Infectious Diseases in the Local Context Lymphatic Filariasis

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Infectious Diseases in the Local Context -
Lymphatic Filariasis

• Lita Crisologo-Vizconde, MD
• Centennial Professorial Lecturer, UP Manila
• Past President, PSMID
• Secretary, CELF - Philppines

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Outline

• Introduction
• Issues/ Challenges/ Constraints
• Recommendations

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Burden of Disease

• 1.254 billion population at risk in 83 countries
• 120 million people in tropical and subtropical
  areas of the world are infected
• 2nd leading cause of disability
• Almost 25 million men suffer from genital disease
  (most commonly hydrocoele)
• Around 15 million people mainly women have
  lymphoedema

.
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LF Endemic Countries Territories
2006,
WHO
Bangladesh, Democratic Republic of Congo, India,
Indonesia, Madagascar, Nigeria Philippines are
among most highly endemic countries.
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LF Endemicity Status in Mekong Area - WHO
Population at-risk 21.3 M - Phil 1.2 M -
Malaysia 0.68M - Vietnam 0.44M - Cambodia
gt90
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Factors Favorable for Elimination of LF - WHO

• Biological factors
• Available tools
• Operational feasibility

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Biological Factors

• Man is the only reservoir host
• Prolonged exposure with multiple mosquito bites
  is required to establish infection in a new host
• Vectors are not efficient biological transmitters
  hence feasible to interrupt transmission once the
  parasite load in the individual is reduced
•  

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Available Tools

• Low cost, safe very effective drugs for
  prevention of infection treatment of morbid
  cases
• Diagnostic kits monitoring tools to detect
  infection in man mosquito
• Cost-effective control technology has been
  developed for elimination of LF in endemic
  countries
•  

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Operational Feasibility

• Some countries have had the rich experiences in
  the time-bound successful elimination of LF
• Community cooperation has been found to be very
  encouraging when LF elimination programme was
  integrated with the control of intestinal
  helminthic infections      
• The infrastructure for implementation of the
  programme is available in endemic countries      

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Operational Feasibility

• The recommended interventions strategy is simple,
  safe effective, and is well accepted
• Clear guidelines are available for all aspects of
  programme implementation
• Reasonable cost of interventions, including
  availability of one of the two MDA drugs, which
  is being supplied free of charge by donors
  (albendazole by GSK and ivermectine by Merck
  Co.) is pledged until 2020

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Mass Drug Administration (MDA)

• To interrupt the transmission of lymphatic
  filariasis, WHO recommends MDA with
  diethylcarbamazine (DEC) albendazole to the
  entire endemic population.
• A single dose is administered annually for 4-6
  years.

Excluded are children below two years and
pregnant women.
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Issues/Challenges/Constraints

• Availability of DEC for nationwide MDA
• MDA coverage of 68
• Prevention alleviation of disability
• Commitment of all stakeholders

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Recommendations

• DOH commitment on DEC nationwide MDA
• Strengthen expand the Coalition for the
  Elimination of Lymphatic Filariasis (CELF- Phil)
• LGU partnerships
• Private sector involvement
• Formation of Provincial CELF

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CELF - Philippines Partners
DENR
League of Cities of the Philippines
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CELF - Philippines
Surigao
Bicol
Sulu (PACAP)
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Partnerships
It is an accepted fact that no health programme
can succeed solely through governmental efforts.

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Let Us Work Together for a

Filariasis-Free Philippines!