Lymphatic Filariasis


The disease

Lymphatic filariasis (LF) is a parasitic infection caused by filarial worms, with transmission occuring when a person is bitten by an infected mosquito.  When the worms grow, they live in the infected person’s lymphatic system, hence the name lymphatic filariasis.  Whilst most people infected with LF are free of symptoms, the damage to the lymphatic system caused by the adult worms can lead to debilitating conditions such as lymphoedema (the collection of fluid which results in swelling, most commonly in the legs), hydrocoele (swelling of the scrotum), and infections refered to as ‘acute attacks’, caused by bacterial skin infections or the bodies immune response to the parasite.

Disease control

Similar to schistosomiasis, LF is currently controlled by annual treatment to the whole at-risk community (with some exclusions, depending on the drug being used) for a minimum of five years, using the deworming drug ivermectin or DEC. As the disease is transmitted by mosquitoes that bite during the night in rural areas of Africa, it is also recommended that people in at-risk areas sleep under mosquito nets. As well as preventing any further transmission of disease, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) also has aims to provide access to care to all those with the clinical symptoms e.g. hydrocoele surgery.

LF_moraga

Pre-control prevalence of lymphatic filariasis, measured by antigenaemia using data from 1990 onwards (Moraga et al., 2015)

Geographical distribution

LF is endemic in 55 countries globally, with around 80% of the cases occurring in just 10 of these: India, Indonesia, Myanmar (Asia) and Angola, Cameroon, Côte d’Ivoire (Ivory Coast) , Democratic Republic of Congo, Mozambique, Nigeria and Tanzania (Africa). The disease is predominantly found in rural areas, where the habitat is suitable for mosquitoes although there is also urban transmission caused by the Culex quinquefasciatus mosquito.

Factors influencing the geographical distribution

Research into the spatial distribution of disease in sub-Saharan Africa tends to focus on the infections transmitted by Anopheles mosquitoes, which is also a major vector species for malaria, and is thus found to be related to factors which delineate suitable Anopheles habitat i.e. altitude, rainfall, temperature, humidity, land cover type and vegetation indices. Less research has been undertaken into the spatial distribution of LF in urban areas, with the locations of environmental infrastructure such as sanitation facilities, sewerage and drainage being of importance as Culex breeding sites tend to be situated in stagnant water collections.

Disease-related spatial models

Spatial models relating to lymphatic filariasis primarily focus on mapping the distribution of disease at the district-level or above, and make use of data collected as part of the national LF elimination programmes. Historical disease prevalence data obtained from small-scale surveys has been used to produce pre-control estimates of disease prevalence e.g. the map by Moraga et al. (2015) which uses data collected prior to 1990, plus environmental information derived from satellite imagery to estimate prevalence. Numerous small scale studies on the spatial distribution of disease in both rural and urban areas have been undertaken.

Due to the success of the GPELF, the prevalence of disease overall is decreasing, hence the spatial distribution is changing. Little has been done to explore the change in the spatial distribution of disease over time, or to look at how the disease may vary within a district. With there being a focus on LF-related morbidity, there is also an interest in the spatial distribution of clinical conditions of LF such as lymphoedema and hydrocoele, however little spatially referenced data is available for these conditions.

 

