Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana

Objectives: Lymphatic filariasis (LF) elimination efforts in Ghana have been ongoing since 2001, achieving substantial progress through mass drug administration (MDA). However, despite significant advances, LF transmission persists in certain areas. Some districts previously classified as nonendemic...

Full description

Saved in:
Bibliographic Details
Main Authors: Joseph L. Opare, Dziedzom K. de Souza, Bright Alomatu, Ernest Mensah, Emmanuel Nyarko, Odame Asiedu, Judith Saare, Charles Brown-Davies, Irene D. Dzathor, Achille Kabore, Ernest O. Mensah
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:International Journal of Infectious Diseases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225000256
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850044635045429248
author Joseph L. Opare
Dziedzom K. de Souza
Bright Alomatu
Ernest Mensah
Emmanuel Nyarko
Odame Asiedu
Judith Saare
Charles Brown-Davies
Irene D. Dzathor
Achille Kabore
Ernest O. Mensah
author_facet Joseph L. Opare
Dziedzom K. de Souza
Bright Alomatu
Ernest Mensah
Emmanuel Nyarko
Odame Asiedu
Judith Saare
Charles Brown-Davies
Irene D. Dzathor
Achille Kabore
Ernest O. Mensah
author_sort Joseph L. Opare
collection DOAJ
description Objectives: Lymphatic filariasis (LF) elimination efforts in Ghana have been ongoing since 2001, achieving substantial progress through mass drug administration (MDA). However, despite significant advances, LF transmission persists in certain areas. Some districts previously classified as nonendemic have reported lymphedema and hydrocele cases, raising concerns about LF endemicity. To address these gaps, a confirmatory mapping survey was conducted to reassess LF prevalence in districts with uncertain morbidity. Methods: A cross-sectional survey using the WHO-approved LF confirmatory mapping tool was conducted in 38/261 districts Ghana. Schoolchildren aged 9-14 years were randomly selected using the TAS Survey Sample Builder tool. Circulating filarial antigen (CFA) levels were measured using the Filaria Test Strip (FTS). Districts were classified as endemic if more than three positive cases were identified out 480 sampled. Subdistrict-level community surveys were conducted to confirm findings. Results: A total of 18,459 children were tested across the selected districts. Positive antigen cases were detected in 17 districts, with two districts (Nkoranza South and Wenchi Municipal) exceeding the critical threshold of three positive cases. Subdistrict surveys further confirmed high antigen prevalence of 1.68% (95% CI, 0.92-2.80; range: 1.00-5.00) and 4.73% (95% CI, 3.35-6.46; range: 0.96-14.29) in the Nkoranza South and Wenchi Municipal districts respectively. Conclusion: The confirmatory mapping survey revealed ongoing LF transmission in two previously classified nonendemic districts. These districts were reclassified as endemic, requiring MDA. Treatment has therefore been initiated in the Nkoranza South and Wenchi Municipal districts. This study underscores the importance of reassessing endemicity and implementing targeted interventions in areas with uncertain LF transmission.
format Article
id doaj-art-fe91a97e4af24b849abeb06956c14ecd
institution DOAJ
issn 1201-9712
language English
publishDate 2025-03-01
publisher Elsevier
record_format Article
series International Journal of Infectious Diseases
spelling doaj-art-fe91a97e4af24b849abeb06956c14ecd2025-08-20T02:54:53ZengElsevierInternational Journal of Infectious Diseases1201-97122025-03-0115210780110.1016/j.ijid.2025.107801Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in GhanaJoseph L. Opare0Dziedzom K. de Souza1Bright Alomatu2Ernest Mensah3Emmanuel Nyarko4Odame Asiedu5Judith Saare6Charles Brown-Davies7Irene D. Dzathor8Achille Kabore9Ernest O. Mensah10Ghana Health Service, Neglected Tropical Diseases Programme, Accra, GhanaNoguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, GhanaGhana Health Service, Neglected Tropical Diseases Programme, Accra, GhanaGhana Health Service, Neglected Tropical Diseases Programme, Accra, GhanaGhana Health Service, Neglected Tropical Diseases Programme, Accra, GhanaGhana Health Service, Neglected Tropical Diseases Programme, Accra, GhanaGhana Health Service, Neglected Tropical Diseases Programme, Accra, GhanaFHI 360, Accra, GhanaFHI 360, Accra, GhanaFHI 360, Washington DC, USAFHI 360, Abidjan, Cote d'Ivoire; Corresponding author.Objectives: Lymphatic filariasis (LF) elimination efforts in Ghana have been ongoing since 2001, achieving substantial progress through mass drug administration (MDA). However, despite significant advances, LF transmission persists in certain areas. Some districts previously classified as nonendemic have reported lymphedema and hydrocele cases, raising concerns about LF endemicity. To address these gaps, a confirmatory mapping survey was conducted to reassess LF prevalence in districts with uncertain morbidity. Methods: A cross-sectional survey using the WHO-approved LF confirmatory mapping tool was conducted in 38/261 districts Ghana. Schoolchildren aged 9-14 years were randomly selected using the TAS Survey Sample Builder tool. Circulating filarial antigen (CFA) levels were measured using the Filaria Test Strip (FTS). Districts were classified as endemic if more than three positive cases were identified out 480 sampled. Subdistrict-level community surveys were conducted to confirm findings. Results: A total of 18,459 children were tested across the selected districts. Positive antigen cases were detected in 17 districts, with two districts (Nkoranza South and Wenchi Municipal) exceeding the critical threshold of three positive cases. Subdistrict surveys further confirmed high antigen prevalence of 1.68% (95% CI, 0.92-2.80; range: 1.00-5.00) and 4.73% (95% CI, 3.35-6.46; range: 0.96-14.29) in the Nkoranza South and Wenchi Municipal districts respectively. Conclusion: The confirmatory mapping survey revealed ongoing LF transmission in two previously classified nonendemic districts. These districts were reclassified as endemic, requiring MDA. Treatment has therefore been initiated in the Nkoranza South and Wenchi Municipal districts. This study underscores the importance of reassessing endemicity and implementing targeted interventions in areas with uncertain LF transmission.http://www.sciencedirect.com/science/article/pii/S1201971225000256Lymphatic filariasisConfirmatory mappingMass drug administrationGhana
spellingShingle Joseph L. Opare
Dziedzom K. de Souza
Bright Alomatu
Ernest Mensah
Emmanuel Nyarko
Odame Asiedu
Judith Saare
Charles Brown-Davies
Irene D. Dzathor
Achille Kabore
Ernest O. Mensah
Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana
International Journal of Infectious Diseases
Lymphatic filariasis
Confirmatory mapping
Mass drug administration
Ghana
title Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana
title_full Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana
title_fullStr Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana
title_full_unstemmed Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana
title_short Confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in Ghana
title_sort confirmatory mapping for lymphatic filariasis in districts previously considered nonendemic in ghana
topic Lymphatic filariasis
Confirmatory mapping
Mass drug administration
Ghana
url http://www.sciencedirect.com/science/article/pii/S1201971225000256
work_keys_str_mv AT josephlopare confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT dziedzomkdesouza confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT brightalomatu confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT ernestmensah confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT emmanuelnyarko confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT odameasiedu confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT judithsaare confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT charlesbrowndavies confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT ireneddzathor confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT achillekabore confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana
AT ernestomensah confirmatorymappingforlymphaticfilariasisindistrictspreviouslyconsiderednonendemicinghana