Opare Joseph L, de Souza Dziedzom K, Alomatu Bright, Mensah Ernest, Nyarko Emmanuel, Asiedu Odame, Saare Judith, Brown-Davies Charles, Dzathor Irene D, Kabore Achille, Mensah Ernest O
Ghana Health Service, Neglected Tropical Diseases Programme, Accra, Ghana.
Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.
Int J Infect Dis. 2025 Mar;152:107801. doi: 10.1016/j.ijid.2025.107801. Epub 2025 Jan 24.
Lymphatic filariasis (LF) elimination efforts in Ghana have been ongoing since 2001, achieving substantial progress through mass drug administration (MDA). However, despite significant advances, LF transmission persists in certain areas. Some districts previously classified as nonendemic have reported lymphedema and hydrocele cases, raising concerns about LF endemicity. To address these gaps, a confirmatory mapping survey was conducted to reassess LF prevalence in districts with uncertain morbidity.
A cross-sectional survey using the WHO-approved LF confirmatory mapping tool was conducted in 38/261 districts Ghana. Schoolchildren aged 9-14 years were randomly selected using the TAS Survey Sample Builder tool. Circulating filarial antigen (CFA) levels were measured using the Filaria Test Strip (FTS). Districts were classified as endemic if more than three positive cases were identified out 480 sampled. Subdistrict-level community surveys were conducted to confirm findings.
A total of 18,459 children were tested across the selected districts. Positive antigen cases were detected in 17 districts, with two districts (Nkoranza South and Wenchi Municipal) exceeding the critical threshold of three positive cases. Subdistrict surveys further confirmed high antigen prevalence of 1.68% (95% CI, 0.92-2.80; range: 1.00-5.00) and 4.73% (95% CI, 3.35-6.46; range: 0.96-14.29) in the Nkoranza South and Wenchi Municipal districts respectively.
The confirmatory mapping survey revealed ongoing LF transmission in two previously classified nonendemic districts. These districts were reclassified as endemic, requiring MDA. Treatment has therefore been initiated in the Nkoranza South and Wenchi Municipal districts. This study underscores the importance of reassessing endemicity and implementing targeted interventions in areas with uncertain LF transmission.
自2001年以来，加纳一直在开展消除淋巴丝虫病（LF）的工作，通过大规模药物给药（MDA）取得了重大进展。然而，尽管取得了显著进展，但LF传播在某些地区仍然存在。一些以前被归类为非流行区的地区报告了淋巴水肿和鞘膜积液病例，这引发了对LF地方性流行的担忧。为了填补这些空白，开展了一项验证性绘图调查，以重新评估发病率不确定地区的LF流行情况。
在加纳261个区中的38个区进行了一项横断面调查，使用了世界卫生组织批准的LF验证性绘图工具。使用TAS调查样本生成工具随机选择9至14岁的学童。使用丝虫检测试纸（FTS）测量循环丝虫抗原（CFA）水平。如果在480个抽样样本中发现超过3例阳性病例，则将该地区归类为流行区。进行了分区级社区调查以确认调查结果。
在选定的各区共对18459名儿童进行了检测。在17个区检测到阳性抗原病例，其中两个区（南科兰扎和温奇市）超过了3例阳性病例的临界阈值。分区调查进一步证实，南科兰扎区和温奇市的抗原高流行率分别为1.68%（95%CI，0.92 - 2.80；范围：1.00 - 5.00）和4.73%（95%CI，3.35 - 6.46；范围：0.96 - 14.29）。
验证性绘图调查显示，在两个以前被归类为非流行区的地区存在持续的LF传播。这些地区被重新归类为流行区，需要进行MDA。因此，已在南科兰扎区和温奇市启动治疗。本研究强调了重新评估地方性流行情况以及在LF传播情况不确定的地区实施有针对性干预措施的重要性。
