The Africa Region Neglected Tropical Diseases (NTD) Programme includes lymphatic filariasis providing technical orientation, support and guidance to Member States in the WHO African Region in order to contribute to the accelerated prevention, control, elimination and eradication of Neglected Tropical Diseases (NTDs) and Zoonoses.
Vision: An African Region free of Neglected Tropical Diseases.
Goal: To accelerate the reduction of the disease burden through the control, elimination and eradication of targeted NTDs and contribute to poverty alleviation, increased productivity and better quality of life of the affected people in the African Region— lymphatic filariasis and trachoma by 2020, advanced control of schistosomiasis and soil-transmitted helminthiasis by 2020 and onchocerciasis by 2025.Achievements, constraints, challenges and lessons learnt.
In 2017, according to 2017 Weekly Epidemiological Report, 343.3 million people in 32 countries were currently considered to require MDA. Based on data reported from 23 countries, 202.1 million people were reported to be treated in MDA, for a regional coverage of 59%. Notable progress in the Region was seen in Eritrea and Guinea, which implemented MDA in all endemic IUs for the first time. Nigeria expanded MDA for the fourth consecutive year, reaching 88% geographical coverage (484 of 553 IUs) where treatment is still required. All 30 IUs in Plateau and Nasarawa states have passed TAS3 and must continue surveillance until the remaining endemic states also meet this criterion. The Democratic Republic of the Congo (DRC) also expanded MDA implementing in 89% of endemic IUs. São Tome and Principe did not implement MDA but prepared a strategic plan to treat all endemic IUs in 2018. Comoros restarted MDA across the country after failing TAS1 in 2014. Madagascar was unable to implement MDA in 2017 due to national efforts to control an epidemic of plague. Reports on MDA from the Central African Republic, Chad, Guinea-Bissau and Zambia are awaited. Mauritania determined that MDA was not required after confirmation mapping found no evidence of recent infection.
A total of 57.3 million treatments were delivered in IUs co-endemic for LF and onchocerciasis in 14 countries. All co-endemic countries reporting in 2017 delivered both ivermectin and albendazole in IUs endemic for LF and onchocerciasis. Cameroon, Congo, DRC and Nigeria implemented recommended albendazole-only MDA in IUs co-endemic for loiasis. Equatorial Guinea, Gabon and South Sudan have not started MDA.
With Malawi and Togo, where MDA is no longer required, 10 other countries have implemented TAS and stopped MDA in some IUs. MDA is no longer required in more than 80% of the endemic IUs in Burkina Faso, Ghana and Uganda. The population requiring MDA in the Region has been reduced by 115.6 million, representing a 25% reduction.
Limited data on MMDP are available from 21 of 34 endemic countries. Reports on the number of lymph- oedema or hydrocele patients and the availability of care by IU are awaited from Angola, Central African Republic, Chad, Congo, Côte d’Ivoire, DRC, Equatorial Guinea, Gabon, Guinea Bissau, Liberia, Malawi, Mozambique, Nigeria, Senegal, South Sudan, United Republic of Tanzania, Zambia and Zimbabwe. The lack of data limits the ability to measure the availability and provision of MMDP in the Region and in the countries approaching the post-MDA surveillance phase, which poses an immediate challenge for documenting validation criteria.
The treatment regime in AFRO endemic countries is albendazole plus Mectizan in areas where LF is co-endemic with onchocerciasis and elsewhere with albendazole plus DEC (diethylcarbamazine).
The Africa Regional Programme Review Group (RPRG) is chaired by:
Bairro da Orli, N° 432,
Anexo ao Hospital Rural de Chókwè, C.P. 30,
rthompsonmz [at] gmail.com
See WHO Weekly Epidemiological Report for the full detailed report