02654nas a2200241   4500000000100000008004100001653001400042653003900056653001200095653002500107653001200132653002700144100001700171700001400188700001200202700001300214700001600227700001300243700001100256245016700267856013500434520184300569       2017                            d10aTreatment10aNeglected tropical diseases (NTDs)10aMapping10aLymphatic filariasis10aLoa loa10aElimination programmes1 aKelly-Hope L1 aStanton M1 aZoure H1 aKinvi BE1 aMikhailov A1 aTekle AH1 aKing J00aA practical approach for scaling up the alternative strategy for the elimination of lymphatic filariasis in Loa loa endemic countries - developing an action plan.  uhttp://ghrp.biomedcentral.com/articles/10.1186/s41256-017-0032-0http://link.springer.com/content/pdf/10.1186/s41256-017-0032-0.pdf3 a<div>
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<h3>Background<br />
Lymphatic filariasis (LF) is a vector-borne parasitic disease that is being targeted for elimination through mass drug administration (MDA). The co-distribution of <em>Loa loa</em> in Central Africa poses a significant barrier to the expansion of the MDA due to risk of severe adverse events (SAEs) associated with the drug ivermectin that is routinely used. National LF programmes are yet to significantly scale up in co-endemic areas and need a practical approach to make preliminary decisions based on the mapping status and potential treatment strategies.</h3>
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<h3>Methods<br />
We reviewed relevant data available to WHO and in the literature for LF-<em>L. loa</em> endemic countries to develop a simple method to support the scale-up of MDA to eliminate LF.</h3>
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<h3>Results<br />
A basic model for national LF programmes to work from at the administrative or implementation unit (IU) level has been developed for LF – <em>L. loa</em> co-endemic countries. The model includes five practical steps, which comprise the development of a national filarial database and a simple classification system to help determine the mapping status and most appropriate treatment strategy. Steps are colour-coded and linked to a general decision tree, which is also presented.</h3>
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<h3>Conclusions<br />
This IU-level model is simple to follow and will help LF elimination programmes develop an action plan and scale up the implementation of alternative treatment strategies in <em>L. loa</em> co-endemic areas. The model could be further developed to incorporate the additional complexity of IUs where an intervention is required to eliminate onchocerciasis, particularly in hypo-endemic areas where ivermectin has not been used.</h3>
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