Sri Lanka (Concluded)

Sri Lanka (Concluded)

Study Sites: Colombo, Gampaha, Kalutara, Kurunegala, Puttalam, Galle, Matara and Hambantota


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.)

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