ArticlePLoS neglected tropical diseases2018
Towards elimination of lymphatic filariasis in southeastern Madagascar: Successes and challenges for interrupting transmission.
Article in PLoS neglected tropical diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- A systematic review of alternative surveillance approaches for lymphatic filariasis in low prevalence settings: Implications for post-validation settings.PLoS neglected tropical diseases · 2020Pooled it
- No evidence of Wuchereria bancrofti infection in Anopheles species after 10 years without mass drug administration: a molecular xenomonitoring study in Hauts-Bassins, Burkina Faso.Tropical medicine and health · 2025Article
- Public health surveillance of tropical diseases in Madagascar: a scoping review of population burden, intervention strategies, and health system responses.BMC public health · 2025Article
- Persistent lymphatic filariasis transmission seven years after validation of elimination as a public health problem: a cross-sectional study in Tonga.The Lancet regional health. Western Pacific · 2025Article
- Prevalence of Strongyloides stercoralis and other helminths in four districts of Madagascar.Tropical medicine and health · 2024Article
- Prevalence of micronutrient deficiencies across diverse environments in rural Madagascar.Frontiers in nutrition · 2024Article
- Implementation of Mass Drug Administration for Lymphatic Filariasis in Madagascar: The Progress, Effectiveness and Financial Savings of Integrating into an Existing Polio Campaign.Research and reports in tropical medicine · 2024Article
- Lymphatic Filariasis Elimination Status:Tropical medicine and infectious disease · 2023Article
- Evaluating elimination thresholds and stopping criteria for interventions against the vector-borne macroparasitic disease, lymphatic filariasis, using mathematical modelling.Communications biology · 2023Article
- Spatially Explicit Environmental Factors Associated with Lymphatic Filariasis Infection in American Samoa.Tropical medicine and infectious disease · 2022Article
- Coverage Validation Survey for Lymphatic Filariasis Treatment in Itang Special District of Gambella Regional State of Ethiopia: A Cross-Sectional Study.Infection and drug resistance · 2021Article
- Human Migration and the Spread of the Nematode Parasite Wuchereria bancrofti.Molecular biology and evolution · 2019Article
- Systematic sampling of adults as a sensitive means of detecting persistence of lymphatic filariasis following mass drug administration in Sri Lanka.PLoS neglected tropical diseases · 2019Article
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8 authors at 5 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA global strategy of mass drug administration (MDA) has greatly reduced the burden of lymphatic filariasis (LF) in endemic countries. In Madagascar, the National Programme to eliminate LF has scaled-up annual MDA of albendazole and diethylcarbamazine across the country in the last decade, but its impact on LF transmission has never been reported. The objective of this study was to evaluate progress towards LF elimination in southeastern Madagascar.
methodsThree different surveys were carried out in parallel in four health districts of the Vatovavy Fitovinany region in 2016: i) a school-based transmission assessment survey (TAS) in the districts of Manakara Atsimo, Mananjary, and Vohipeno (following a successful pre-TAS in 2013); ii) a district-representative community prevalence survey in Ifanadiana district; and iii) a community prevalence survey in sentinel and spot-check sites of these four districts. LF infection was assessed using the Alere Filariasis Test Strips, which detect circulating filarial antigens (CFA) of adult worms. A brief knowledge, attitudes and practices questionnaire was included in the community surveys. PRINCIPAL
findingsNone of the 1,825 children sampled in the TAS, and only one in 1,306 children from sentinel and spot-check sites, tested positive to CFA. However, CFA prevalence rate in individuals older than 15 years was still high in two of these three districts, at 3.5 and 9.7% in Mananjary and Vohipeno, respectively. Overall CFA prevalence in sentinel and spot-check sites of these three districts was 2.80% (N = 2,707), but only two individuals had detectable levels of microfilaraemia (0.06%). Prevalence rate estimates for Ifanadiana were substantially higher in the district-representative survey (15.8%; N = 545) than in sentinel and spot-check sites (0.8%; N = 618). Only 51.2% of individuals surveyed in these four districts reported taking MDA in the last year, and 42.2% reported knowing about LF.
conclusionsAlthough TAS results suggest that MDA can be stopped in three districts of southeastern Madagascar, the adult population still presents high CFA prevalence levels. This discordance raises important questions about the TAS procedures and the interpretation of their results.
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