References

  • [DOI] Bockarie Moses J, Taylor Mark J, Gyapong John O. Current practices in the management of lymphatic filariasis.. Expert review of anti-infective therapy 2009;7(5):595-605.
    [Bibtex]
    @article{Bockarie2009,
    abstract = {Lymphatic filariasis is a major cause of acute and chronic morbidity in 81 countries. The availability of safe treatment regimens along with rapid diagnostic tools resulted in a global program to eliminate the disease. The two main objectives of the global elimination program are to interrupt transmission of the parasites and to provide care for those with the disease. The strategy for transmission interruption is preventive chemotherapy through mass drug administration. This article reviews the current treatment regimens for lymphatic filariasis and discusses the challenges posed by co-endemicity with other diseases. The role of integrated vector management as a supplementary strategy for mass drug administration and new strategies for treatment and morbidity control through antibiotic targeting of the Wolbachia endosymbionts are also discussed.},
    author = {Bockarie, Moses J and Taylor, Mark J and Gyapong, John O},
    doi = {10.1586/eri.09.36},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Bockarie, Taylor, Gyapong - 2009 - Current practices in the management of lymphatic filariasis(2).pdf:pdf},
    issn = {1744-8336},
    journal = {Expert review of anti-infective therapy},
    keywords = {Animals,Brugia,Brugia: drug effects,Brugia: microbiology,Culex,Culex: parasitology,Delivery of Health Care,Elephantiasis,Filarial,Filarial: drug therapy,Filarial: parasitology,Filarial: prevention {\&} control,Filarial: transmission,Filaricides,Filaricides: therapeutic use,Humans,Insect Vectors,Insect Vectors: parasitology,Microfilaria,Microfilaria: drug effects,Wolbachia,Wolbachia: drug effects,Wuchereria bancrofti,Wuchereria bancrofti: drug effects,Wuchereria bancrofti: microbiology},
    month = {jun},
    number = {5},
    pages = {595--605},
    pmid = {19485799},
    title = {{Current practices in the management of lymphatic filariasis.}},
    volume = {7},
    year = {2009}
    }
  • [DOI] Brady Molly. Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis: reaching the vision by scaling up, scaling down, and reaching out.. Parasites & vectors 2014;7(1):46.
    [Bibtex]
    @article{Brady2014,
    abstract = {This report summarizes the 7th meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF), Washington DC, November 18-19, 2012. The theme, "A Future Free of Lymphatic Filariasis: Reaching the Vision by Scaling Up, Scaling Down and Reaching Out", emphasized new strategies and partnerships necessary to reach the 2020 goal of elimination of lymphatic filariasis (LF) as a public-health problem.},
    author = {Brady, Molly},
    doi = {10.1186/1756-3305-7-46},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Brady - 2014 - Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis reaching the vision by scaling up, scaling do(2).pdf:pdf},
    issn = {1756-3305},
    journal = {Parasites {\&} vectors},
    month = {jan},
    number = {1},
    pages = {46},
    pmid = {24450283},
    title = {{Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis: reaching the vision by scaling up, scaling down, and reaching out.}},
    url = {http://www.parasitesandvectors.com/content/7/1/46},
    volume = {7},
    year = {2014}
    }
  • [DOI] Cano Jorge, Rebollo Maria P, Golding Nick, Pullan Rachel L, Crellen Thomas, Soler Anna, Hope Louise Kelly- A, Lindsay Steve W, Hay Simon I, Bockarie Moses J, Brooker Simon J. The global distribution and transmission limits of lymphatic filariasis: past and present.. Parasites & vectors 2014;7(1):466.
    [Bibtex]
    @article{Cano2014,
    abstract = {BackgroundLymphatic filariasis (LF) is one of the neglected tropical diseases targeted for global elimination by 2020 and to guide elimination efforts countries have, in recent years, conducted extensive mapping surveys. Documenting the past and present distribution of LF and its environmental limits is important for a number of reasons. Here, we present an initiative to develop a global atlas of LF and present a new global map of the limits of LF transmission.MethodsWe undertook a systematic search and assembly of prevalence data worldwide and used a suite of environmental and climatic data and boosted regression trees (BRT) modelling to map the transmission limits of LF.ResultsData were identified for 66 of the 72 countries currently endemic and for a further 17 countries where LF is no longer endemic. Our map highlights a restricted and highly heterogeneous distribution in sub-Saharan Africa, with transmission more widespread in West Africa compared to east, central and southern Africa where pockets of transmission occur. Contemporary transmission occurs across much of south and South-east Asia and the Pacific. Interestingly, the risk map reflects environmental conditions suitable for LF transmission across Central and South America, including the southern States of America, although active transmission is only known in a few isolated foci. In countries that have eliminated LF, our predictions of environmental suitability are consistent with historical distribution.ConclusionsThe global distribution of LF is highly heterogeneous and geographically targeted and sustained control will be required to achieve elimination. This first global map can help evaluate the progress of interventions and guide surveillance activities.},
    author = {Cano, Jorge and Rebollo, Maria P and Golding, Nick and Pullan, Rachel L and Crellen, Thomas and Soler, Anna and Hope, Louise A Kelly- and Lindsay, Steve W and Hay, Simon I and Bockarie, Moses J and Brooker, Simon J},
    doi = {10.1186/PREACCEPT-4166218931344497},
    issn = {1756-3305},
    journal = {Parasites {\&} vectors},
    language = {en},
    month = {oct},
    number = {1},
    pages = {466},
    pmid = {25303991},
    publisher = {BioMed Central Ltd},
    title = {{The global distribution and transmission limits of lymphatic filariasis: past and present.}},
    url = {http://www.parasitesandvectors.com/content/7/1/466/abstract},
    volume = {7},
    year = {2014}
    }
