Lymphatic Filariasis elimination (LFE)


Lymphatic filariasis is caused by thread-like parasitic worms of the species Wunchereria bancrofti, called filariae. These filarial parasites, in their adult stage, live in the vessels of the lymphatic system for 4-6 years, producing millions of very small larvae - immature microfilariae that circulate in the peripheral blood. The infection is transmitted by mosquitoes that bite infected humans and pick up the microfilariae from the blood.

Acute manifestations of lymphatic filariasis commonly include local symptoms such as swelling, warmth, redness, and pain of the affected area. Most pronounced chronic manifestations of the disease comprise of lymphoedema, elephantiasis, and hydrocele. The disease is rarely fatal but characteristically disfiguring, and resulting in stigmatization. In addition, LF is also closely associated with conditions of extreme poverty and considerable psycho-social burden.

Of the 120 million people that are at risk for LF in 80 countries world wide, the African region accounts for about 38% of the global estimate.

The World Health Assembly Resolution WHA 50.29 calls for the elimination of lymphatic filariasis as a global public health problem within a period of 20 years. As a consequence, a Global Programme for Elimination of Lymphatic Filariasis (GPELF) was launched, and each endemic member country is expected to set up a Programme for Elimination of Lymphatic Filariasis (PELF). Indeed most endemic countries in Africa have now set up their elimination programs.

The programme to eliminate lymphatic filariasis as a public health problem aims at interrupting transmission of infection through annual mass drug administration of at risk population with ivermectin or diethylcarbamizine citrate (DEC) in combination with albendazole for 5- 6 years. Disability prevention and management is carried out as a complementary strategy, mostly through hydrocele surgery and lyphoedema management.

The Regional LF elimination program has accomplished the following to date:

  • Assessment of lymphatic filariasis disease burden has been completed in 26 out of the 39 endemic countries and is in progress in 11 more countries;
  • More than 50 million people have benefited from treatment through mass drug administration activities in 2008 alone - up from 47.2 million in the year 2007. Over 209.6 million cumulative treatments have been delivered from 2000 - 2008.
  • Interruption of transmission of lymphatic filariasis has been achieved through mass drug administration in Togo and in Zanzibar;

The Lymphatic Filariasis elimination program is made possible due to the drug donations of Ivermectin by Merck & Co. and albendazole by Glaxosmithkline, commitments from communities and National Governments and their in-country partners, and technical support from LF Support Centres in USA, UK and Africa. Other partners include The Global Alliance for Elimination of Lymphatic Filariasis (GAELF) and non-governmental development organizations, mainly supporting disability management and prevention activities in national programmes.