The story of Lymphatic Filariasis elimination as a public health problem from Yemen

• Published in: Acta tropica 2020-12, Vol.212, p.105676-105676, Article 105676
• Main Authors: Al-Kubati, Abdul Samid, Al-Samie, Abdul Rahim, Al-Kubati, Saeed, Ramzy, Reda M.R.
• Format: Article
• Language: English
• Subjects: Albendazole - therapeutic use; Animals; Elephantiasis, Filarial - epidemiology; Elephantiasis, Filarial - prevention & control; Elimination; Humans; Ivermectin - therapeutic use; Lymphatic Filariasis; Mass Drug Administration; Public Health; Validation; Yemen; Yemen - epidemiology
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2020.105676

•The Ministry of Public Health and Population in Yemen was among the first countries to join the WHO global efforts and initiated a national lymphatic filariasis elimination program (NLFEP) in 2000.•Form the start, the NLFEP was fully integrated with the Leprosy Elimination Programme, supported by both the German Leprosy Relief Association and the Yemen Leprosy Elimination Society.•The district was chosen as the implementation unit (IU) for mass drug administration (MDA). Of 333 districts (Ozla, in local language) in Yemen, 8 districts were eligible for MDA (population of approximately 111,036 people). After five effective MDA rounds (≥80%, albendazole and ivermectin), MDA was stopped in seven IUs in the mainland, and continued in one IU in Socotra island. In 2011 the last MDA was implemented in Socotra IU. The last transmission assessment survey was conducted in 2017, revealing that LF has likely been eliminated as a public health problem.•Morbidity management and disability prevention and training on self-management are provided to 610 lymphoedema patients (379 males and 231 females) and 31 hydrocele patients.•In 2019, after almost two decades of sustained disease control and prevention measures, Yemen was validated by WHO for achieving elimination of LF as a public health problem. In 2000, Yemen joined the WHO global efforts to eliminate lymphatic filariasis (LF) as a public health problem by initiating a National LF Elimination Programme (NLFEP), that was fully integrated with the National Leprosy Elimination Programme (NLEP), the Ministry of Public Health and Population. This article reviews the NLFEP extensive efforts and interventions to eliminate LF in Yemen. LF mapping was started in 2000, followed by five annual rounds of mass drug administration (MDA) with ivermectin and albendazole in 8 implementation units (IUs) during 2002-2006. The epidemiological coverage for all MDA rounds was ≥80%. Based on WHO guidelines of 2005, MDA was stopped in 7 IUs, additional MDA rounds were continued in one IU until 2011. Microfilaremia monitoring and evaluation, and MDA stopping surveys were conducted based on WHO guidelines of 2005 and 2011. Information about the presence of patients suffering from lymphoedema/elephantiasis and hydrocele was collected, and basic care provided to all chronic cases by NLEP coordinators, trained on LF morbidity management and disability prevention (MMDP). As of 2017, a total of 610 lymphoedema patients were trained on self-managem