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. 2011 Jun;84(6):988-93.
doi: 10.4269/ajtmh.2011.10-0610.

A laboratory-based surveillance system for Wuchereria bancrofti in Togo: a practical model for resource-poor settings

Els Mathieu  1 , Ameyo Dorkenoo, Felix K J Otogbe, Philip J Budge, Yao K Sodahlon
Affiliations

A laboratory-based surveillance system for Wuchereria bancrofti in Togo: a practical model for resource-poor settings

Els Mathieu et al. Am J Trop Med Hyg. 2011 Jun.

Abstract

One goal of the Global Program to Eliminate Lymphatic Filariasis (GAELF) is interruption of disease transmission through annual mass drug administration (MDA) in areas where LF prevalence is greater than 1%. After MDAs are completed, the World Health Organization (WHO) recommends a period of passive surveillance before final certification of LF elimination is achieved. Guidelines for such a surveillance system have yet to be developed. This paper describes a surveillance system launched in Togo in 2006. The system uses existing laboratories with technicians on call at night who, among other activities, prepare nocturnal thick blood smears for malaria diagnosis that can also be used for LF diagnosis. During its first 2 years (2006-2007), the system provided geographically disperse sampling nationwide, and 1 of 750 people residing in Togo was tested. Over the same period, the system detected two cases of LF, both from areas previously considered non-endemic. This system could be a cost-effective, sustainable model for WHO-mandated passive surveillance after cessation of MDA.

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Figures

Figure 1.
Figure 1.
Map of Togo indicating the LF-endemic districts (mapping from 2000), districts in which cases were located, and the route of the nomadic Peuhl tribe.
Figure 2.
Figure 2.
Algorithm for responding to a positive thick blood smear.
Figure 3.
Figure 3.
Number of slides submitted per month in 2006 and 2007.
Figure 4.
Figure 4.
Geographic distribution of patients sampled in 2006 and 2007. A plots the number of patients sampled in each location compared with the endemic districts (shown in yellow). B shows the sample plot compared with the underlying population density in Togo.
See this image and copyright information in PMC

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