02970nas a2200313   4500000000100000008004100001260003700042653002400079653005700103100001700160700001400177700001400191700001600205700001300221700001400234700001200248700001800260700001300278700002200291700001400313700001400327700001500341245015100356856009900507300001300606490000700619520201600626022001402642       2022                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health1 aAdu Mensah D1 aDebrah LB1 aGyamfi PA1 aRahamani AA1 aOpoku VS1 aBoateng J1 aObeng P1 aOsei-Mensah J1 aKroidl I1 aKlarmann-Schulz U1 aHoerauf A1 aDebrah AY1 aFischer PU00aOccurrence of Lymphatic Filariasis infection after 15 years of mass drug administration in two hotspot districts in the Upper East Region of Ghana  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0010129&type=printable  ae00101290 v163 a<p>Background Lymphatic filariasis (LF) causes chronic morbidity, which usually manifests as lymphedema or hydrocele. Mass drug administration (MDA) began in Kassena Nankana East Municipal (KNEM) and Nabdam, two hotspot districts in the Upper East Region in Ghana, in 2000 and 2005, respectively. This cross-sectional study evaluated the impact of 15 years of MDA on the control of LF as determined by circulating filarial antigen (CFA) and microfilariae assessment in the KNEM and the Nabdam districts.</p>

<p>Methodology/Principal findings A total of 7,453 participants from eight sub-districts in the two hotspot districts (KNEM: N = 4604; Nabdam: N = 2849) were recruited into the study. The overall CFA prevalence as determined by the FTS was 19.6% and 12.8% in the KNEM and Nabdam districts, respectively. Manyoro, a sub-district on the border with Burkina Faso, recorded the highest CFA prevalence of 26% in the KNEM. Assessment of microfilariae and Og4C3 antigen was done from 1009 (KNEM: N = 799 (79.2%); Nabdam: N = 210 (20.8%)) randomly selected FTS-positive (N = 885) and FTS-negative (N = 124) individuals. The Og4C3 antigen was found in 22.6%/23.0% of the selected individuals (KNEM/Nabdam), whereas the night blood revealed microfilariae in only 0.7%/0.5%. Conclusions/Significance Using the WHO endorsed FTS, CFA prevalence exceeded the long-standing &lt;2% threshold—which may need revision and validation. Surprisingly, the Og4C3 ELISA showed positive results in only about one-fifth of the FTS positive samples. However, even this result would not have met the &lt;2% CFA criteria for LF elimination. In contrast, projections from the microfilariae results revealed a halt in LF transmission. The global elimination target was due in 2020 but has been extended to 2030 since this could not be met. Focused MDA intervention intensification on seasonal migrants and non-compliers, and implementation of alternative treatment strategies may suffice for the elimination of the disease.</p>
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