  • [DOI] Gyapong JO, Kyelem D, Kleinschmidt I, Agbo K, Ahouandogbo F, Gaba J, Owusu-Banahene G, Sanou S, Sodahlon YK, Biswas G, Kale OO, Molyneux DH, Roungou JB, Thomson MC, Remme J. The use of spatial analysis in mapping the distribution of bancroftian filariasis in four West African countries.. Annals of tropical medicine and parasitology 2002;96(7):695-705.
    [Bibtex]
    @article{Gyapong2002,
    abstract = {The geographical distribution of human infection with Wuchereria bancrofti was investigated in four West African countries (Benin, Burkina Faso, Ghana and Togo), using a commercial immunochromatographic test for filarial antigen. Efforts were made to cover each health-system implementation unit and to ensure no sampling point was {\textgreater}50 km from another, but otherwise the 401 study communities were selected at random. The aim was to enable spatial analysis of the data, to provide a prediction of the overall spatial relationships of the infection. The results, which were subjected to an independent random validation in Burkina Faso and Ghana, revealed that prevalence in the adult population of some communities exceeded 70{\%} and that, over large areas of Burkina Faso, community prevalences were between 30{\%} and 50{\%}. Most of Togo, southern Benin and much of southern Ghana appeared completely free of the infection. Although there were foci on the Ghanaian coast with prevalences of 10{\%}-30{\%}, such high prevalences did not extend into coastal Togo or costal Benin. The prevalence map produced should be useful in prioritizing areas for filariasis control, identifying potential overlap with ivermectin-distribution activities undertaken by onchocerciasis-control programmes, and enabling inter-country and sub-regional planning to be initiated. The results indicate that bancroftian filariasis is more widely distributed in arid areas of Burkina Faso than hitherto recognized and that the prevalences of infection have remained fairly stable for at least 30 years. The campaign to eliminate lymphatic filariasis as a public-health problem in Africa will require significantly more resources (human, financial, and logistic) than previously anticipated.},
    author = {Gyapong, J O and Kyelem, D and Kleinschmidt, I and Agbo, K and Ahouandogbo, F and Gaba, J and Owusu-Banahene, G and Sanou, S and Sodahlon, Y K and Biswas, G and Kale, O O and Molyneux, D H and Roungou, J B and Thomson, M C and Remme, J},
    doi = {10.1179/000349802125001735},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Gyapong et al. - 2002 - The use of spatial analysis in mapping the distribution of bancroftian filariasis in four West African countr(4).pdf:pdf},
    isbn = {0003498021250},
    issn = {0003-4983},
    journal = {Annals of tropical medicine and parasitology},
    keywords = {Adolescent,Adult,Africa, Western,Africa, Western: epidemiology,Aged,Animals,Antigens, Helminth,Antigens, Helminth: blood,Elephantiasis, Filarial,Elephantiasis, Filarial: epidemiology,Female,Health Surveys,Humans,Male,Middle Aged,Models, Statistical,Prevalence,Public Health,Public Health: methods,Residence Characteristics,Rural Health,Topography, Medical,Urban Health,Wuchereria bancrofti,Wuchereria bancrofti: immunology},
    month = {oct},
    number = {7},
    pages = {695--705},
    pmid = {12537631},
    title = {{The use of spatial analysis in mapping the distribution of bancroftian filariasis in four West African countries.}},
    url = {http://www.ncbi.nlm.nih.gov/pubmed/12537631},
    volume = {96},
    year = {2002}
    }
  • [DOI] Kastner Randee J, Stone Christopher M, Steinmann Peter, Tanner Marcel, Tediosi Fabrizio. What Is Needed to Eradicate Lymphatic Filariasis? A Model-Based Assessment on the Impact of Scaling Up Mass Drug Administration Programs.. Plos neglected tropical diseases 2015;9(10):e0004147.
    [Bibtex]
    @article{Kastner2015,
    abstract = {BACKGROUND: Lymphatic filariasis (LF) is a neglected tropical disease for which more than a billion people in 73 countries are thought to be at-risk. At a global level, the efforts against LF are designed as an elimination program. However, current efforts appear to aim for elimination in some but not all endemic areas. With the 2020 goal of elimination looming, we set out to develop plausible scale-up scenarios to reach global elimination and eradication. We predict the duration of mass drug administration (MDA) necessary to reach local elimination for a variety of transmission archetypes using an existing model of LF transmission, estimate the number of treatments required for each scenario, and consider implications of rapid scale-up.
    METHODOLOGY: We have defined four scenarios that differ in their geographic coverage and rate of scale-up. For each scenario, country-specific simulations and calculations were performed that took into account the pre-intervention transmission intensity, the different vector genera, drug regimen, achieved level of population coverage, previous progress toward elimination, and potential programmatic delays due to mapping, operations, and administration.
    PRINCIPAL FINDINGS: Our results indicate that eliminating LF by 2020 is unlikely. If MDA programs are drastically scaled up and expanded, the final round of MDA for LF eradication could be delivered in 2028 after 4,159 million treatments. However, if the current rate of scale-up is maintained, the final round of MDA to eradicate LF may not occur until 2050.
    CONCLUSIONS/SIGNIFICANCE: Rapid scale-up of MDA will decrease the amount of time and treatments required to reach LF eradication. It may also propel the program towards success, as the risk of failure is likely to increase with extended program duration.},
    author = {Kastner, Randee J and Stone, Christopher M and Steinmann, Peter and Tanner, Marcel and Tediosi, Fabrizio},
    doi = {10.1371/journal.pntd.0004147},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Kastner et al. - 2015 - What Is Needed to Eradicate Lymphatic Filariasis A Model-Based Assessment on the Impact of Scaling Up Mass Drug.pdf:pdf},
    issn = {1935-2735},
    journal = {PLoS neglected tropical diseases},
    month = {oct},
    number = {10},
    pages = {e0004147},
    pmid = {26451729},
    publisher = {Public Library of Science},
