Authors

K K Frempong²; D A Boakye⁴; M Y Osei-Atweneboana¹; S Odoom³; N K Biritwum³; L E Coffeng²; S J Sake²; W Stolk²;  ¹ Council for Scientific and Industrial Research (CSIR)-Water Research Institute, Accra, Ghana;  ² Department of Public Health, Erasmus MC, Rotterdam, Netherlands;  ³ Neglected Tropical Disease Programme, Ghana Health Services, Accra, Ghana;  ⁴ Noguchi Memorial Institute for Medical Research, Accra, Ghana

Discussion

Lymphatic filariasis (LF) is a devastating disease endemic in Ghana. Since the year 2000 mass treatment (MDA) with lbendazole and ivermectin has driven prevalence very low. Over 50% of the 98 endemic districts passed transmission assessment surveys between 2010-2015 and currently stopped MDA. Some areas with infections still undergo treatment. WHO aims at eliminating LF by 2020. This research is to ascertain the possibility of LF elimination in Ghana by the set target. Mf prevalence and coverage data on 480 communities (2000-2015) were obtained from the Ghana Health Services and individual research works. We analyzed observed trends in infection prevalence during 15 years of MDA using the simulation model LYMFASIM, an individual-based stochastic model. The model was fitted to all datapoints jointly, to mimic average trends; it was also fitted to data from individual communities for which we had baseline endemicity data and at least one measurement later in time. The model predicted general trends in infection as observed. A slower-than-expected decline in mf prevalence can be explained by high baseline ndemicity (reflecting unfavourable transmission conditions) with low coverage. LF elimination is possible by 2020 in some communities based on the current strategy of MDA. However, this may require remedial actions such as measures to improve coverage & compliance and use of more effective drugs.