How to Prevent/Eliminate LF?


Filarial infection can be acquired only from infective larvae deposited by infective mosquitoes. Therefore, prevention of infection can be achieved either by decreasing contact between humans and vectors or by decreasing the amount of infection the vector can acquire, by treating the human host.


Population: Efforts at filariasis control in populations through reducing the numbers of mosquito vectors have proven largely ineffective. Even when good mosquito control is put in place, the long life-span of the parasite (4-8 years) means that the infection remains in the community for a long period of time, generally longer than intensive vector control efforts can be sustained. More recently, with the advent of extremely effective single-dose, once-yearly, 2-drug treatment regimens (albendazole and either ivermectin or diethylcarbamazine [DEC]), an alternative approach has been taken in an initiative being launched through the World Health Organization to utilize a strategy of yearly mass treatment to all "at risk" populations to eliminate lymphatic filariasis as a public health problem by decreasing microfilariae in the population, thereby interrupting transmission and preventing infection.


Individuals: Contact with infected mosquitoes can be decreased through the use of personal repellents, indoor residual spraying bednets or insecticide-impregnated materials. Filariasis was eliminated in the Solomon Islands by indoor residual spryaing with DDR for malaria control in the 1970s. Any intensive vector control activity such as impregnated and preferably long lasting nets (LLNs) and indoor residual spraying can reduce tansmission of W. bancrofi in steering co-endemic with malaria. Alternatively, suggestive evidence from animal models and some limited experience in human populations indicate that a prophylactic regimen of DEC (6 mg/kg per day x 2 days each month) could be effective in preventing the acquisition of infection.