    title = {{What Is Needed to Eradicate Lymphatic Filariasis? A Model-Based Assessment on the Impact of Scaling Up Mass Drug Administration Programs.}},
    url = {http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004147},
    volume = {9},
    year = {2015}
    }
  • Mathieu Els, Amann Josef, Eigege Abel, Richards Frank, Sodahlon Yao. Collecting baseline information for national morbidity alleviation programs: different methods to estimate lymphatic filariasis morbidity prevalence.. The american journal of tropical medicine and hygiene 2008;78(1):153-8.
    [Bibtex]
    @article{Mathieu2008,
    abstract = {The lymphatic filariasis elimination program aims not only to stop transmission, but also to alleviate morbidity. Although geographically limited morbidity projects exist, few have been implemented nationally. For advocacy and planning, the program coordinators need prevalence estimates that are currently rarely available. This article compares several approaches to estimate morbidity prevalence: (1) data routinely collected during mapping or sentinel site activities; (2) data collected during drug coverage surveys; and (3) alternative surveys. Data were collected in Plateau and Nasarawa States in Nigeria and in 6 districts in Togo. In both settings, we found that questionnaires seem to underestimate the morbidity prevalence compared with existing information collected through clinical examination. We suggest that program managers use the latter for advocacy and planning, but if not available, questionnaires to estimate morbidity prevalence can be added to existing surveys. Even though such data will most likely underestimate the real burden of disease, they can be useful in resource-limited settings.},
    author = {Mathieu, Els and Amann, Josef and Eigege, Abel and Richards, Frank and Sodahlon, Yao},
    issn = {0002-9637},
    journal = {The American journal of tropical medicine and hygiene},
    keywords = {Adult,Data Collection,Databases,Elephantiasis,Factual,Female,Filarial,Filarial: epidemiology,Filarial: etiology,Filarial: mortality,Filarial: prevention {\&} control,Humans,Male,Nigeria,Nigeria: epidemiology,Prevalence,Questionnaires,Sentinel Surveillance,Togo,Togo: epidemiology},
    month = {jan},
    number = {1},
    pages = {153--8},
    pmid = {18187799},
    title = {{Collecting baseline information for national morbidity alleviation programs: different methods to estimate lymphatic filariasis morbidity prevalence.}},
    volume = {78},
    year = {2008}
    }
  • [DOI] Moraga Paula, Cano Jorge, Baggaley Rebecca F, Gyapong John O, Njenga Sammy M, Nikolay Birgit, Davies Emmanuel, Rebollo Maria P, Pullan Rachel L, Bockarie Moses J, Hollingsworth Déirdre T, Gambhir Manoj, Brooker Simon J. Modelling the distribution and transmission intensity of lymphatic filariasis in sub-Saharan Africa prior to scaling up interventions: integrated use of geostatistical and mathematical modelling. Parasites & vectors 2015;8(1):560.
    [Bibtex]
    @article{Moraga2015,
    abstract = {BACKGROUND:Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for global elimination. The ability to interrupt transmission is, partly, influenced by the underlying intensity of transmission and its geographical variation. This information can also help guide the design of targeted surveillance activities. The present study uses a combination of geostatistical and mathematical modelling to predict the prevalence and transmission intensity of LF prior to the implementation of large-scale control in sub-Saharan Africa.METHODS:A systematic search of the literature was undertaken to identify surveys on the prevalence of Wuchereria bancrofti microfilaraemia (mf), based on blood smears, and on the prevalence of antigenaemia, based on the use of an immuno-chromatographic card test (ICT). Using a suite of environmental and demographic data, spatiotemporal multivariate models were fitted separately for mf prevalence and ICT-based prevalence within a Bayesian framework and used to make predictions for non-sampled areas. Maps of the dominant vector species of LF were also developed. The maps of predicted prevalence and vector distribution were linked to mathematical models of the transmission dynamics of LF to infer the intensity of transmission, quantified by the basic reproductive number (R 0 ).RESULTS:The literature search identified 1267 surveys that provide suitable data on the prevalence of mf and 2817 surveys that report the prevalence of antigenaemia. Distinct spatial predictions arose from the models for mf prevalence and ICT-based prevalence, with a wider geographical distribution when using ICT-based data. The vector distribution maps demonstrated the spatial variation of LF vector species. Mathematical modelling showed that the reproduction number (R 0 ) estimates vary from 2.7 to 30, with large variations between and within regions.CONCLUSIONS:LF transmission is highly heterogeneous, and the developed maps can help guide intervention, monitoring and surveillance strategies as countries progress towards LF elimination.},
    author = {Moraga, Paula and Cano, Jorge and Baggaley, Rebecca F. and Gyapong, John O. and Njenga, Sammy M. and Nikolay, Birgit and Davies, Emmanuel and Rebollo, Maria P. and Pullan, Rachel L. and Bockarie, Moses J. and Hollingsworth, T. D{\'{e}}irdre and Gambhir, Manoj and Brooker, Simon J.},
    doi = {10.1186/s13071-015-1166-x},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Moraga et al. - 2015 - Modelling the distribution and transmission intensity of lymphatic filariasis in sub-Saharan Africa prior to s(3).pdf:pdf},
    issn = {1756-3305},
    journal = {Parasites {\&} Vectors},
    month = {oct},
    number = {1},
    pages = {560},
    title = {{Modelling the distribution and transmission intensity of lymphatic filariasis in sub-Saharan Africa prior to scaling up interventions: integrated use of geostatistical and mathematical modelling}},
    url = {http://www.parasitesandvectors.com/content/8/1/560},
    volume = {8},
    year = {2015}
    }
  • [DOI] Ngwira BMM, Tambala Phillimon, Perez Maria A, Bowie Cameron, Molyneux David H. The geographical distribution of lymphatic filariasis infection in Malawi.. Filaria journal 2007;6:12.
    [Bibtex]
    @article{Ngwira2007a,
