Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping

Objectives: Zimbabwe is endemic for lymphatic filariasis (LF) with 39 districts identified for mass drug administration (MDA) in 2014. The objective of this study was to reassess the current population requiring MDA. Methods: The LF confirmatory mapping method was used to evaluate the prevalence of...

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Main Authors: Nicholas Midzi, Masceline Jenipher Mutsaka-Makuvaza, Isaac Phiri, Karen Palatio, Didier Bakajika, Honorat M. Zouré, Elizabeth Juma, Molly Anderson, Rebecca Mwabvu, Moses J. Bockarie, Jorge Cano, Sammy M. Njenga
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225000153
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author Nicholas Midzi
Masceline Jenipher Mutsaka-Makuvaza
Isaac Phiri
Karen Palatio
Didier Bakajika
Honorat M. Zouré
Elizabeth Juma
Molly Anderson
Rebecca Mwabvu
Moses J. Bockarie
Jorge Cano
Sammy M. Njenga
author_facet Nicholas Midzi
Masceline Jenipher Mutsaka-Makuvaza
Isaac Phiri
Karen Palatio
Didier Bakajika
Honorat M. Zouré
Elizabeth Juma
Molly Anderson
Rebecca Mwabvu
Moses J. Bockarie
Jorge Cano
Sammy M. Njenga
author_sort Nicholas Midzi
collection DOAJ
description Objectives: Zimbabwe is endemic for lymphatic filariasis (LF) with 39 districts identified for mass drug administration (MDA) in 2014. The objective of this study was to reassess the current population requiring MDA. Methods: The LF confirmatory mapping method was used to evaluate the prevalence of circulating filarial antigens among school-aged children (9-14 years) in previously endemic districts. This was achieved through a cross-sectional survey between 2021 and 2023, applying a cluster sampling approach across 39 districts, targeting 18,720 children to assess ongoing LF transmission. Results: The findings revealed a significant decline in LF prevalence, with an overall rate of 0.43%. Importantly, 82.05% of districts previously identified as endemic were reclassified as nonendemic. Only seven districts retained endemic status, necessitating continued MDA using the triple-drug therapy regimen. Population estimates based on 2022 census data indicated that 1.19 million individuals across these districts require MDA, representing an 84.4% reduction compared to previous estimates. Despite the progress, the persistence of low-level transmission in certain districts highlights the need for sustained surveillance and morbidity management services, including hydrocele surgery and lymphedema care. Conclusion: There was a significant reduction in the number of people requiring MDA. The decline in LF endemicity is attributed to a combination of factors, including prior rounds of MDA and vector control initiatives including historical interventions, such as dichlorodiphenyltrichloroethane spraying against human African trypanosomiasis.
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spelling doaj-art-0fa2f458a6324fbb95910032f7ce882e2025-08-20T02:11:00ZengElsevierInternational Journal of Infectious Diseases1201-97122025-03-0115210779110.1016/j.ijid.2025.107791Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mappingNicholas Midzi0Masceline Jenipher Mutsaka-Makuvaza1Isaac Phiri2Karen Palatio3Didier Bakajika4Honorat M. Zouré5Elizabeth Juma6Molly Anderson7Rebecca Mwabvu8Moses J. Bockarie9Jorge Cano10Sammy M. Njenga11National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe; Corresponding author: Nicholas Midzi, National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe.National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe; Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, Butare, RwandaNational Institute of Health Research, Ministry of Health and Child Care, Harare, ZimbabweEND Fund, New York, NY, USAExpanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Republic of CongoExpanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Republic of CongoExpanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Republic of CongoEND Fund, New York, NY, USAHigherlife Foundation, Harare, ZimbabweCollege of Medical Sciences, Njala University, Bo Campus, Freetown, Sierra LeoneExpanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Republic of CongoKenya Medical Research Institute, Nairobi, KenyaObjectives: Zimbabwe is endemic for lymphatic filariasis (LF) with 39 districts identified for mass drug administration (MDA) in 2014. The objective of this study was to reassess the current population requiring MDA. Methods: The LF confirmatory mapping method was used to evaluate the prevalence of circulating filarial antigens among school-aged children (9-14 years) in previously endemic districts. This was achieved through a cross-sectional survey between 2021 and 2023, applying a cluster sampling approach across 39 districts, targeting 18,720 children to assess ongoing LF transmission. Results: The findings revealed a significant decline in LF prevalence, with an overall rate of 0.43%. Importantly, 82.05% of districts previously identified as endemic were reclassified as nonendemic. Only seven districts retained endemic status, necessitating continued MDA using the triple-drug therapy regimen. Population estimates based on 2022 census data indicated that 1.19 million individuals across these districts require MDA, representing an 84.4% reduction compared to previous estimates. Despite the progress, the persistence of low-level transmission in certain districts highlights the need for sustained surveillance and morbidity management services, including hydrocele surgery and lymphedema care. Conclusion: There was a significant reduction in the number of people requiring MDA. The decline in LF endemicity is attributed to a combination of factors, including prior rounds of MDA and vector control initiatives including historical interventions, such as dichlorodiphenyltrichloroethane spraying against human African trypanosomiasis.http://www.sciencedirect.com/science/article/pii/S1201971225000153Lymphatic filariasisMass drug administrationConfirmatory mappingTripple therapyNeglected tropical diseases
spellingShingle Nicholas Midzi
Masceline Jenipher Mutsaka-Makuvaza
Isaac Phiri
Karen Palatio
Didier Bakajika
Honorat M. Zouré
Elizabeth Juma
Molly Anderson
Rebecca Mwabvu
Moses J. Bockarie
Jorge Cano
Sammy M. Njenga
Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
International Journal of Infectious Diseases
Lymphatic filariasis
Mass drug administration
Confirmatory mapping
Tripple therapy
Neglected tropical diseases
title Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
title_full Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
title_fullStr Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
title_full_unstemmed Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
title_short Shrinking the lymphatic filariasis map of Zimbabwe: Reassessing the population requiring treatment through confirmatory mapping
title_sort shrinking the lymphatic filariasis map of zimbabwe reassessing the population requiring treatment through confirmatory mapping
topic Lymphatic filariasis
Mass drug administration
Confirmatory mapping
Tripple therapy
Neglected tropical diseases
url http://www.sciencedirect.com/science/article/pii/S1201971225000153
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