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...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225000256 |
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| 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 |
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