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Mapping exercise to determine need to expand Mass Drug Administration campaign
Elephantiasis is a symptom of filaria.
Four regions have been targeted by the Ministry of Public Health as it advances its fight against lymphatic filariasis also known as filaria. The four regions that have been subjected to Mass Drug Administration [MDA] exercises are Regions Three, Four, Five and 10.
However, the Ministry is currently on a mission to ascertain whether the remaining six regions will require similar attention. According to the Ministry’s Head of Public Relations and Health Promotion, Mr. Terrence Esseboom, “the Ministry is in the process of mapping out the prevalence of microfilaria amongst school aged children in the six regions that are currently not under Mass Drug Administration.”
This tactical move, he explained, is with the aim of identifying specific at-risk populations. “If more than two percent of the children tested in a particular cluster are found to have the antigen to microfilaria in their blood stream, it would indicate that filaria is endemic necessitating MDA there,” Esseboom related.
Microfilariae are the larval stages of filaria worms of which there are many genera and species occurring in birds. The filaria infection is known to spread from person to person by mosquito bites and the adult worm lives in the human lymph vessel, mates and produces millions of microscopic worms.
Esseboom just recently was tasked with disseminating information about this disease to the public. In so doing, he shared that an individual usually takes years after becoming infected for the visible signs of chronic filaria to become apparent. These signs, he said, could include gross swelling of the scrotum in men [hydrocele], the labia [the inner and outer folds of the vulva, at either side of the vagina] in women or gross swelling of the lower legs [elephantiasis]. Elephantiasis has no known cure and can likewise be both disfiguring and debilitating, as such the consequences of having this very obvious disfigurement can include loss of relationships, social isolation, loss of self esteem, and the inability to perform jobs requiring a high mobility.
However, patients with hydrocele sometimes are required to wait for long periods for corrective surgery if they are not in a financial position to pay for this privately.
“This could mean prolonged embarrassment, loss of jobs, social isolation and depression for those unfortunate enough to be both sick and poor,” Esseboom noted.
Moreover, the preventative actions being taken by the Public Health Ministry, through its MDA campaign, is expected to help save hundreds of men and women from the severe social and personal impact of chronic filaria.
The Ministry just recently concluded a second round of its MDA campaign, having started a first in 2017. According to Esseboom, the Ministry “looks forward to the continued cooperation as we fight to break the cycle of transmission of filaria and its negative effect on our population and development.”
According to the Ministry, 86 percent of the target population for the MDA campaign to eliminate filaria was reached during the past year. The campaign is one that saw the administration of 100 mg Diethylcarbamazine [DEC] and 400 mg Albendazole. The doses administered were one DEC and one Albendazole to children age two to five; to those six to 14, two DEC and one albendazole, while those 15 and older were given three DEC and one Albendazole tablets.
According to the Public Health Ministry, at least four additional consecutive years will be required to achieve eligibility of the current regimen of the two drugs.
However, this publication reported earlier this week that the Ministry is aiming to fast-track its MDA campaign efforts by embracing a recommendation of the Pan American Health Organisation/World Health Organisation [PAHO/WHO].
PAHO/WHO has recommended a Triple Therapy tactic using Ivermectin in conjunction with DEC and Albendazole [IDA]. This regimen, it is believed, would only require only two additional years of mass administration, that is, 2019 and 2020.
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