DOLF Classic Community Trials Summary

In the first DOLF grant funding from the Bill and Melinda Gates Foundation, we accomplished several research objectives for optimizing mass drug administration for lymphatic filariasis. Furthermore, we were able to assess in some study areas the impact of the MDA for elimination of LF  as well as the impact of MDA on onchocerciasis and STH infections.

Optimization of MDA with existing drugs for lymphatic filariasis and onchoceriaisis
Part 1: Cost/benefit based studies of accelerated mass drug administration (MDA) for elimination of lymphatic filariasis (LF)

Based on previously published data from Ghana and India, DOLF researchers modeled the impact and costs of semiannual MDA for LF elimination and predicted acceleration of elimination at slightly reduced cost for the total MDA campaign (Stolk et al. 2013). Similar studies using data collected during the DOLF community trials are still in progress. All of these studies indicated that high compliance with MDA is crucial and the DOLF team reviewed factors that influence the individual compliance (Krentel et al. 2013).

Part 2: Population based studies of accelerated mass drug administration (MDA) for elimination of lymphatic filariasis (LF)

Seven of these large, community-based studies were performed in 6 countries in Africa Liberia – 2 sites, Cote d’Ivoire, Republic of Congo, Democratic Republic of Congo, 1 country in Asia, Indonesia, and in the western Pacific,Papua New Guinea. Five studies are comparing the relative impact and cost effectiveness of annual vs. semiannual MDA for elimination of LF. Our results from Flores (Indonesia) show that annual MDA was sufficient to reduce Mf prevalence to less than 1% in areas with low to moderate baseline prevalence, while semiannual MDA was useful for rapidly reducing Mf prevalence in an area with higher baseline endemicity (Supali et al. 2019).

We also performed two community studies to determine whether semiannual MDA with Albendazole alone can eliminate LF in Central Africa where the standard MDA regimen (Ivermectin plus Albendazole) cannot be used because of coendemic loiasis.

Results from the Republic of Congo show that this approach is not only successful to reducing LF, but also for reducing STH, especially hookworm infections (Pion et al. 2015, Pion et al. 2017). Data from a parallel study in the Democratic Republic of Congo is currently being analyzed.

Publications

Comparison of the impact of annual and semiannual mass drug administration on lymphatic filariasis prevalence in Flores Island, Indonesia.
T Supali, Y Djuardi, A Lomiga,  SN Linda, E Iskander, CW Goss, JP Miller, GJ Weil, PU Fischer
Am J Trop Med Hyg. 2019;100(2)336-343

Effect of 3 years of biannual mass drug administration with albendazole on lymphatic filariasis and soil-transmitted helminth infections: a community-based study in Republic of the Congo.
SDS Pion, CB Chenaiz, GJ Weil, PU Fischer, F Missamou, M Boussinesq
Lancet Infect Dis. 2017;17(7):763-769

The Impact of Two Semi-annual Treatments with Albendazole Alone on Lymphatic Filariasis and Soil-Transmitted Helminth Infections: A Community-based Study in the Republic of Congo.
SDS Pion, CB Chesnais, J Bopda, F Louya, PU Fischer, AC Majewski, GJ Weil, M Boussinesq, F Missamou
Am J Trop Med Hyg. 2015;92(5):959-966

Modeling the impact and costs of semiannual mass drug administration for accelerated elimination of lymphatic filariasis.
WA Stolk, QA ten Bosch, SJ de Vlas, PU Fischer, GJ Weil, AS Goldman
PLoS NTD. 2013;7(1):e1984

A review of factors that influence individual compliance with mass drug administration for elimination of lymphatic filariasis.
A Krentel, PU Fischer, GJ Weil
PLoS NTD. 2013;7(11):e2447