About PacELF

What is PacELF

PacELF is the Pacific Programme for the Elimination of Lymphatic Filariasis.

It was formed in 1999 to coordinate the elimination efforts in Pacific Island Countries (PICs). It works within the framework of the Global Programme to Eliminate Lymphatic Filariasis (GAELF).

PacELF, the first regional filariasis elimination programme, is a network of the twenty-two Pacific island countries and territories aimed at eliminating filariasis in the Pacific. The strategy for achieving this goal is annual mass drug administration (MDA) using diethylcarbamazine citrate (DEC) with albendazole to stop transmission together with clinical management of infections to minimize pathodema in those individuals that are already infected.

Prior to PacELF

Many people have done a substantial amount of work in the Pacific over the last few decades to control and eliminate lymphatic filariasis (LF) as a public health problem. In the latter half of the 1990s, a number of events and activities brought LF to a higher profile. Previously, several countries had been working more or less independently on LF control.

In Fiji, the late Doctor Mataika and his staff made substantial progress in mapping and instigating programmes in areas of the country. In Samoa, the Ministry of Health supported by WHO, conducted annual mass drug administration with different drug regimens. In French Polynesia, the Ministry of Health and the Malarde Institute (a pioneer institute of Pacific filariasis) had also been very active in LF control and studies. Wallis and Futuna have been implementing yearly rounds of MDA for nearly thirty years.

About Lymphatic Filariasis (LF)

What is LF

Lymphatic filariasis is a parasitic disease caused by microscopic, thread-like worms. The adult worms only live in the human lymph system, this system maintains the body's fluid balance and fights infections.

Lymphatic filariasis is a threat to 1 billion people in 80 countries with over 120 million affected and 40 million severely disfigured and incapacitated. It is considered as the second leading cause of disability worldwide. Not only do those individuals affected suffer physically; but there are also enormous social and economic burdens affecting both the individuals and their families. Even when no clinical symptoms are present, hidden lymphatic pathology and kidney damages exist. The visible and disfiguring consequences of the disease, such as elephantiasis and hydrocele, will often drag entire families into poverty.

How is LF spread

The disease spreads from person to person by mosquito bites. When a mosquito bites a person who has lymphatic filariasis, microscopic worms circulating in the person's blood enter and infect the mosquito. People get lymphatic filariasis from the bite of an infected mosquito. The microscopic worms pass from the infected mosquito through the skin, and travel to the lymph vessels. In the lymph vessels they grow into adults. An adult worm lives for about 5-7 years. The adult worms mate and release millions of microscopic worms, called microfilariae, into the blood. People with the worms in their blood give the infection to others through mosquitoes (life cycle).

The diagram was sourced from the Center for Disease Control and Prevention.

How is LF diagnosed

The standard method for diagnosing active infection of microfilariae is by microscopic examination. This is not always feasible because in most parts of the world, microfilariae are nocturnally periodic, which means they only circulate in the blood at night. For this reason, the blood collection has be done at night to coincide with the appearance of the microfilariae.

Serologic techniques provide an alternative to microscopic detection of microfilariae for the diagnosis of lymphatic filariasis. Because lymphedema may develop many years after infection, lab tests are often negatives with these patients.

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