Evaluation of the effect of mass drug administration against lymphatic filariasis in three health districts and public health implications: study of 12 epidemiological surveillance sites in Burkina Faso.

Abstract

The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and ivermectin (150-200 μm/kg) since 2001 has helped to change the epidemiological profile of lymphatic filariasis (LF) in many health districts in Burkina Faso. From 2002 to 2016, 14 rounds of MDA have taken place in the Central East zone, with therapeutic coverage exceeding 65%. The objective of the current study was to evaluate the impact of MDA in the fight against LF at 12 sentinel and spot-check sites. This descriptive cross-sectional study surveyed subjects aged 5 years and older between April and July 2017 at these 12 sites. The blood smear performed on nocturnal samples was used to diagnose Wuchereria bancrofti infection. The study included 4364 subjects. Their mean age was 20.55 years with a standard deviation of 14.22 and a range of 5 to 96 years. The overall prevalence of microfilaremia was 0.62% (27/4364), with rates exceeding 1% at three (3) sites. The average microfilaremia density was 106 μf/mL. The overall prevalence of morbidity was low (0.91%), predominantly lymphedema (0.60%). The MDA strategy has helped to reduce the prevalence of LF significantly in Burkina Faso, but some outbreaks still have microfilarial prevalence greater than 1%. Continuation of the additional 2-year strategy with improved adherence to treatment and vector control would help break LF transmission.