Following baseline surveys carried out in 1999 and 2000, the Pacific Programme to Eliminate Lymphatic Filariasis categorized:
- 11 countries as Endemic
- 5 countries as Partially Endemic
- 6 countries as Non-Endemic
A first in-depth review of the Programme in October 2006 identified gaps and challenges and new directions were taken to address them. In 2007 prevalence surveys were carried out in a number of Pacific Islands Countries. These surveys provided a clear picture of the situation and strong scientific bases for decision making.
In June 2008 WHO conveyed the First Technical Working Group (TWG) meeting which brought together national and international experts to review the progress made and discuss the next steps. This group highlighted the progress made by Pacific Island Countries in working towards the elimination target of <1% antigenemia prevalence.
Following this review, a new classification was established to better reflect the progress made by Pacific Island Countries and the nature of on-going elimination activities.
1. Mass Drug Administration (MDA)
The recommended strategy for MDA in the Pacific was a combination of diethylcarbamazine citrate (DEC) and albendazole (ALB) once per year for five years.
Based on the recent reviews of the progress made, the Pacific Programme to Eliminate LF now strongly recommends that countries aim to achieve a minimum coverage of 80% of the population using a Directly Observed Treatment (DOT) strategy. Samoa was the first country to implement MDA in 1999 and has completed a 7th round of MDA in September 2008 reaching an unprecedented surveyed coverage of 87% by DOT.
2. Antigenemia Prevalence
Elimination activities in the Pacific Program to Eliminate LF are monitored and evaluated using surveys of antigenemia prevalence, as measured by ICT, a rapid diagnosis test. As a whole, the Program has achieved a 71% reduction in Ag prevalence across the Pacific, decreasing from 10.7% Ag prevalence at baseline to 3.1% Ag prevalence following post-MDA surveys. However, these data must be interpreted with caution as the survey methods, the sites and the samples changed over the years. In 2008 five countries have completed post-MDA surveys. Only provisional data has been included in the charts below.
3. Morbidity control
There is no data available on the disease burden due to LF in the Pacific and only limited activities have been inplemented so far.
In 2008 a morbidity control assistant coordinator is being recruited to develop this part of the program in the Pacific. The first task will be to gather detailed data on the current burden LF represents in Pacific Islands Countries.