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. 2022 May 28;15(1):181.
doi: 10.1186/s13071-022-05268-w.

A refined and updated health impact assessment of the Global Programme to Eliminate Lymphatic Filariasis (2000-2020)

Hugo C Turner  1 , Eric A Ottesen  2 , Mark H Bradley  3
Affiliations

A refined and updated health impact assessment of the Global Programme to Eliminate Lymphatic Filariasis (2000-2020)

Hugo C Turner et al. Parasit Vectors. .

Abstract

Background: Lymphatic filariasis (LF) is a neglected tropical disease (NTD). In 2000 the World Health Organization (WHO) established the Global Programme to Eliminate Lymphatic Filariasis (GPELF). A key component of this programme is mass drug administration (MDA). Between 2000 and 2020, the GPELF has delivered over 8.6 billion treatments to at-risk populations. The last impact assessment of the programme evaluated the treatments provided between 2000-2014. The goal of this analysis is to provide an updated health impact assessment of the programme, based on the numbers treated between 2000-2020.

Methods: We updated and refined a previously established model that estimates the number of clinical manifestations and disability-adjusted life years (DALYs) averted by the treatments provided by the GPELF. The model comprises three different population cohorts that can benefit from MDA provided (those protected from acquiring infection, those with subclinical morbidity prevented from progressing and those with clinical disease alleviated). The treatment numbers were updated for all participating countries using data from the WHO. In addition, data relating to the estimated number of individuals initially at risk of LF infection were updated where possible. Finally, the DALY calculations were refined to use updated disability weights.

Results: Using the updated model and corresponding treatment data, we projected that the total benefit cohort of the GPELF (2000-2020) would consist of approximately 58.5 million individuals and the programme would avert 44.3 million chronic LF cases. Over the lifetime of the benefit cohorts, this corresponded to 244 million DALYs being averted.

Conclusion: This study indicates that substantial health benefits have resulted from the first 20 years of the GPELF. It is important to note that the GPELF would have both additional benefits not quantified by the DALY burden metric as well as benefits on other co-endemic diseases (such as soil-transmitted helminths, onchocerciasis and scabies)-making the total health benefit underestimated. As with the past impact assessments, these results further justify the value and importance of continued investment in the GPELF.

Keywords: DALYs averted; GPELF; Health impact; Lymphatic filariasis; Programme evaluation.

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Conflict of interest statement

MHB currently works for GlaxoSmithKline.

Figures

Fig. 1
Fig. 1
Breakdown of the total number of DALYs averted. a Stratified by morbidity manifestation. b Stratified by benefit cohort. ADL Acute adenolymphangitis. DALY Disability-adjusted life year
Fig. 2
Fig. 2
Tornado plot illustrating the impact of the sensitivity analysis on the estimated total health impact (number of DALYs averted) of the GPELF (2000–2020). The parameter ranges are presented in Table 2
See this image and copyright information in PMC

References

    1. WHA50.29: Elimination of lymphatic filariasis as a public health problem. http://www.who.int/neglected_diseases/mediacentre/WHA_50.29_Eng.pdf. Accessed 25 March 2022
    1. World Health Organization: Global Programme to Eliminate Lymphatic Filariasis. http://www.who.int/lymphatic_filariasis/elimination-programme/en/. Accessed 25 March 2022
    1. World Health Organization. Global Programme to Eliminate Lymphatic Filariasis: progress report 2000–2009 and strategic plan 2010–2020. World Health Organization. 2010; http://apps.who.int/iris/handle/10665/44473 Accessed 25 March 2022
    1. World Health Organization Global programme to eliminate lymphatic filariasis: progress report, 2020. Wkly Epidemiol Rec. 2021;96:497–508.
    1. World Health Organization: Guideline: alternative mass drug administration regimens to eliminate lymphatic filariasis. World Health Organization. 2017. https://www.ncbi.nlm.nih.gov/books/NBK487830/ Accessed 25 March 2022 - PubMed

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