    abstract = {Mapping distribution of lymphatic filariasis (LF) is a prerequisite for planning national elimination programmes. Results from a nation wide mapping survey for lymphatic filariasis (LF) in Malawi are presented. Thirty-five villages were sampled from 23 districts excluding three districts (Karonga, Chikwawa and Nsanje) that had already been mapped and Likoma, an Island, where access was not possible in the time frame of the survey. Antigenaemia prevalence [based on immunochromatographic card tests (ICT)] ranged from 0{\%} to 35.9{\%}. Villages from the western side of the country and distant from the lake tended to be of lower prevalence. The exception was a village in Mchinji district on the Malawi-Zambia border where a prevalence of 18.2{\%} was found. In contrast villages from lake shore districts [Salima, Mangochi, Balaka and Ntcheu (Bwanje valley)] and Phalombe had prevalences of over 20{\%}.A national map is developed which incorporates data from surveys in Karonga, Chikwawa and Nsanje districts, carried out in 2000. There is a marked decline in prevalence with increasing altitude. Further analysis revealed a strong negative correlation (R2 = 0.7 p {\textless} 0.001) between altitude and prevalence. These results suggest that the lake shore, Phalombe plain and the lower Shire valley will be priority areas for the Malawi LF elimination programme. Implications of these findings as regards implementing a national LF elimination programme in Malawi are discussed.},
    author = {Ngwira, B M M and Tambala, Phillimon and Perez, A Maria and Bowie, Cameron and Molyneux, David H},
    doi = {10.1186/1475-2883-6-12},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ngwira et al. - 2007 - The geographical distribution of lymphatic filariasis infection in Malawi(2).pdf:pdf},
    issn = {1475-2883},
    journal = {Filaria journal},
    month = {jan},
    pages = {12},
    pmid = {18047646},
    title = {{The geographical distribution of lymphatic filariasis infection in Malawi.}},
    volume = {6},
    year = {2007}
    }
  • [DOI] Ottesen Eric A. Lymphatic filariasis: Treatment, control and elimination.. Advances in parasitology 2006;61:395-441.
    [Bibtex]
    @article{Ottesen2006,
    abstract = {Lymphatic filariasis (LF) is a disease not just treatable or controllable; it is a disease that can be eliminated. Indeed, LF is currently the target of a major global initiative to do just that; a few visionaries of the past 50 years did hypothesize that LF elimination was feasible. However, for most of the scientific and global health communities, the elimination of such a broadly disseminated, mosquito-borne disease has seemed highly unlikely. During the past decade, however, both the treatment strategies and the control strategies for LF have undergone profound paradigm shifts-all because of a rapid increase in knowledge and understanding of LF that derived directly from a series of remarkable achievements by the scientific and medical research communities. As a result, a public health dimension with a focus on affected populations, now supplements the earlier, predominantly patient-oriented clinical approach to LF. The early uncertainties, then the essential steps leading to this change in outlook are outlined below, followed by descriptions of the new strategy for LF elimination, the Global Programme created to attain this goal and the successes achieved to date.},
    author = {Ottesen, Eric A},
    doi = {10.1016/S0065-308X(05)61010-X},
    isbn = {9780120317615},
    issn = {0065-308X},
    journal = {Advances in parasitology},
    keywords = {Animals,Anthelmintics,Anthelmintics: therapeutic use,Elephantiasis, Filarial,Elephantiasis, Filarial: drug therapy,Elephantiasis, Filarial: epidemiology,Elephantiasis, Filarial: prevention {\&} control,Elephantiasis, Filarial: transmission,Endemic Diseases,Endemic Diseases: prevention {\&} control,Global Health,Humans,Insect Vectors,Mosquito Control,National Health Programs,National Health Programs: economics,National Health Programs: organization {\&} administr,National Health Programs: trends,Public Health},
    month = {jan},
    pages = {395--441},
    pmid = {16735170},
    title = {{Lymphatic filariasis: Treatment, control and elimination.}},
    url = {http://www.sciencedirect.com/science/article/pii/S0065308X0561010X},
    volume = {61},
    year = {2006}
    }
  • [DOI] Rebollo Maria P, Bockarie Moses J. Toward the elimination of lymphatic filariasis by 2020: treatment update and impact assessment for the endgame.. Expert review of anti-infective therapy 2013;11(7):723-31.
    [Bibtex]
    @article{Rebollo2013,
    abstract = {Lymphatic filariasis (LF) is an important public health problem endemic in 73 countries, where it is a major cause of acute and chronic morbidity and a significant impediment to socioeconomic development. It is targeted for elimination by 2020, through preventive chemotherapy using albendazole in combination with either ivermectin or diethylcarbamazine citrate. Preventive chemotherapy enables the regular and coordinated administration of safe, single-dose medications delivered through mass drug administration (MDA). Many countries are now scaling down MDA activities after achieving 100{\%} geographic coverage and instituting monitoring and evaluation procedures to establish the impact of several consecutive rounds of MDA and determine if transmission has been interrupted. At the same time, countries yet to initiate MDA for elimination of LF will adopt improved mapping and coverage assessment protocols to accelerate the efforts for achieving global elimination by 2020. This review provides an update on treatment for LF and describes the current global status of the elimination efforts, transmission control processes and strategies for measuring impact and continuing surveillance after MDA has ceased.},
    author = {Rebollo, Maria P and Bockarie, Moses J},
    doi = {10.1586/14787210.2013.811841},
    issn = {1744-8336},
    journal = {Expert review of anti-infective therapy},
    month = {jul},
    number = {7},
    pages = {723--31},
    pmid = {23879610},
    title = {{Toward the elimination of lymphatic filariasis by 2020: treatment update and impact assessment for the endgame.}},
    volume = {11},
    year = {2013}
    }
