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TropicalMed
Special Issues
Elimination of Lymphatic Filariasis: Endgame Prospects, Challenges and Complexities
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Elimination of Lymphatic Filariasis: Endgame Prospects, Challenges and Complexities

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Neglected and Emerging Tropical Diseases".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 13416

Special Issue Editors

Prof. Dr. Edwin Michael

E-Mail Website
Guest Editor
Center for Global Health Infectious Disease Research, University of South Florida, Tampa, FL 33612, USA
Interests: epidemiology; population biology; neglected tropical diseases; vector ecology; mathematical modelling; computational science; complex adaptive systems; social epidemiology; integrated disease management
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. James W. Kazura

E-Mail Website
Guest Editor
Center for Global Health & Diseases, Case Western Reserve University, Cleveland, OH 44106, USA
Interests: epidemiology; clinical medicine, parasite immunology, population biology; neglected tropical diseases; vector ecology; mathematical modeling; computational science; complex adaptive systems; social epidemiology; community disease management

Special Issue Information

Dear Colleagues,

Lymphatic filariasis (LF) represents the first major neglected tropical macroparasitic disease chosen by the WHO for either elimination or eradication as a public health problem globally. Since its inception in 2000, the launch of the Global Program to Eliminate LF (GPELF), which espoused meeting the goal of eliminating this disease in all 73 endemic countries initially by 2020 through the application of annual mass drug administration (MDA) maintained over at least 4–6 years primarily, has led to major strides in reducing infection prevalences in virtually all endemic countries. This striking success has meant that many national LF programs are now beginning to enter the endgame phase of intervention, leading to increasing focus on how best to define and implement intervention stopping decisions and maintain transmission control or interruption over the longer term.

This Special Issue is dedicated to exploring and discussing the latest research on the ecological, programmatic, and surveillance complexities and challenges that arise during the endgame and beyond for achieving the elimination of this parasitic disease. Topics may include accelerating the interruption of transmission using emerging advances in chemotherapy, vector control, novel innovations in effective program delivery in difficult-to-control settings, including the use of social enterprises and community participatory approaches, modeling work that highlights the impact of spatial transmission heterogeneity and its impact as control/elimination nears and identification of best methods to maintain long-term transmission interruption, development of surveillance sampling, diagnostic tools, and methods for evaluating and supporting area-wide eliminination decisions, immunological and clinical studies of host responses and impact on morbidity outcomes under conditions of interventions, molecular approaches to investigating parasite and vector popution change and for drug discovery, the role and effects of multiparasitism, epdemiological studies of multisectoral and integrated approaches at the subnational, national, and regional levels, and social epidemiological investigations for designing and governing long-term sustainable control.

Prof. Dr. Edwin Michael
Prof. Dr. James W. Kazura
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Lymphatic filariasis
  • Eradication epidemiology
  • Surveillance systems
  • Area-wide eradication
  • Spatial epidemiology
  • Filarial immunology
  • Filarial morbidity
  • Population modeling
  • Parasite diagnostics
  • Vector ecology
  • Integrated control
  • Co-infection
  • Social science studies
  • Community participation
  • Innovative health delivery
  • Sustainable control

Published Papers (3 papers)

