Egypt: first country in Eastern Mediterranean region to eliminate lymphatic filariasis
12 March 2018 | Cairo | Geneva – Egypt becomes the first country in the Eastern Mediterranean Region of the World Health Organization (WHO) and the latest in the world to eliminate lymphatic filariasis (LF) as a public health problem.
Egypt’s success comes after almost two decades of implementing sustained control and prevention measures (including mass treatment of populations) and surveillance in affected/at-risk localities.
Egypt’s struggle to overcome lymphatic filariasis (also known as elephantiasis) is perhaps one of the oldest in the history of public health, with field activities going back to the early 20th century. Its clinical manifestations are shown in pharaonic statues and works of art, and are described in early Arabic literature, although its causal agent, the parasite Wuchereria bancrofti, was first documented there in 1874.
The disease burden was fully appreciated in the 20th century through large-scale surveys, which revealed its endemicity in rural areas, especially in the eastern Nile Delta region, where clinical manifestations such as lymphoedema and hydrocele (swollen limbs and genitals) were commonly observed.
Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The infection impairs the lymphatic system triggering abnormal enlargement of body parts, causing pain, severe disability and social stigma.
The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.
Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.
Almost 856 million people in 52 countries worldwide remain threatened by LF and require preventive treatment to stop its spread. Regular MDA reduces the density of microfilariae in the bloodstream and prevents the spread of parasites to mosquitoes.
MDA can interrupt the transmission cycle when conducted annually for 4–6 years with effective coverage of the total population at risk.
Salt fortified with DEC has also been used in a few settings to interrupt the transmission cycle.
Parasites that cause LF are transmitted by four main types of mosquitoes: Culex, Mansonia, Anopheles and Aedes.