January 30, 2015
The 8th biennial meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF 8) was held in December 2014 in Addis Ababa, Ethiopia. The DOLF team was invited to present important findings at a special session dedicated to operational research. Health ministers and policy experts heard from Drs. Gary Weil and Peter Fischer as they shared recent research advances from DOLF studies that have practical implications for global lymphatic filariasis (LF) and neglected tropical diseases (NTD) programs.
Gary Weil presented a talk on Alternative Mass Drug Administration (MDA) Strategies that could speed up LF and onchocerciasis elimination using existing drugs in novel dosing regimens. Examples of promising strategies being investigated by the DOLF project include:
- Early results from a DOLF study site in the Republic of the Congo suggest that semiannual MDA with Albendazole can be used to eliminate LF in central Africa where co-endemicity with Loa loa rules out traditional treatment with Albendazole plus Ivermectin. This study is being conducted by a team led by Drs. Michel Boussinseq (IRD, Montpellier) and Francois Missamou (MOH, Brazzaville,Republic of Congo). Final results from this study will be available in late 2015, and DOLF has initiated a parallel study in the Democratic Republic of the Congo.
- A DOLF pilot study in Papua New Guinea suggests that a triple drug regimen (DEC/Alb/Ivermectin) appears to be safe and more effective for clearing microfilaremia than traditional treatment with DEC/Alb. This project is led by Drs. Chris King and Jim Kazura (Case-Western Reserve University School of Medicine).
Peter Fischer presented a talk on The Impact of Community MDA on Soil-Transmitted Helminthes (STH) with data collected from seven DOLF study sites. These studies are providing important data on the impact of MDA on STH infections in populations. Early highlights from this research follow:
- We compared Kato-Katz with mini-FLOTAC for the detection of STH eggs. While mini-FLOTAC has certain advantages over Kato-Katz, we prefer the latter test for DOLF field studies, where technician capacity is limiting and where the priority is for timely reading of many samples over a period of weeks.
- Results from several study sites have shown that MDA for LF has a dramatic effect on prevalence rates for hookworm, a moderate effect on Ascaris, and a fair effect on Trichuris. MDA also reduces infection intensities for all three species.
- It may be possible to achieve local elimination of hookworm in some settings by MDA alone.
- Resurgence of STH infection is likely after MDA is phased out, unless it is followed by a maintenance program.
- These early results show that community-wide MDA has a huge impact on STH. More time (and more studies) will be needed to determine whether MDA (alone or in combination with other interventions) will be sufficient to eliminate STH in some settings.