Authors

D de Souza¹;  ¹ University of Ghana, Ghana

Discussion

The establishment of Global Programme to Eliminate Lymphatic Filariasis (GPELF) in the year 2000 was made possible by the availability of an easy-to-use rapid diagnostic test and the drugs ivermectin, albendazole and diethylcarbamazine. At the onset of programme and based on modelling studies, it was assumed that 5 to 6 years of treatment with 80% coverage of the entire population should be sufficient to break the cycle of transmission of W. bancrofti and Brugia spp. and eliminate LF as a disease of public health concern in endemic communities. Since the launch of the GPELF there has been significant progress with many implementation units stopping mass drug administration (MDA). However, the infection persists in many endemic country settings despite more than two decades of control activities. Using Ghana as an example, we will delve into the LF situation in one of the first countries to implement MDA using ivermectin and albendazole, based on the WHO guidelines for countries that are co-endemic for LF and onchocerciasis and where the antigen prevalence is above 2%. Monitoring and impact assessments of the Ghana LF programme followed WHO guidelines and protocols. However, in the implementation of these guidelines various challenges were encountered. This presentation is an overview of the evolution of the LF situation in Ghana, the impact of MDA on the transmission of LF, the challenges encountered, the role of vectors in the persistent transmission, and current studies to address the endgame challenges.