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A case of elephantiasis
Eliminating Lymphatic Filariasis from Africa: prospects and challenges
Introduction
The adoption by the World Health Assembly of resolution 50.29 calling for the elimination of lymphatic filariasis as a public health problem has put the disease on a much higher pedestal than before. The resolution, coupled with the donations of albendazole and Mectizan (ivermectin, MSD) by GlaxoSmithKline and Merck & Co., Inc., respectively, for as long as necessary, present exciting but challenging times ahead. In Africa where the disease is a major cause of clinical morbidity and an impediment to socio-economic development, the challenges are even greater and impose a tremendous burden on the health care systems. The World Health Organisation (WHO) African Region has set a goal of eliminating lymphatic filariasis as a public health problem by the year 2020 and hopes to contribute to the attainment of better health for underprivileged communities in the region.
The strategic objectives of the programme include:
1. Improving the general health status of endemic populations through increased access to public health interventions, preferably working through existing health structures and programmes.2. Reducing and ultimately interrupting transmission of lymphatic filariasis in all endemic communities by mass chemotherapy with albendazole co-administered with Mectizan (in countries co-endemic for onchocerciasis and lymphatic filariasis) or DEC and albendazole, as well as vector control through the promotion of insecticide treated materials.
3. Alleviating the suffering of people with overt disease such as elephantiasis and hydrocoele by use of specific morbidity control or disability prevention techniques.
4. Setting up an effective programme monitoring system that will continually assess progress of the programme and will bring to the fore operational issues and problems related to programme implementation.
5. Continuously improving programme delivery through operational research.
It is currently estimated that some 480 million people are at risk
of infection in the WHO African Region with some 4.6 million cases of
ymphoedema and more than 10 million cases of hydrocoele. These represent
about 38% of the global burden of the disease (figure 1).
Fig.
1 Regional distribution of the global burden of LF