  • [DOI] Sabesan Shanmugavelu, Raju Hari Kishan K, Srividya AdiNarayanan, Das Pradeep Kumar. Delimitation of lymphatic filariasis transmission risk areas: a geo-environmental approach.. Filaria journal 2006;5:12.
    [Bibtex]
    @article{Sabesan2006,
    abstract = {The Global Programme to Eliminate Lymphatic Filariasis (GPELF) depends upon Mass Drug Administration (MDA) to interrupt transmission. Therefore, delimitation of transmission risk areas is an important step, and hence we attempted to define a geo-environmental risk model (GERM) for determining the areas of potential transmission of lymphatic filariasis.},
    author = {Sabesan, Shanmugavelu and Raju, Hari Kishan K and Srividya, AdiNarayanan and Das, Pradeep Kumar},
    doi = {10.1186/1475-2883-5-12},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Sabesan et al. - 2006 - Delimitation of lymphatic filariasis transmission risk areas a geo-environmental approach(2).pdf:pdf},
    issn = {1475-2883},
    journal = {Filaria journal},
    month = {jan},
    pages = {12},
    pmid = {17092355},
    title = {{Delimitation of lymphatic filariasis transmission risk areas: a geo-environmental approach.}},
    url = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1654150{\&}tool=pmcentrez{\&}rendertype=abstract},
    volume = {5},
    year = {2006}
    }
  • [DOI] Simonsen Paul E, Mwakitalu Mbutolwe E. Urban lymphatic filariasis.. Parasitology research 2013;112(1):35-44.
    [Bibtex]
    @article{Simonsen2013a,
    abstract = {Lymphatic filariasis (LF) is a disabling and disfiguring disease resulting from a mosquito-borne parasitic infection. It is a major public health problem in many countries with a warm climate. Research and control activities have mainly focused on LF in rural areas where it also has its major impact. However, with rapid and unplanned growth of cities in the developing world, there is a need also to consider LF transmission and control in urban settings. Here, we review currently available knowledge on urban LF and the environmental and socio-economic basis for its occurrence. Among the three parasite species causing LF in humans, only Wuchereria bancrofti has been documented to have a significant potential for urban transmission. This is primarily because one of its vectors, Culex quinquefasciatus, thrives and proliferates excessively in crowded city areas with poor sanitary, sewerage and drainage facilities. For this reason, urban LF also often shows a marked focality in distribution, with most cases clustered in areas inhabited by the less privileged city populations. More knowledge on urban LF is needed, in particular on its socio-economic and human behavioural context, on the potential for transmission in regions where other LF vector species predominate, and on rapid methods for identification and mapping of risk areas, to provide a strong evidence base for its control.},
    author = {Simonsen, Paul E and Mwakitalu, Mbutolwe E},
    doi = {10.1007/s00436-012-3226-x},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Simonsen, Mwakitalu - 2013 - Urban lymphatic filariasis.pdf:pdf},
    issn = {1432-1955},
    journal = {Parasitology research},
    keywords = {Animals,Culex,Culex: growth {\&} development,Culex: parasitology,Disease Vectors,Ecosystem,Elephantiasis, Filarial,Elephantiasis, Filarial: epidemiology,Elephantiasis, Filarial: transmission,Humans,Socioeconomic Factors,Urban Population,Wuchereria bancrofti,Wuchereria bancrofti: pathogenicity},
    month = {jan},
    number = {1},
    pages = {35--44},
    pmid = {23239094},
    title = {{Urban lymphatic filariasis.}},
    url = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3536942{\&}tool=pmcentrez{\&}rendertype=abstract},
    volume = {112},
    year = {2013}
    }
  • [DOI] Slater Hannah, Michael Edwin. Mapping, bayesian geostatistical analysis and spatial prediction of lymphatic filariasis prevalence in Africa.. Plos one 2013;8(8):e71574.
    [Bibtex]
    @article{Slater2013,
    abstract = {There is increasing interest to control or eradicate the major neglected tropical diseases. Accurate modelling of the geographic distributions of parasitic infections will be crucial to this endeavour. We used 664 community level infection prevalence data collated from the published literature in conjunction with eight environmental variables, altitude and population density, and a multivariate Bayesian generalized linear spatial model that allows explicit accounting for spatial autocorrelation and incorporation of uncertainty in input data and model parameters, to construct the first spatially-explicit map describing LF prevalence distribution in Africa. We also ran the best-fit model against predictions made by the HADCM3 and CCCMA climate models for 2050 to predict the likely distributions of LF under future climate and population changes. We show that LF prevalence is strongly influenced by spatial autocorrelation between locations but is only weakly associated with environmental covariates. Infection prevalence, however, is found to be related to variations in population density. All associations with key environmental/demographic variables appear to be complex and non-linear. LF prevalence is predicted to be highly heterogenous across Africa, with high prevalences ({\textgreater}20{\%}) estimated to occur primarily along coastal West and East Africa, and lowest prevalences predicted for the central part of the continent. Error maps, however, indicate a need for further surveys to overcome problems with data scarcity in the latter and other regions. Analysis of future changes in prevalence indicates that population growth rather than climate change per se will represent the dominant factor in the predicted increase/decrease and spread of LF on the continent. We indicate that these results could play an important role in aiding the development of strategies that are best able to achieve the goals of parasite elimination locally and globally in a manner that may also account for the effects of future climate change on parasitic infection.},
    author = {Slater, Hannah and Michael, Edwin},
    doi = {10.1371/journal.pone.0071574},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Slater, Michael - 2013 - Mapping, bayesian geostatistical analysis and spatial prediction of lymphatic filariasis prevalence in Africa.pdf:pdf},
