Centro de Prevención y Control de Enfermedades Transmitidas por Vectores y Zoonosis, Ministerio de Salud Pública, Santo Domingo, The Dominican Republic.
The Carter Center, Atlanta, Georgia, United States of America.
PLoS Negl Trop Dis. 2021 Aug 10;15(8):e0009590. doi: 10.1371/journal.pntd.0009590. eCollection 2021 Aug.
Lymphatic filariasis (LF) is a mosquito-transmitted parasitic disease that is a leading cause of disability globally. The island of Hispaniola, which the Dominican Republic shares with Haiti, accounts for approximately 90% of LF cases in the Americas region. In 1998, the Dominican Ministry of Public Health created the Program to Eliminate Lymphatic Filariasis (PELF) with the goal of eliminating LF transmission by 2020. Baseline mapping revealed 19 (12% of total) endemic municipalities clustered into three geographic foci (Southwest, La Ciénaga and East), with a total at-risk population of 262,395 people. Beginning in 2002, PELF sequentially implemented mass drug administration (MDA) in these foci using albendazole and diethylcarbamazine (DEC). In total, 1,174,050 treatments were given over three to five annual rounds of house-to-house MDA per focus with a median coverage of 81.7% (range 67.4%-92.2%). By 2018, LF antigen prevalence was less than 2% in all foci, thus meeting criteria to stop MDA and begin post-treatment surveillance (PTS). This success has been achieved against a shifting landscape of limited domestic funding, competing domestic public health priorities, and sporadic external donor support. Remaining steps include the need to scale-up morbidity management and disability prevention services for LF and to continue PTS until LF transmission is interrupted across Hispaniola.
淋巴丝虫病（LF）是一种由蚊子传播的寄生虫病，是全球致残的主要原因。海地与多米尼加共和国共有伊斯帕尼奥拉岛，该岛占美洲地区 LF 病例的约 90%。1998 年，多米尼加公共卫生部创建了消除淋巴丝虫病计划（PELF），目标是到 2020 年消除 LF 传播。基线绘图显示，19 个（占总数的 12%）流行市被分为三个地理焦点（西南部、拉西恩加和东部），总受威胁人口为 262395 人。从 2002 年开始，PELF 开始在这些焦点中使用阿苯达唑和乙胺嗪（DEC）序贯实施大规模药物治疗（MDA）。总共进行了三轮至五轮每年一次的逐户 MDA，每个焦点共进行了 1174050 次治疗，中位数覆盖率为 81.7%（范围为 67.4%-92.2%）。到 2018 年，所有焦点的 LF 抗原流行率均低于 2%，因此符合停止 MDA 并开始治疗后监测（PTS）的标准。在国内资金有限、国内公共卫生重点不断变化以及外部捐助者支持时有时无的情况下，取得了这一成功。剩下的步骤包括需要扩大 LF 的发病率管理和残疾预防服务，并继续 PTS，直到在伊斯帕尼奥拉岛中断 LF 传播。
