Monitoring and epidemiological assessment of mass drug administration in the global programme to eliminate lymphatic filariasis: a manual for national elimination programmes, 2nd ed

Overview

This revision and update of the 2011 guidance includes a new mapping protocol, adapted from the TAS, as a practical tool for determining when MDA is required in areas of uncertain endemicity. Best practices and new tools for monitoring MDA coverage are provided to ensure that MDA is delivered to all eligible people. Epidemiological monitoring surveys (EMS) have replaced pre-TAS and focus on the assessment of infection in the adult population. TAS has been strengthened by use of updated models of LF to more accurately measure the threshold below which transmission is assumed to be unsustainable, even in the absence of treatment. A protocol for measuring the impact of the new triple therapy regimen of ivermectin, diethylcarbamazine and albendazole (IDA) is included. More detailed guidance is provided for following up people found to be infected during surveys. Tools and guidance are provided to help national programmes mitigate persistent transmission, and new guidance is introduced, outlining possible platforms for post-validation surveillance. The use of integrated surveys is highlighted. The manual provides general guidance to national programmes and relevant background information on technical issues. Technical details and tools for implementing the guidance are provided in annexes. The diversity of the viii epidemiology of LF and the unique programme situations encountered may not correspond to all of the categories or scenarios presented in this manual, and consultation with WHO continues to be recommended in such cases.