Step towards elimination of Wuchereria bancrofti in Southwest Tanzania 10 years after mass drug administration with Albendazole and Ivermectin

PLoS Negl Trop Dis. 2022 Jul 20;16(7):e0010044. doi: 10.1371/journal.pntd.0010044. eCollection 2022 Jul.

Abstract

Background: Lymphatic filariasis is a mosquito transmitted parasitic infection in tropical regions. Annual mass treatment with ivermectin and albendazole is used for transmission control of Wuchereria bancrofti, the infective agent of lymphatic filariasis in many African countries, including Tanzania.

Methodology: In a general population study in Southwest Tanzania, individuals were tested for circulating filarial antigen, an indicator of W. bancrofti adult worm burden in 2009 before mass drug administration commenced in that area. Seven annual rounds with ivermectin and albendazole were given between 2009 and 2015 with a population coverage of over 70%. Participants of the previous study took part in a follow-up activity in 2019 to measure the effect of this governmental activity.

Findings: One thousand two hundred and ninety nine inhabitants of Kyela district in Southwest Tanzania aged 14 to 65 years who had participated in the study activities in 2009 were revisited in 2010/11 and 2019. Among this group, the prevalence of lymphatic filariasis of the 14-65 years olds in 2009 was 35.1%. A follow-up evaluation in 2010/11 had shown a reduction to 27.7%. In 2019, after 7 years of annual treatment and an additional three years of surveillance, the prevalence had dropped to 1.7%, demonstrating successful treatment by the national control programme. Risk factors for W. bancrofti-infection were the occupation as farmer, male sex, and older age. Most infected individuals in the 2019 follow-up study already had a positive test for filarial antigen in 2009 and/or 2010/11.

Conclusions: This data supports the findings of the Tanzanian Neglected Tropical Disease Control Programme (NTDCP), who conducted Transmission Assessment Surveys and found an impressive reduction in the prevalence of LF in children. Our results complement this data by showing a similar decrease in prevalence of LF in the adult population in the same area. The elimination of LF seems achievable in the near future.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albendazole / adverse effects
  • Animals
  • Antigens, Helminth / therapeutic use
  • Elephantiasis, Filarial* / drug therapy
  • Elephantiasis, Filarial* / epidemiology
  • Elephantiasis, Filarial* / prevention & control
  • Filaricides* / therapeutic use
  • Follow-Up Studies
  • Humans
  • Ivermectin / adverse effects
  • Male
  • Mass Drug Administration
  • Tanzania / epidemiology
  • Wuchereria bancrofti

Substances

  • Antigens, Helminth
  • Filaricides
  • Ivermectin
  • Albendazole

Grants and funding

The RHINO study was supported by the German Research Foundation (DFG, KR 3615/1-1 to IK and HO 2009/11-1 to AHoe). The EMINI study was funded by the European Union as part of EuropAid (SANTE/2004/078-545/130 and SANTE/2006/129-931 to MH) and the German Ministry of Science (BMBF, grant 01KA0904 to IK). AHoe is also funded by the DFG under Germany’s Excellence Strategy – EXC2151 – 390873048. AHoe, CG, FR, ES, MH and IK are funded by the German Center for Infection Research under TTU 03.815 (to AHoe) and 03.817 (to MH, CG, FR, ES and IK). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.