    issn = {1932-6203},
    journal = {PloS one},
    keywords = {Africa,Africa: epidemiology,Bayes Theorem,Elephantiasis, Filarial,Elephantiasis, Filarial: epidemiology,Environment,Geographic Mapping,Humans,Models, Statistical,Prevalence,Reproducibility of Results,Spatio-Temporal Analysis},
    month = {jan},
    number = {8},
    pages = {e71574},
    pmid = {23951194},
    publisher = {Public Library of Science},
    title = {{Mapping, bayesian geostatistical analysis and spatial prediction of lymphatic filariasis prevalence in Africa.}},
    url = {http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0071574},
    volume = {8},
    year = {2013}
    }
  • [DOI] Slater Hannah, Michael Edwin. Predicting the current and future potential distributions of lymphatic filariasis in Africa using maximum entropy ecological niche modelling.. Plos one 2012;7(2):e32202.
    [Bibtex]
    @article{Slater2012,
    abstract = {Modelling the spatial distributions of human parasite species is crucial to understanding the environmental determinants of infection as well as for guiding the planning of control programmes. Here, we use ecological niche modelling to map the current potential distribution of the macroparasitic disease, lymphatic filariasis (LF), in Africa, and to estimate how future changes in climate and population could affect its spread and burden across the continent. We used 508 community-specific infection presence data collated from the published literature in conjunction with five predictive environmental/climatic and demographic variables, and a maximum entropy niche modelling method to construct the first ecological niche maps describing potential distribution and burden of LF in Africa. We also ran the best-fit model against climate projections made by the HADCM3 and CCCMA models for 2050 under A2a and B2a scenarios to simulate the likely distribution of LF under future climate and population changes. We predict a broad geographic distribution of LF in Africa extending from the west to the east across the middle region of the continent, with high probabilities of occurrence in the Western Africa compared to large areas of medium probability interspersed with smaller areas of high probability in Central and Eastern Africa and in Madagascar. We uncovered complex relationships between predictor ecological niche variables and the probability of LF occurrence. We show for the first time that predicted climate change and population growth will expand both the range and risk of LF infection (and ultimately disease) in an endemic region. We estimate that populations at risk to LF may range from 543 and 804 million currently, and that this could rise to between 1.65 to 1.86 billion in the future depending on the climate scenario used and thresholds applied to signify infection presence.},
    author = {Slater, Hannah and Michael, Edwin},
    doi = {10.1371/journal.pone.0032202},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Slater, Michael - 2012 - Predicting the current and future potential distributions of lymphatic filariasis in Africa using maximum en(2).pdf:pdf},
    issn = {1932-6203},
    journal = {PloS one},
    keywords = {Africa,Africa: epidemiology,Climate Change,Ecosystem,Elephantiasis, Filarial,Elephantiasis, Filarial: epidemiology,Entropy,Forecasting,Humans,Models, Theoretical},
    month = {jan},
    number = {2},
    pages = {e32202},
    pmid = {22359670},
    title = {{Predicting the current and future potential distributions of lymphatic filariasis in Africa using maximum entropy ecological niche modelling.}},
    url = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3281123{\&}tool=pmcentrez{\&}rendertype=abstract},
    volume = {7},
    year = {2012}
    }
  • [DOI] Sodahlon Yao, Malecela Mwele, Gyapong John O. Lymphatic Filariasis (Elephantiasis). In: Neglected tropical diseases – sub-saharan africa. , 2016, 159-186.
    [Bibtex]
    @incollection{Sodahlon2016,
    author = {Sodahlon, Yao and Malecela, Mwele and Gyapong, John O.},
    booktitle = {Neglected Tropical Diseases - Sub-Saharan Africa},
    doi = {10.1007/978-3-319-25471-5_8},
    pages = {159--186},
    title = {{Lymphatic Filariasis (Elephantiasis)}},
    url = {http://link.springer.com/10.1007/978-3-319-25471-5{\_}8},
    year = {2016}
    }
  • [DOI] Stanton Michelle C, Mkwanda Square Z, Debrah Alexander Y, Batsa Linda, Biritwum Nana-Kwadwo, Hoerauf Achim, Cliffe Matthew, Best Abigail, Molineux Andrew, Kelly-Hope Louise A. Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: Case studies from Malawi and Ghana. Bmc infectious diseases 2015;15(214).
    [Bibtex]
    @article{Stanton2015,
    author = {Stanton, Michelle C. and Mkwanda, Square Z. and Debrah, Alexander Y. and Batsa, Linda and Biritwum, Nana-Kwadwo and Hoerauf, Achim and Cliffe, Matthew and Best, Abigail and Molineux, Andrew and Kelly-Hope, Louise A.},
    doi = {10.1186/s12879-015-0946-4},
    journal = {BMC infectious diseases},
    number = {214},
    title = {{Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: Case studies from Malawi and Ghana}},
    volume = {15},
    year = {2015}
    }
  • [DOI] Stanton Michelle, Molineux Andrew, Mackenzie Charles, Kelly-Hope Louise. Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases. Jmir public health and surveillance 2016;2(1):e2.
    [Bibtex]
    @article{Stanton2016,
