02939nas a2200349   4500000000100000008004100001653003900042653003000081653001200111653001400123653001800137653002900155653001200184653001700196653003600213653002500249100001100274700001000285700001100295700001300306700001100319700001100330700001400341700001200355700001700367245010200384856007700486300000700563490000600570520199900576022001402575       2018                            d10aNeglected tropical diseases (NTDs)10aLymphatic filariasis (LF)10aMapping10aModelling10aElephantiasis10aMass drug administration10aMyanmar10aSurveillance10aTransmission assessment surveys10aWuchereria bancrofti1 aAye NN1 aLin Z1 aLon KN1 aLinn NYY1 aNwe TW1 aMon KM1 aRamaiah K1 aBetts H1 aKelly-Hope L00aMapping and modelling the impact of mass drug adminstration on filariasis prevalence in Myanmar.  uhttps://idpjournal.biomedcentral.com/track/pdf/10.1186/s40249-018-0420-9  a560 v73 a<p><strong>BACKGROUND: </strong>Lymphatic filariasis (LF) is endemic in Myanmar and targeted for elimination. To highlight the National Programme to Eliminate Lymphatic Filariasis (NPELF) progress between 2000 and 2014, this paper describes the geographical distribution of LF, the scale-up and impact of mass drug administration (MDA) implementation, and the first evidence of the decline in transmission in five districts.</p>

<p><strong>METHODS: </strong>The LF distribution was determined by mapping historical and baseline prevalence data collected by NPELF. Data on the MDA implementation, reported coverage rates and sentinel site surveillance were summarized. A statistical model was developed from the available prevalence data to predict prevalence at township level by year of measurement. Transmission assessment survey (TAS) methods, measuring antigenemia (Ag) prevalence in children, were used to determine whether prevalence was below a level where recrudescence is unlikely to occur.</p>

<p><strong>RESULTS: </strong>The highest baseline LF prevalence was found in the Central Valley region. The MDA implementation activities scaled up to cover 45 districts, representing the majority of the endemic population, with drug coverage rates ranging from 60.0% to 98.5%. Challenges related to drug supply and local conflict were reported, and interrupted MDA in some districts. Overall, significant reductions in LF prevalence were found, especially after the first 2 to 3 rounds of MDA, which was supported by the corresponding model. The TAS activities in five districts found&nbsp;only two Ag positive children, resulting in all districts passing the critical threshold.</p>

<p><strong>CONCLUSION: </strong>Overall, the Myanmar NPELF has made positive steps forward in the elimination of LF despite several challenges, however, it needs to maintain momentum, drawing on international stakeholder support, to aim towards the national and global goals of elimination.</p>
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