Sri Lanka (Concluded)
Study Sites: Colombo, Gampaha, Kalutara, Kurunegala, Puttalam, Galle, Matara and Hambantota
- Physical Address: Colombo, Sri Lanka
Studies
Research for Elimination of Lymphatic Filariasis
Study Sites: Colombo, Gampaha, Kalutara, Kurunegala, Puttalam, Galle, Matara and Hambantota
The Sri Lankan Anti-Filariasis Campaign (AFC), Ministry of Health distributed 5 rounds of MDA according to WHO guidelines (i.e. with DEC and albendazole) to some 10 million people in 8 endemic districts with >65% coverage between 2002 and 2006. MDA with DEC and albendazole reduced Mf prevalence to <1% in all implementation units (IUs). WHO guided School-TAS in 2013 easily passed in all 11 evaluation units (EU). Sri Lanka met WHO validation criteria for the elimination of lymphatic filariasis (LF) as a public health problem in 2016. However the DOLF project detected low-level persistence of LF in many areas in Sri Lanka as a result of comprehensive post-MDA surveillance and Molecular Xenomonitoring (MX). Cluster based MX, additional cross sectional studies and community based transmission assessments in adults (i.e., adult-TAS) showed many foci, or “hotspots”, with persistent filarial infectionand ongoing transmission in coastal Galle (Rao et al, 2014-2018). DOLF researchers concluded that adult-TAS for antigen, and MX, and school TAS for antibody are more sensitive than current protocol for TAS for detecting residual LF following MDA. This research will help strengthen TAS and improve end-game surveillance strategies in low prevalence settings where countries are nearing LF elimination as a public health problem. We recommend the Sri Lankan program should consider activities other than MDA that focus on surveillance in sub-populations with higher prevalence rates (e.g., adult males, fishing community) and other interventions for hotspot removal (e.g, new treatments such as IDA, bed net usage, and integrated vector management in problem areas).
Comparison of Binax Filariasis Card Test and the Alere Filariasis Test Strip Cross-sectional Community Surveillance Using Filarial Antigen and Microfilaria Tests in Low level Persistence LF Areas following MDA in Sri Lanka
Study Sites: Galle and Matara, Sri Lanka
Results from this study agree with similar studies from other sites that find the Alere test strips are more sensitive than the Binax Now card test. The final results were published by Yahathugoda et al. in Parasites & Vectors, 2015.
Research for Integrated Surveillance for STH and Filariasis
Study Site: Gampaha
Washington University researchers also worked together with AFC and Sri Lankan scientists to develop a pilot project on integrated school-based surveillance for LF and soil transmitted helminth infections (Gunawardena et al, 2014.)
Publications
Comprehensive assessment of a hotspot with persistent bancroftian filariasis in coastal Sri Lanka
Am J Trop Med Hyg. 2018;99:735-742
Reassessment of areas with persistent Lymphatic Filariasis nine years after cessation of mass drug administration in Sri Lanka (Mosquito net photo)
PLoS Negl Trop Dis. 2017; 11:e0006066
Programmatic Use of Molecular Xenomonitoring at the Level of Evaluation Units to Assess Persistence of Lymphatic Filariasis in Sri Lanka
PLoS neglected Trop Dis. 2016;10:1-16
A comparison of two tests for filarial antigenemia in areas in Sri Lanka and Indonesia with low-level persistence of lymphatic filariasis following mass drug administration
Parasit Vectors. 2015;8:369
A comprehensive assessment of lymphatic filariasis in Sri Lanka six years after cessation of mass drug administration
PLoS Neglected Trop. Dis 2014;8:e3281
Integrated school based STH TAS Sri Lanka
Am J Trop Med Hyg. 2014;90:661-666
Implementation Partners
Research Collaborator
University of Ruhuna, Faculty of Medicine, Filariasis Research Training & Service Unit. Galle, Sri Lanka
Dr. Channa Yahathugoda, Dr. Mirani Weerasooriya
Ministry of Health, Anti Filariasis Campaign
Colombo, Sri Lanka
Dr. Devika Mendis, Director
Dr. Tilaka Liyanage, Dr. Sunil Settinayake, Dr. Udaya Ranasinghe (Former AFC Directors)
University of Colombo Department of Parasitology,
Faculty of Medicine, Colombo, Sri Lanka
Dr. Sharmini Gunawardena
University of Kelaniya, Department of Parasitology,
Faculty of Medicine, Gampaha, Sri Lanka
Dr. Nilanthi deSilva
Coordinating Investigators
Washington University School of Medicine, The DOLF Project
St. Louis, Missouri
Dr. Ramakrishna Rao and Dr. Gary Weil