Lymphatic filariasis primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Overview
Avoidance of mosquito bites through personal protection measures or community-level vector control is the best option to prevent lymphatic filariasis. Periodic examination of blood for infection and initiation of recommended treatment are also likely to prevent clinical manifestations.
Primary Prevention
- The best way to prevent lymphatic filariasis is to avoid mosquito bites. The mosquitoes that carry the microscopic worms usually bite between the hours of dusk and dawn. If you live in an area with lymphatic filariasis:
- At night
- Sleep in an air-conditioned room
- Sleep under a mosquito net
- Between dusk and dawn
- Wear long sleeves and trousers
- Use mosquito repellent on exposed skin
- At night
- Another approach to prevention includes giving entire communities medicine that kills the microscopic worms -- and controlling mosquitoes. Annual mass treatment reduces the level of microfilariae in the blood and thus, diminishes transmission of infection. This is the basis of the global campaign to eliminate lymphatic filariasis. Experts consider that lymphatic filariasis, a Neglected Tropical Disease (NTD), can be eradicated and a global campaign to eliminate lymphatic filariasis as a public health problem is under way. The elimination strategy is based on annual treatment of whole communities with combinations of drugs that kill the microfilariae. As a result of the generous contributions of these drugs by the companies that make them, tens of millions of people are being treated each year. Since these drugs also reduce levels of infection with intestinal worms, benefits of treatment extend beyond lymphatic filariasis. Successful campaigns to eliminate lymphatic filariasis have taken place in China and other countries.
The Global Programme to Eliminate Lymphatic Filariasis[1]
In 1997, following advances in diagnosis and treatment of the disease, WHO classified lymphatic filariasis, along with five other infectious diseases, as eradicable or potentially eradicable. The same year, the World Health Assembly adopted Resolution WHA 50.29, which called on Member States to initiate steps to eliminate lymphatic filariasis as a public health problem. In response to this call, WHO launched the Global Programme to Eliminate Lymphatic Filariasis in 2000.
Two pharmaceutical companies — GlaxoSmithKline (then known as SmithKline Beecham) and Merck & Co. Inc. — made a pledge to donate the much-needed drugs for as long as it would take to eliminate the disease.
The elimination strategy has two components: (i) to stop the spread of infection (interrupting transmission); and (ii) to alleviate the suffering of affected populations (controlling morbidity).
In order to interrupt transmission, districts in which lymphatic filariasis is endemic must be mapped and community-wide mass treatment programmes implemented to treat the entire at-risk population. Most of these programmes are based on once-yearly administration of single doses of two drugs given together. The following recommended drug regimens need to be administered once a year for at least 5 years, with a coverage of at least 65% of the total at-risk population:
6 mg/kg of body weight diethylcarbamazine citrate (DEC) + 400 mg albendazole; or
150 µg/kg of body weight ivermectin + 400 mg albendazole (in areas that are also endemic for onchocerciasis).
An alternative and equally effective community-wide regimen in endemic regions is the use of common table salt or cooking salt fortified with DEC for a period of one year.
The suffering caused by the disease can be alleviated through community education programmes to raise awareness among patients. These programmes promote the benefits of intensive local hygiene practices as well as the prevention of debilitating and painful episodes of inflammation.
References
- ↑ "WHO | Programme". Retrieved 2012-12-31.