The road to eliminating lymphatic filariasis by 2020

15 Aug 2018

CNTD Background

The Centre for Neglected Tropical Diseases (CNTD) at the Liverpool School of Tropical Medicine was formed in 2009 with a grant from DFID to work towards the goal of elimination of lymphatic filariasis (LF) as a public health problem by 2020 through disease mapping followed by mass drug administration (MDA). 

In 2013, DFID increased its commitment with further funding of £20M over four years to support the scale-up of national programmes delivering treatments for LF across entire populations at risk in 12 countries in sub-Saharan Africa and Asia. In 2014, DFID committed additional funding for morbidity management, which became an integrated part of the overall LF elimination programme.

CNTD supports national NTD programmes in strengthening and increasing their capacity for NTD programme implementation, including carrying out monitoring and evaluation and operational research to provide evidence of elimination.

In July 2017, DFID confirmed a further £8.4M commitment to the programme, extending the end date of the programme to 31 March 2019. 

Key activities and achievements

  • Over 264 million treatments delivered through MDA since the start of the LF programme since 2009.
  • Over 500,000 community drug distributors trained to deliver MDA in 12 countries since 2013.
  • Over 25,000 hydrocele surgeries conducted in nine countries since 2015.
  • Over 22,000 health workers trained in lymphoedema management in nine countries since 2015.

Over the last year (October 2017 to July 2018) an extensive number of activities have been conducted, including: 

  • 17.4 million treatments delivered through MDA.
  • 18% of CNTD-supported districts progressed to post-MDA surveillance and conducted Transmission Assessment Surveys (TAS).
  • 8,000 hydrocele surgeries supported in five countries.
  • 5,700 health workers trained in lymphoedema management in five countries.

Highlights of recent mHealth activities

Since 2015, CNTD has been scaling up the use of its mHealth tool (MeasureSMS morbidity) for reporting LF clinical cases. Health workers have been trained in selected districts across seven countries in Africa and Asia to identify and report the main clinical conditions, namely lymphoedema and hydrocele. 

The mHealth tool enables local health workers to report cases by a simple SMS text message, which is then sent to a server and stored in an online secure database available for in-country partners to use and manage with technical assistance from CNTD. 

To date, the tool has been used to report over 25,000 cases of LF-related morbidity across seven countries. 

Upcoming implementation activities

Over the next six months, the following key activities will take place in CNTD-supported countries:

  • MDA activities will take place in six countries.
  • Impact assessment surveys will be conducted in Dar es Salaam, Tanzania, to assess the impact of MDA in the city with a population of 6 million people.
  • Impact assessment surveys will take place across Zambia, with the potential to confirm that MDA is no longer required in selected areas.
  • Bangladesh and Malawi are completing the final TAS activities in the majority of endemic districts, which will mark an important achievement in completing the WHO requirements for post-MDA surveillance bringing them one step closer to the elimination goal. 
  • MMDP training and hydrocele surgeries will continue to scale up across all 12 countries.
  • CNTD has organised and will chair a symposium at the annual ASTMH Conference on “Enhancing and integrating morbidity management in LF endemic countries to achieve Sustainable Development Goals”. CNTD is part of a group of multidisciplinary initiatives within LSTM that focuses on neglected tropical diseases (NTDs).

For more information contact cntd [at] lstmed [dot] ac [dot] uk, visit the website or follow on Twitter.