@article{fdi:010074118,
  title = {{T}owards elimination of lymphatic filariasis in southeastern {M}adagascar : successes and challenges for interrupting transmission},
  author = {{G}architorena, {A}ndres and {R}aza-{F}anomezanjanahary, {E}. {M}. and {M}ioramalala, {S}. {A}. and {C}hesnais, {C}. {B}. and {R}atsimbasoa, {C}. {A}. and {R}amarosata, {H}. and {B}onds, {M}. {H}. and {R}abenantoandro, {H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction {A} global strategy of mass drug administration ({MDA}) has greatly reduced the burden of lymphatic filariasis ({LF}) in endemic countries. {I}n {M}adagascar, the {N}ational {P}rogramme to eliminate {LF} has scaled-up annual {MDA} of albendazole and diethylcarbamazine across the country in the last decade, but its impact on {LF} transmission has never been reported. {T}he objective of this study was to evaluate progress towards {LF} elimination in southeastern {M}adagascar. {M}ethods {T}hree different surveys were carried out in parallel in four health districts of the {V}atovavy {F}itovinany region in 2016: i) a school-based transmission assessment survey ({TAS}) in the districts of {M}anakara {A}tsimo, {M}ananjary, and {V}ohipeno (following a successful pre-{TAS} in 2013); ii) a district-representative community prevalence survey in {I}fanadiana district; and iii) a community prevalence survey in sentinel and spot-check sites of these four districts. {LF} infection was assessed using the {A}lere {F}ilariasis {T}est {S}trips, which detect circulating filarial antigens ({CFA}) of adult worms. {A} brief knowledge, attitudes and practices questionnaire was included in the community surveys. {P}rincipal findings {N}one of the 1,825 children sampled in the {TAS}, and only one in 1,306 children from sentinel and spot-check sites, tested positive to {CFA}. {H}owever, {CFA} prevalence rate in individuals older than 15 years was still high in two of these three districts, at 3.5 and 9.7% in {M}ananjary and {V}ohipeno, respectively. {O}verall {CFA} prevalence in sentinel and spot-check sites of these three districts was 2.80% ({N} = 2,707), but only two individuals had detectable levels of microfilaraemia (0.06%). {P}revalence rate estimates for {I}fanadiana were substantially higher in the district-representative survey (15.8%; {N} = 545) than in sentinel and spot-check sites (0.8%; {N} = 618). {O}nly 51.2% of individuals surveyed in these four districts reported taking {MDA} in the last year, and 42.2% reported knowing about {LF}. {C}onclusions {A}lthough {TAS} results suggest that {MDA} can be stopped in three districts of southeastern {M}adagascar, the adult population still presents high {CFA} prevalence levels. {T}his discordance raises important questions about the {TAS} procedures and the interpretation of their results.},
  keywords = {{MADAGASCAR}},
  booktitle = {},
  journal = {{PLOS} {N}eglected {T}ropical {D}iseases},
  volume = {12},
  numero = {9},
  pages = {e0006780 [16 p.]},
  ISSN = {1935-2735},
  year = {2018},
  DOI = {10.1371/journal.pntd.0006780},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074118},
}