Advancing toward the Elimination of Lymphatic Filariasis.

The Global Program to Eliminate Lymphatic Filariasis (GPELF) was established in 2000 after the adoption of a World Health Assembly resolution in 1997 that called for member states of the World Health Organization (WHO) to eliminate lymphatic filariasis as a public health problem. The condition is caused by one of three filarial parasites. Wuchereria bancrofti, the most common of the three, causes 90% of lymphatic filariasis infections worldwide and is transmitted by several genera of mosquitoes — anopheles, aedes, mansonia, and culex. The strategy, known as preventive chemotherapy, is annual treatment by means of mass drug administration of a two-drug combination of diethylcarbamazine and albendazole to all those eligible (with the exclusion of children younger than 2 years of age, pregnant women, and the very sick) in all countries except where onchocerciasis is coendemic (most of Africa and Yemen), in which case a combination of ivermectin and albendazole is used (with the exclusion of children shorter than 90 cm, pregnant women, and the very sick) because of the potential side effects of diethylcarbamazine in patients with onchocerciasis. The strategy is based on the premise that treatments reduce the number of microfilarial parasites circulating in the blood to a level at which transmission by mosquitoes is not sustainable.