Determinants of Success in National Programs to Eliminate Lymphatic Filariasis: A Perspective Identifying Essential Elements and Research Needs

Dominique Kyelem Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Gautam Biswas Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Moses J. Bockarie Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Mark H. Bradley Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Maged El-Setouhy Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Peter U. Fischer Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Ralph H. Henderson Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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James W. Kazura Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Patrick J. Lammie Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Sammy M. Njenga Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Eric A. Ottesen Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Kapa D. Ramaiah Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Frank O. Richards Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Gary J. Weil Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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Steven A. Williams Lymphatic Filariasis Support Center, Task Force for Child Survival and Development, Decatur, Georgia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Community Partnerships, GlaxoSmithKline, Brentford, United Kingdom; Department of Public Health, Ain Shams University, Cairo, Egypt; School of Medicine, Washington University, St. Louis, Missouri; Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Nairobi, Kenya; Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India; Carter Center, Atlanta, Georgia; Clark Science Center, Smith College, Northampton, Massachusetts

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DOI:
https://doi.org/10.4269/ajtmh.2008.79.480
Volume/Issue:
Volume 79: Issue 4
Page(s):
480–484
Restricted access
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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.

Author Notes

Copyright:
Copyright 2008 The American Society of Tropical Medicine 2008
Received:
16 Jun 2008
|
Accepted:
20 Aug 2008
|
Published Online:
Oct 2008
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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