• Journal Article

Determinants of success in national programs to eliminate lymphatic filariasis: A perspective identifying essential elements and research needs

Citation

Kyelem, D., Biswas, G., Bockarie, M. J., Bradley, M. H., El-Setouhy, M., Fischer, P. U., ... Williams, S. A. (2008). Determinants of success in national programs to eliminate lymphatic filariasis: A perspective identifying essential elements and research needs. American Journal of Tropical Medicine and Hygiene, 79(4), 480-484.

Abstract

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000. To understand why some national programs have been more successful than others, a panel of individuals with expertise in LF elimination efforts met to assess available data from programs in 8 countries. The goal was to identify: 1) the factors determining success for national LF elimination programs (defined as the rapid, sustained reduction in microfilaremia/antigenemia after repeated mass drug administration [MDA]); 2) the priorities for operational research to enhance LF elimination efforts.Of more than 40 factors identified, the most prominent were 1) initial level of LF endemicity; 2) effectiveness of vector mosquitoes; 3) MDA drug regimen; 4) population compliance.Research important for facilitating program success was identified as either biologic (i.e., [1] quantifying differences in vectorial capacity; [2] identifying seasonal variations affecting LF transmission) or programmatic (i.e., [1] identifying quantitative thresholds, especially the population compliance levels necessary for success, and the antigenemia or microfilaremia prevalence at which MDA programs can stop with minimal risk of resumption of transmission; [2] defining optimal drug distribution strategies and timing; [3] identifying those individuals who are “persistently non-compliant” during MDAs, the reasons for this non-compliance and approaches to overcoming it).While addressing these challenges is important, many key determinants of program success are already clearly understood; operationalizing these as soon as possible will greatly increase the potential for national program success.