![]() Therefore, children born after the cessation of LF transmission should be antibody negative. Previous studies demonstrated that antibody production in response to LF exposure occurs during the first few years of life. Antibody responses to LF exposure have been suggested as an ideal immunological measurement for identifying areas of residual endemicity in future surveillance campaigns. Īs the prevalence of LF declines, the sensitivities of the gold standards, which measure Mf and CFA, also decrease, potentially making these assays less useful during this stage of the LF elimination programme. The CTS was completed in two countries which had entered surveillance mode, Tonga and Vanuatu, and Samoa, where transmission was ongoing. Since drafting the surveillance strategy, three South Pacific countries have finished their CTS, either alone or in conjunction with post-MDA prevalence surveys. Upon detection of a CFA positive child, using the field immunochromatographic test (ICT), surrounding residents (200 m radius or 24 houses) would be tested to identify the microfilaraemic (Mf) positive case from the child's house of residence. The strategy was based on the preapproved LF diagnostic assays available and took into consideration resource and funding constraints. This method relies on detecting CFA positive children in either school-based or community-based surveys. Recently, child transmission surveys (CTS) have been proposed as a potential method for surveillance in the South Pacific as part of the “draft LF active surveillance strategy for the Pacific Island Countries and Territories (PICT)”. The challenge for this phase of the LF programme is to find a suitable strategy for surveillance in those countries that have reached the target threshold. The Cook Islands, Niue, Vanuatu, and Tonga have reached <1% CFA prevalence of the population following five rounds of MDA and are now implementing activities to ensure that transmission has been interrupted and to detect any remaining and/or new foci of transmission. They were American Samoa, the Cook Islands, the Federated States of Micronesia, Fiji, French Polynesia, Kiribati, the Marshall Islands, New Caledonia, Niue, Palau, Papua New Guinea, Samoa, Tonga, Tuvalu, Vanuatu, and Wallis and Futuna. Sixteen of the 22 countries falling under the jurisdiction of PacELF were classified as endemic for LF following baseline prevalence surveys. Elimination of LF was defined as <1% circulating filarial antigen (CFA) prevalence of the population and <0.1% CFA prevalence in children born after the implementation of MDAs. PacELF resolved to eliminate LF as a public health problem in the Pacific using mass drug administrations (MDAs). ![]() The Global Elimination Programme to eliminate LF (GPELF) began in the late 1990s, and the Pacific counterpart of GPELF, formed in 1999 under the auspices of the World Health Organization (WHO), was named the Pacific Programme for the Elimination of Lymphatic Filariasis (PacELF). ![]() Lymphatic filariasis (LF), a mosquito-transmitted parasitic disease caused by the filarial nematodes Wuchereria bancrofti, Brugia malayi, and Brugia timori, is classified as a neglected tropical disease (NTD) that is endemic in many parts of the world including the South Pacific.
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