Is it time to rethink how we treat lymphatic filariasis in urban areas?

Is it time to rethink how we treat lymphatic filariasis in urban areas?

New research published today raises questions regarding the effectiveness of the large-scale distribution of medication to treat lymphatic filariasis (LF) in urban areas.

Researchers from the Liverpool School of Tropical Medicine (UK), international NGO Sightsavers, the Noguchi Memorial Institute for Medical Research at the University of Ghana, the Ghana Health Service, and the ministries of health of Burkina Faso and Côte d’Ivoire (West Africa) have found that mass drug administration (MDA) for lymphatic filariasis is often challenging and costly to carry out in urban centres.

What is lymphatic filariasis?

There are 120 million people worldwide infected with LF, which is transmitted via a mosquito bite and often categorised by the substantial enlargement of body parts, causing pain, disability and stigma.

The world’s leading cause of physical disability, LF is one of a group of preventable and treatable conditions known as neglected tropical diseases (NTDs).

The issue with the current treatment

The current treatment programmes for LF in both urban and rural areas focus on the distribution of preventive drugs, disregarding the patient’s infection status.

The scale of the LF challenge and the financial issues surrounding MDA make it difficult to achieve the standard of reaching 65% of the population with medication consistently.

This poses a threat to the global goal of eliminating LF as a public health problem by 2020.

Analysing the approach to treating NTDs

Professor David Molyneux, co-author of the research from the Liverpool School of Tropical Medicine, said: “The problems faced by the filariasis community in addressing these challenges reflect a wider problem of how to tackle urban neglected tropical diseases given the increased rate of rural-urban migration, resource limitations and population heterogeneity.”

The research calls for more detailed studies of how effective MDA is in densely populated towns and cities in Africa.

It also argues that a greater focus needs to be placed on vector control – including repellents, long-lasting insecticidal nets and improved housing structures in African cities – to minimise the risk of contracting LF from mosquito bites.

Simon Bush, a co-author from Sightsavers, added: “The research published today illustrates that we must continue to analyse our approach to treating neglected tropical diseases. Bringing together experts to review the issues identified, along with the resulting consequences for national programmes, is essential.”

The research was published in The Lancet Infectious Diseases.

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