    abstract = {Background: As global mobile phone penetration increases, direct health information communication from hard-to-reach communities is becoming commonplace. Mobile health (mHealth) tools that enable disease control programs to benefit from this information, while simultaneously empowering community members to take control of their own health, are vital to the goal of universal health care. Objective: Our aim was to highlight the development of the Liverpool mHealth Suite (LMS), which has been designed to address this need and improve health services for neglected tropical diseases being targeted for global elimination, such as lymphatic filariasis. Methods: The LMS has two main communication approaches{\&}{\#}8212;short message service and mobile phone apps{\&}{\#}8212;to facilitate real-time mass drug administration (MDA) coverage, reporting patient numbers, managing stock levels of treatment supplies, and exchanging health information to improve the quality of care of those affected. Results: The LMS includes the MeasureSMS-MDA tool to improve drug supplies and MDA coverage rates in real-time (currently being trialed in urban Tanzania); the MeasureSMS-Morbidity tool to map morbidity, including lymphedema and hydrocele cases (initially piloted in rural Malawi and Ghana, then extended to Ethiopia, and scaled up to large urban areas in Bangladesh and Tanzania); the LyMSS-lymphedema management supply system app to improve distribution of treatments (trialed for 6 months in Malawi with positive impacts on health workers and patients); and the HealthFront app to improve education and training (in development with field trials planned). Conclusions: The current success and scale-up of the LMS by many community health workers in rural and urban settings across Africa and Asia highlights the value of this simple and practical suite of tools that empowers local health care workers to contribute to local, national, and global elimination of disease. [JMIR Public Health Surveill 2016;2(1):e2]},
    author = {Stanton, Michelle and Molineux, Andrew and Mackenzie, Charles and Kelly-Hope, Louise},
    doi = {10.2196/publichealth.5064},
    issn = {2369-2960},
    journal = {JMIR Public Health and Surveillance},
    keywords = {LF,NTDs,SMS,apps,community engagement,elephantiasis,lymphatic filariasis,mhealth,neglected tropical diseases,smartphones},
    language = {en},
    month = {jan},
    number = {1},
    pages = {e2},
    publisher = {JMIR Public Health and Surveillance},
    title = {{Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases}},
    url = {http://publichealth.jmir.org/2016/1/e2/},
    volume = {2},
    year = {2016}
    }
  • World Health Organization. Global programme to eliminate lymphatic filariasis: progress report, 2014. Weekly epidemiological record 2015;38(90):489-504.
    [Bibtex]
    @article{WorldHealthOrganization2015,
    author = {{World Health Organization}},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Unknown - 2015 - Weekly epidemiological record Relev{\'{e}} {\'{e}}pid{\'{e}}miologique hebdomadaire.pdf:pdf},
    issn = {0049-8114},
    journal = {Weekly Epidemiological Record},
    number = {90},
    pages = {489--504},
    title = {{Global programme to eliminate lymphatic filariasis: progress report, 2014}},
    url = {http://www.who.int/wer},
    volume = {38},
    year = {2015}
    }
  • World Health Organization. Operational guidelines for rapid mapping of Bancroftian filariasis in Africa. Geneva: 2000.
    [Bibtex]
    @techreport{WorldHealthOrganization2000b,
    address = {Geneva},
    author = {{World Health Organization}},
    title = {{Operational guidelines for rapid mapping of Bancroftian filariasis in Africa}},
    year = {2000}
    }
  • World Health Organization. WHO position statement on integrated vector management to control malaria and lymphatic filariasis. Weekly epidemiological record 2011;13:121-127.
    [Bibtex]
    @article{WorldHealthOrganization2011c,
    author = {{World Health Organization}},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/World Health Organization - 2011 - WHO position statement on integrated vector management to control malaria and lymphatic filariasis(2).pdf:pdf},
    journal = {Weekly Epidemiological Record},
    pages = {121--127},
    title = {{WHO position statement on integrated vector management to control malaria and lymphatic filariasis}},
    volume = {13},
    year = {2011}
    }
  • World Health Organization. Lymphatic filariasis: Managing Morbidity and Preventing Disability. 2013.
    [Bibtex]
    @techreport{WorldHealthOrganization2013,
    author = {{World Health Organization}},
    title = {{Lymphatic filariasis: Managing Morbidity and Preventing Disability}},
    url = {http://apps.who.int/iris/bitstream/10665/85347/1/9789241505291{\_}eng.pdf},
    year = {2013}
    }
  • [DOI] Zeldenryk Lynne Michelle, Gray Marion, Speare Richard, Gordon Susan, Melrose Wayne. The emerging story of disability associated with lymphatic filariasis: a critical review.. Plos neglected tropical diseases 2011;5(12):e1366.
    [Bibtex]
    @article{Zeldenryk2011,
    abstract = {Globally, 40 million people live with the chronic effects of lymphatic filariasis (LF), making it the second leading cause of disability in the world. Despite this, there is limited research into the experiences of people living with the disease. This review summarises the research on the experiences of people living with LF disability. The review highlights the widespread social stigma and oppressive psychological issues that face most people living with LF-related disability. Physical manifestations of LF make daily activities and participation in community life difficult. The findings confirm the need for the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to support morbidity management activities that address the complex biopsychosocial issues that people living with LF-related disability face.},
    author = {Zeldenryk, Lynne Michelle and Gray, Marion and Speare, Richard and Gordon, Susan and Melrose, Wayne},
    doi = {10.1371/journal.pntd.0001366},
    file = {:C$\backslash$:/Users/michelle.stanton/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zeldenryk et al. - 2011 - The emerging story of disability associated with lymphatic filariasis a critical review(2).pdf:pdf},
    issn = {1935-2735},
    journal = {PLoS neglected tropical diseases},
    keywords = {Disabled Persons,Disabled Persons: psychology,Disabled Persons: statistics {\&} numerical data,Elephantiasis, Filarial,Elephantiasis, Filarial: complications,Elephantiasis, Filarial: pathology,Elephantiasis, Filarial: physiopathology,Elephantiasis, Filarial: psychology,Humans,Social Isolation,Social Isolation: psychology,Social Stigma},
    month = {dec},
    number = {12},
    pages = {e1366},
    pmid = {22216361},
    publisher = {Public Library of Science},
    title = {{The emerging story of disability associated with lymphatic filariasis: a critical review.}},
    url = {http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001366{\#}pntd-0001366-g002},
    volume = {5},
    year = {2011}
    }