University of Medicine Samoa, Apia, Samoa 6 College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Life Science Institute, ROMANIA 3 Samoa Ministry of Health, Apia, Samoa 2 School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia 1 University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia 4 School of Medicine, National University of Samoa, Apia, Samoa |
| AuthorAffiliation_xml | – name: 1 University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia – name: 3 Samoa Ministry of Health, Apia, Samoa – name: University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Life Science Institute, ROMANIA – name: 4 School of Medicine, National University of Samoa, Apia, Samoa – name: 5 Oceania University of Medicine Samoa, Apia, Samoa – name: 2 School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia – name: 6 College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia |
| Author_xml | – sequence: 1 givenname: Helen J. orcidid: 0000-0003-3462-4324 surname: Mayfield fullname: Mayfield, Helen J. – sequence: 2 givenname: Benn surname: Sartorius fullname: Sartorius, Benn – sequence: 3 givenname: Sarah surname: Sheridan fullname: Sheridan, Sarah – sequence: 4 givenname: Maddison surname: Howlett fullname: Howlett, Maddison – sequence: 5 givenname: Beatris Mario surname: Martin fullname: Martin, Beatris Mario – sequence: 6 givenname: Robert surname: Thomsen fullname: Thomsen, Robert – sequence: 7 givenname: Rossana surname: Tofaeono-Pifeleti fullname: Tofaeono-Pifeleti, Rossana – sequence: 8 givenname: Satupaitea surname: Viali fullname: Viali, Satupaitea – sequence: 9 givenname: Patricia M. surname: Graves fullname: Graves, Patricia M. – sequence: 10 givenname: Colleen L. surname: Lau fullname: Lau, Colleen L. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38935622$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_pathogens13121088 crossref_primary_10_1371_journal_pone_0313957 crossref_primary_10_1016_j_ijid_2025_107891 crossref_primary_10_1016_j_ijid_2025_107809 |
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| Copyright | Copyright: © 2024 Mayfield et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. COPYRIGHT 2024 Public Library of Science 2024 Mayfield et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2024 Mayfield et al 2024 Mayfield et al 2024 Mayfield et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| References_xml | – volume: 95 start-page: 361 issue: 4 year: 2001 ident: pntd.0012236.ref028 article-title: Annual single-dose diethylcarbamazine plus ivermectin for control of bancroftian filariasis: comparative efficacy with and without vector control publication-title: Ann Trop Med Parasitol doi: 10.1080/00034983.2001.11813649 – volume: 12 issue: 12 year: 2023 ident: pntd.0012236.ref030 article-title: Mosquitoes, Lymphatic Filariasis, and Public Health: A Systematic Review of Anopheles and Aedes Surveillance Strategies. publication-title: Pathogens doi: 10.3390/pathogens12121406 – year: 2016 ident: pntd.0012236.ref026 publication-title: Census projection Apia – volume: 17 start-page: 451 issue: 4 year: 2017 ident: pntd.0012236.ref016 article-title: Effectiveness of a triple-drug regimen for global elimination of lymphatic filariasis: a modelling study publication-title: The Lancet Infectious Diseases doi: 10.1016/S1473-3099(16)30467-4 – volume: 14 start-page: e0008927 issue: 12 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