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Research

14 pages, 2963 KiB  
Article
Bayesian Network Analysis of Lymphatic Filariasis Serology from Myanmar Shows Benefit of Adding Antibody Testing to Post-MDA Surveillance
by Benjamin F. R. Dickson, Jesse J. R. Masson, Helen J. Mayfield, Khin Saw Aye, Kyi May Htwe, Maureen Roineau, Athena Andreosso, Stephanie Ryan, Luke Becker, Janet Douglass and Patricia M. Graves
Trop. Med. Infect. Dis. 2022, 7(7), 113; https://doi.org/10.3390/tropicalmed7070113 - 21 Jun 2022
Cited by 3 | Viewed by 2242
Abstract
The elimination of lymphatic filariasis (LF) is achieved through repeated mass drug administration (MDA) of anti-filarial medications, which interrupts transmission and prevents new infections. Accurate transmission assessments are critical to deciding when to stop MDA. Current methods for evaluating transmission may be insufficiently [...] Read more.
The elimination of lymphatic filariasis (LF) is achieved through repeated mass drug administration (MDA) of anti-filarial medications, which interrupts transmission and prevents new infections. Accurate transmission assessments are critical to deciding when to stop MDA. Current methods for evaluating transmission may be insufficiently sensitive, resulting in post-MDA resurgence. We, therefore, evaluated potential diagnostic testing scenarios for post-MDA surveillance. Data were used from two surveys (a household cluster and a cohort) conducted in an area of Mandalay Region, Myanmar, with ongoing transmission following several rounds of MDA. First, age- and sex-adjusted seroprevalence were estimated for the area using the household survey. Next, three Bayesian networks were built from the combined datasets to compare antigens by immunochromatic testing (ICT) and/or Og4C3 enzyme-linked immunosorbent assay (ELISA) and antibody (Ab) detection methods (Wb123 or Bm14 Ab ELISA). The networks were checked for validity and then used to compare diagnostic testing scenarios. The adjusted prevalence from the household survey for antigen, Wb123 Ab and Bm14 Ab were 4.4% (95% CI 2.6–7.3%), 8.7% (5.96–12.5%) and 20.8% (16.0–26.6%), respectively. For the three networks, the True Skill Statistic and Area Under the Receiver Operating Characteristic Curve for antigen, Wb123 and Bm14 Ab were 0.79, 0.68 and 0.55; and 0.97, 0.92 and 0.80, respectively. In the Bayesian network analysis, a positive case was defined as testing positive to one or more infection markers. A missed result was therefore the probability of a positive case having a negative test result to an alternate marker. The probability of a positive case prior to any testing scenario was 17.4%, 16.8% and 26.6% for antigen, Wb123 Ab and Bm14 Ab, respectively. In the antigen-only testing scenario, the probability of a missed positive LF result was 5.2% for Wb123 and 15.6% for Bm14 Ab. The combination of antigen plus Bm14 Ab testing reduced the probability of missing a positive LF case as measured by Wb123 Ab to 0.88%. The combination of antigen plus Wb123 Ab was less successful and yielded an 11.5% probability of a missed positive result by Bm14 Ab testing. Across scenarios, there was a greater discordance between Bm14 and both antigen and Wb123 Ab in the 1–10 age group compared to older ages. These findings suggest that the addition of Bm14 Ab improves the sensitivity of LF testing for current or past infection. The combination of antigen plus Bm14 Ab should therefore be considered for inclusion in post-MDA surveillance to improve the sensitivity of transmission surveys and prevent the premature cessation of MDA. Full article
(This article belongs to the Special Issue Elimination of Lymphatic Filariasis: Endgame Prospects, Challenges and Complexities)
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8 pages, 226 KiB  
Article
Comparison of Immunochromatographic Test (ICT) and Filariasis Test Strip (FTS) for Detecting Lymphatic Filariasis Antigen in American Samoa, 2016
by Meru Sheel, Colleen L. Lau, Sarah Sheridan, Saipale Fuimaono and Patricia M. Graves
Trop. Med. Infect. Dis. 2021, 6(3), 132; https://doi.org/10.3390/tropicalmed6030132 - 14 Jul 2021
Cited by 3 | Viewed by 4967
Abstract
Circulating filarial antigen (Ag) prevalence, measured using rapid point-of-care tests, is the standard indicator used for monitoring and surveillance in the Global Program to Eliminate Lymphatic Filariasis. In 2015, the immunochromatographic test (ICT) was replaced with the filariasis test strip (FTS), which has [...] Read more.
Circulating filarial antigen (Ag) prevalence, measured using rapid point-of-care tests, is the standard indicator used for monitoring and surveillance in the Global Program to Eliminate Lymphatic Filariasis. In 2015, the immunochromatographic test (ICT) was replaced with the filariasis test strip (FTS), which has higher reported sensitivity. Despite differences in sensitivity, no changes in recommended surveillance targets were made when the FTS was introduced. In 2016, we conducted lymphatic filariasis surveys in American Samoa using FTS, which found higher Ag prevalence than previous surveys that used ICT. To determine whether the increase was real, we assessed the concordance between FTS and ICT results by paired testing of heparinised blood from 179 individuals (63% FTS-positive). ICT had 93.8% sensitivity and 100% specificity for identifying FTS-positive persons, and sensitivity was not associated with age, gender, or presence of microfilariae. Based on these findings, if ICT had been used in the 2016 surveys, the results and interpretation would have been similar to those reported using FTS. American Samoa would have failed Transmission Assessment Survey (TAS) of Grade 1 and 2 children with either test, and community prevalence would not have been significantly different (4.1%, 95% CI, 3.3–4.9% with FTS vs. predicted 3.8%, 95%, CI: 3.1–4.6% with ICT). Full article
(This article belongs to the Special Issue Elimination of Lymphatic Filariasis: Endgame Prospects, Challenges and Complexities)
14 pages, 20144 KiB  
Article
Triple-Drug Treatment Is Effective for Lymphatic Filariasis Microfilaria Clearance in Samoa
by Patricia M. Graves, Sarah Sheridan, Jessica Scott, Filipina Amosa-Lei Sam, Take Naseri, Robert Thomsen, Christopher L. King and Colleen L. Lau
Trop. Med. Infect. Dis. 2021, 6(2), 44; https://doi.org/10.3390/tropicalmed6020044 - 01 Apr 2021
Cited by 2 | Viewed by 4161
Abstract
Following the first triple-drug mass drug administration (MDA) for lymphatic filariasis in Samoa in 2018, unexpected persistence of microfilaria (Mf) positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1–2 months later. Of the 18 Mf positive [...] Read more.
Following the first triple-drug mass drug administration (MDA) for lymphatic filariasis in Samoa in 2018, unexpected persistence of microfilaria (Mf) positivity in 18 (15%) of 121 antigen-positive persons was observed in a nationwide household survey 1–2 months later. Of the 18 Mf positive persons, 14 reported taking the MDA, raising concerns about MDA efficacy. In 2019, 5–6 months after the 2018 survey, a monitored treatment study was done to evaluate directly observed weight-based treatment in these Mf positive individuals. Mf presence and density were assessed before and 7 days after treatment, using 1 mL membrane filtered venous blood, and 60 uL thick blood films on slides prepared from venous or fingerprick blood. All 14 participants were still Mf positive on filters from venous blood pre-treatment samples, but two were negative by slide made from the same samples. Mf were cleared completely by day 7 in 12 of 13 participants followed up, and by day 30 in the remaining participant. Filtered blood using EDTA samples (to reduce clumping of Mf) is preferred over slides alone for improving the likelihood of detecting Mf and estimating their density. The triple-drug MDA strategy was effective at clearing Mf when given and taken at the correct dose. Full article
(This article belongs to the Special Issue Elimination of Lymphatic Filariasis: Endgame Prospects, Challenges and Complexities)
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