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Shrinking the Lymphatic Filariasis Map of Ethiopia: Reassessing the Population at Risk through Nationwide Mapping.

P Rebollo M, Sime H, Assefa A, Cano J, Deribe K, Gonzalez-Escalada A, Shafi O, Davey G, Brooker SJ, Kebede A, Bockarie MJ - PLoS Negl Trop Dis (2015)

Bottom Line: In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities.Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission.We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale.

View Article: PubMed Central - PubMed

Affiliation: Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom.

ABSTRACT

Background: Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated.

Methodology/principal finding: A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities. Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission. Combining these results with other data it is estimated that 11 580 010 people in 112 woredas will be exposed to infection in 2016.

Conclusions: We have conducted nationwide mapping of LF in Ethiopia and demonstrated that the number of people living in LF endemic areas is 60% lower than current estimates. We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale.

No MeSH data available.


Related in: MedlinePlus

Map showing the locations of 1315 communities surveyed in Ethiopia during the mapping project in 2013.Eighty-nine communities in which one or more persons out of 100 individuals tested were found to be positive for circulating filarial antigen (CFA) are shown in red. Communities where no positive individuals were identified after testing approximately 100 adults are marked in blue.
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pntd.0004172.g001: Map showing the locations of 1315 communities surveyed in Ethiopia during the mapping project in 2013.Eighty-nine communities in which one or more persons out of 100 individuals tested were found to be positive for circulating filarial antigen (CFA) are shown in red. Communities where no positive individuals were identified after testing approximately 100 adults are marked in blue.

Mentions: In total, 140 people were found to be positive for CFA by ICT performed in 89 different communities (Table 1). The median age of CFA-positive individuals was 35.8 (IQR: 25–41.5) years with range between 15 and 80 years. Fig 1 shows the location of all 1315 communities that were surveyed and the distribution of the 89 communities with CFA positive individuals. Communities with CFA positive individuals were observed in all the regions surveyed with the exception of Somali and the two city administration councils of Addis Ababa and Dire Dawa. Only one community was shown to be positive in the Afar Region. Communities with positive individuals were equally distributed in the northern and southern parts of the country. The CFA positivity rates for males and females in the endemic woredas were 0.8% (60/7443) and 1.1% (80/7429), respectively.


Shrinking the Lymphatic Filariasis Map of Ethiopia: Reassessing the Population at Risk through Nationwide Mapping.

P Rebollo M, Sime H, Assefa A, Cano J, Deribe K, Gonzalez-Escalada A, Shafi O, Davey G, Brooker SJ, Kebede A, Bockarie MJ - PLoS Negl Trop Dis (2015)

Map showing the locations of 1315 communities surveyed in Ethiopia during the mapping project in 2013.Eighty-nine communities in which one or more persons out of 100 individuals tested were found to be positive for circulating filarial antigen (CFA) are shown in red. Communities where no positive individuals were identified after testing approximately 100 adults are marked in blue.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4634982&req=5

pntd.0004172.g001: Map showing the locations of 1315 communities surveyed in Ethiopia during the mapping project in 2013.Eighty-nine communities in which one or more persons out of 100 individuals tested were found to be positive for circulating filarial antigen (CFA) are shown in red. Communities where no positive individuals were identified after testing approximately 100 adults are marked in blue.
Mentions: In total, 140 people were found to be positive for CFA by ICT performed in 89 different communities (Table 1). The median age of CFA-positive individuals was 35.8 (IQR: 25–41.5) years with range between 15 and 80 years. Fig 1 shows the location of all 1315 communities that were surveyed and the distribution of the 89 communities with CFA positive individuals. Communities with CFA positive individuals were observed in all the regions surveyed with the exception of Somali and the two city administration councils of Addis Ababa and Dire Dawa. Only one community was shown to be positive in the Afar Region. Communities with positive individuals were equally distributed in the northern and southern parts of the country. The CFA positivity rates for males and females in the endemic woredas were 0.8% (60/7443) and 1.1% (80/7429), respectively.

Bottom Line: In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities.Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission.We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale.

View Article: PubMed Central - PubMed

Affiliation: Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom.

ABSTRACT

Background: Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated.

Methodology/principal finding: A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities. Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission. Combining these results with other data it is estimated that 11 580 010 people in 112 woredas will be exposed to infection in 2016.

Conclusions: We have conducted nationwide mapping of LF in Ethiopia and demonstrated that the number of people living in LF endemic areas is 60% lower than current estimates. We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale.

No MeSH data available.


Related in: MedlinePlus