03141nas a2200385   4500000000100000008004100001653001600042653002200058653001700080653001500097653001600112653000900128653001100137653001600148653001100164653002800175653001700203653002100220653001000241653001000251653001500261100001300276700001200289700001300301700001300314700001100327700001200338700001500350245014300365856009000508300001000598490000600608520212700614022001402741       2013                            d10aYoung Adult10aTreatment Outcome10aSierra Leone10aPrevalence10aMiddle Aged10aMale10aHumans10aFilaricides10aFemale10aElephantiasis, Filarial10aDrug Therapy10aChild, Preschool10aChild10aAdult10aAdolescent1 aKoroma J1 aSesay S1 aSonnie M1 aHodges M1 aSahr F1 aZhang Y1 aBockarie M00aImpact of three rounds of mass drug administration on lymphatic filariasis in areas previously treated for onchocerciasis in Sierra Leone.  uhttp://journals.plos.org/plosntds/article/asset?id=10.1371%2Fjournal.pntd.0002273.PDF  ae22730 v73 a<p><strong>BACKGROUND: </strong>1974-2005 studies across Sierra Leone showed onchocerciasis endemicity in 12 of 14 health districts (HDs) and baseline studies 2005-2008 showed lymphatic filariasis (LF) endemicity in all 14 HDs. Three integrated annual mass drug administration (MDA) were conducted in the 12 co-endemic districts 2008-2010 with good geographic, programme and drug coverage. Midterm assessment was conducted 2011 to determine impact of these MDAs on LF in these districts.</p>

<p><strong>METHODOLOGY/PRINCIPAL FINDINGS: </strong>The mf prevalence and intensity in the 12 districts were determined using the thick blood film method and results compared with baseline data from 2007-2008. Overall mf prevalence fell from 2.6% (95% CI: 2.3%-3.0%) to 0.3% (95% CI: 0.19%-0.47%), a decrease of 88.5% (p = 0.000); prevalence was 0.0% (100.0% decrease) in four districts: Bo, Moyamba, Kenema and Kono (p = 0.001, 0.025, 0.085 and 0.000 respectively); and seven districts had reductions in mf prevalence of between 70.0% and 95.0% (p = 0.000, 0.060, 0.001, 0.014, 0.000, 0.000 and 0.002 for Bombali, Bonthe, Kailahun, Kambia, Koinadugu, Port Loko and Tonkolili districts respectively). Pujehun had baseline mf prevalence of 0.0%, which was maintained. Only Bombali still had an mf prevalence ≥1.0% (1.58%, 95% CI: 0.80%-3.09%)), and this is the district that had the highest baseline mf prevalence: 6.9% (95% CI: 5.3%-8.8%). Overall arithmetic mean mf density after three MDAs was 17.59 mf/ml (95% CI: 15.64 mf/ml-19.55 mf/ml) among mf positive individuals (65.4% decrease from baseline of 50.9 mf/ml (95% CI: 40.25 mf/ml-61.62 mf/ml; p = 0.001) and 0.05 mf/ml (95% CI: 0.03 mf/ml-0.08 mf/ml) for the entire population examined (96.2% decrease from baseline of 1.32 mf/ml (95% CI: 1.00 mf/ml-1.65 mf/ml; p = 0.000)).</p>

<p><strong>CONCLUSIONS/SIGNIFICANCE: </strong>The results show that mf prevalence decreased to &lt;1.0% in all but one of the 12 districts after three MDAs. Overall mf density reduced by 65.0% among mf-positive individuals, and 95.8% for the entire population.</p>
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