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Impact of mass drug administration for elimination of lymphatic filariasis in Nepal.

Abstract Lymphatic filariasis (LF) is a neglected tropical disease transmitted by mosquitoes. Nepal has implemented a national effort to eliminate LF by 2020 through mass drug administration (MDA) using diethylcarbamazine (DEC) and albendazole (ALB). We assessed the impact of MDAs on LF in selected districts of Nepal after the recommended six MDA rounds had been completed.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28723904
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170809
LR  - 20170809
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 7
DP  - 2017 Jul
TI  - Impact of mass drug administration for elimination of lymphatic filariasis in
      Nepal.
PG  - e0005788
LID - 10.1371/journal.pntd.0005788 [doi]
AB  - BACKGROUND: Lymphatic filariasis (LF) is a neglected tropical disease transmitted
      by mosquitoes. Nepal has implemented a national effort to eliminate LF by 2020
      through mass drug administration (MDA) using diethylcarbamazine (DEC) and
      albendazole (ALB). We assessed the impact of MDAs on LF in selected districts of 
      Nepal after the recommended six MDA rounds had been completed. METHODOLOGY AND
      PRINCIPAL FINDINGS: Baseline surveys were conducted in seven districts and
      mapping data were used as baseline in the other three districts before starting
      MDA in 2009. LF antigen (Ag) prevalence ranged from 1.06% to 20% among districts 
      included in the baseline and mapping study. The number of people who received DEC
      and ALB were recorded during each MDA round and population-based cluster surveys 
      were conducted at least once in each district during the life of the program. The
      reported MDA coverage in five districts was consistently at least 65%. Two
      districts achieved the targeted coverage in four out of five rounds and the rest 
      three districts achieved the target only in the first round. A pre-transmission
      assessment survey (pre-TAS) was conducted in one sentinel site and at least one
      spot check site in each of the districts after five MDA rounds. In pre-TAS, all
      the sites of five districts (Pyuthan, Arghakhanchi, Kaski, Bhaktapur, and
      Kathmandu) and all but one spot check site of Lalitpur district had LF Ag < 2%
      (ranging from 0.0% to 1.99%). Transmission assessment survey (TAS) was conducted 
      in six evaluation units (EUs) consisting of six districts qualified on pre-TAS.
      Though MDA coverage of 65% was not achieved in three districts (Kathmandu,
      Lalitpur and Bhaktapur), Nepal government in consultation with World Health
      Organization (WHO) decided to conduct TAS. All six EUs achieved the LF Ag
      threshold required to stop MDA in TAS, despite the low reported MDA coverage in
      those three districts. CONCLUSIONS: Although Nepal has achieved significant
      progress towards LF elimination, five rounds of MDA were not sufficient to
      disrupt the transmission cycle in all districts, probably because of high
      baseline prevalence.
FAU - Ojha, Chet Raj
AU  - Ojha CR
AUID- ORCID: http://orcid.org/0000-0002-6816-8892
AD  - Department of Immunology, Herbert Wertheim College of Medicine, Florida
      International University, Miami, Florida, United States of America.
FAU - Joshi, Basant
AU  - Joshi B
AD  - Leadership for Environment and Development Nepal, Kathmandu, Nepal.
FAU - Kc, Khagendra Prakash
AU  - Kc KP
AD  - Leadership for Environment and Development Nepal, Kathmandu, Nepal.
FAU - Dumre, Shyam Prakash
AU  - Dumre SP
AD  - Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki
      University, Nagasaki, Japan.
FAU - Yogi, Keshav Kumar
AU  - Yogi KK
AD  - World Health Organization, Lalitpur, Nepal.
FAU - Bhatta, Bandana
AU  - Bhatta B
AD  - Save the Children International, Kathmandu, Nepal.
FAU - Adhikari, Tulasi
AU  - Adhikari T
AD  - Epidemiology and Disease Control Division, Ministry of Health and Population,
      Government of Nepal, Kathmandu, Nepal.
FAU - Crowley, Kathryn
AU  - Crowley K
AD  - RTI International, Washington, District of Columbia, United States of America.
FAU - Marasini, Babu Ram
AU  - Marasini BR
AD  - Epidemiology and Disease Control Division, Ministry of Health and Population,
      Government of Nepal, Kathmandu, Nepal.
LA  - eng
PT  - Journal Article
DEP - 20170719
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Filaricides)
RN  - F4216019LN (Albendazole)
RN  - V867Q8X3ZD (Diethylcarbamazine)
SB  - IM
MH  - Albendazole/administration & dosage
MH  - Child
MH  - Diethylcarbamazine/administration & dosage
MH  - Disease Transmission, Infectious/*prevention & control
MH  - Drug Therapy/*methods
MH  - Drug Utilization
MH  - Elephantiasis, Filarial/drug therapy/*epidemiology/*prevention &
      control/transmission
MH  - Female
MH  - Filaricides/*administration & dosage
MH  - Health Services Research
MH  - Humans
MH  - Male
MH  - Nepal/epidemiology
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
PMC - PMC5536438
EDAT- 2017/07/21 06:00
MHDA- 2017/08/10 06:00
CRDT- 2017/07/21 06:00
PHST- 2016/08/02 [received]
PHST- 2017/07/06 [accepted]
PHST- 2017/07/31 [revised]
AID - 10.1371/journal.pntd.0005788 [doi]
AID - PNTD-D-16-01403 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Jul 19;11(7):e0005788. doi:
      10.1371/journal.pntd.0005788. eCollection 2017 Jul.