Assessment of transmission in areas of uncertain endemicity for lymphatic filariasis in Brazil

The objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been sub...

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Bibliographic Details
Published in:	PLoS neglected tropical diseases Vol. 13; no. 11; p. e0007836
Main Authors:	Xavier, Amanda, Oliveira, Heloize, Aguiar-Santos, Ana, Barbosa Júnior, Walter, da Silva, Ellyda, Braga, Cynthia, Bonfim, Cristine, Medeiros, Zulma
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 01-11-2019 Public Library of Science (PLoS)
Subjects:	Adolescent Allochthonous deposits Analysis Anopheles Antigens Aquatic insects Brazil - epidemiology Breeding grounds Breeding sites Child Children Confidence intervals Disease Eradication Disease Transmission, Infectious - prevention & control Elementary school students Elephantiasis, Filarial - epidemiology Elephantiasis, Filarial - prevention & control Elephantiasis, Filarial - transmission Endemism Epidemiology Family Female Filariasis Filaricides - therapeutic use Health surveillance Humans Infections Literature reviews Male Mass Drug Administration Medicine and Health Sciences Metropolitan areas Mosquitoes Municipalities Organizations People and places Polls & surveys Population Prevalence Public health Public health movements Schools Social Sciences Surveying Surveys Transmission Tropical diseases Vector-borne diseases Brazil
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Summary:	The objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been subjected to mass drug administration (MDA) and in places adjoining these endemic areas. While three municipalities in Brazil have completed MDA, the epidemiological situation remains uncertain in nine adjoining municipalities. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil. For review of the literature, both formal and informal literature sources were accessed since the first reports of filariasis in the Metropolitan Region of Recife, Brazil. We conducted a school-based survey in 2016 using immunochromatographic card tests (ICTs) among schoolchildren aged 6-10 years living in nine municipalities contiguous with the endemic areas in which MDA was conducted. Our review of the literature identified eight studies involving surveys demonstrating that microfilariae had been circulating in eight of the municipalities since 1967, with a low prevalence of microfilaremia, isolated autochthonous cases, and treatment of individual cases. The school-based survey included 17,222 children in 185 urban schools in the nine areas of Brazil with uncertain endemicity. One child affected by allochthonous transmission was antigen positive based on ICT and lived in a municipality adjacent to Recife; this child's family came from Recife, but no other case was diagnosed within the family. The study results suggest that there is no transmission of LF in the municipalities investigated. However, these areas have population migration and socioenvironmental conditions favorable to mosquito breeding grounds; therefore, surveillance is strongly recommended in these areas.
Bibliography:	new_version ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 The authors have declared that no competing interests exist.
ISSN:	1935-2735 1935-2727 1935-2735
DOI:	10.1371/journal.pntd.0007836