The prevalence of lymphatic filariasis infection and disease following six rounds of mass drug administration in Mandalay Region, Myanmar

PLoS Negl Trop Dis. 2018 Nov 12;12(11):e0006944. doi: 10.1371/journal.pntd.0006944. eCollection 2018 Nov.

Abstract

Lymphatic filariasis is widely endemic in Myanmar. Despite the establishment of an elimination program in 2000, knowledge of the remaining burden of disease relies predominantly on programmatic information. To assist the program, we conducted an independent cross-sectional household cluster survey to determine the prevalence of filariasis infection, morbidity and mass-drug administration coverage in four townships of the Mandalay Region: Amarapura, Patheingyi, Tada-U and Wundwin. The survey included 1014 individuals from 430 randomly selected households in 24 villages. Household members one year and older were assessed for antigenaemia using immunochromatographic test cards and if positive, microfilaraemia by night-time thick blood smear. Participants 15 years and older were assessed for filariasis morbidity by ultrasound-assisted clinical examination. The overall prevalence of infection was 2.63% by antigenaemia (95% confidence interval (CI) 1.71-4.04%) and 1.03% by microfilaraemia (95%CI 0.59-1.47%). The prevalence of hydrocoele in adult males was 2.78% (95%CI 1.23-6.15%) and of lymphoedema in both genders was 0% (95%CI 0-0.45%). These results indicate the persistence of filarial infection and transmission despite six rounds of annual mass drug administration and highlight the need for further rounds as well as the implementation of morbidity management programs in the country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Albendazole / therapeutic use
  • Animals
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diethylcarbamazine / therapeutic use
  • Elephantiasis, Filarial / drug therapy*
  • Elephantiasis, Filarial / epidemiology*
  • Elephantiasis, Filarial / immunology
  • Elephantiasis, Filarial / transmission
  • Female
  • Filaricides / therapeutic use
  • Humans
  • Infant
  • Lymphedema / epidemiology
  • Male
  • Mass Drug Administration / adverse effects
  • Mass Drug Administration / statistics & numerical data*
  • Middle Aged
  • Morbidity
  • Myanmar / epidemiology
  • Parasitemia / epidemiology
  • Prevalence
  • Risk Factors
  • Surveys and Questionnaires
  • Testicular Hydrocele / epidemiology
  • Wuchereria bancrofti / drug effects*
  • Wuchereria bancrofti / immunology
  • Young Adult

Substances

  • Filaricides
  • Albendazole
  • Diethylcarbamazine

Grants and funding

This study was funded by the generous support of the Australian Institute of International Affairs, Euan Crone, the College of Medicine and Dentistry of James Cook University and The Royal College of Pathologists of Australasia. BFRD was the recipient of all study funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.