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      2020                            d  bElsevier BV10aGeneral Medicine10aGeospatial analysis10aGlobal distribution1 aCromwell EA1 aSchmidt CA1 aKwong KT1 aPigott DM1 aMupfasoni D1 aBiswas G1 aShirude S1 aHill E1 aDonkers KM1 aAbdoli A1 aAbrigo MRM1 aAdekanmbi V1 aAdetokunboh OO1 aAdinarayanan S1 aAhmadpour E1 aAhmed MB1 aAkalu TY1 aAlanezi FM1 aAlanzi TM1 aAlinia C1 aAlipour V1 aAmit A1 aAnber NH1 aAncuceanu R1 aAndualem Z1 aAnjomshoa M1 aAnsari F1 aAntonio CAT1 aAnvari D1 aAppiah SCY1 aArabloo J1 aArnold B1 aAusloos M1 aAyanore MA1 aBadirzadeh A1 aBaig AA1 aBanach M1 aBaraki AG1 aBärnighausen TW1 aBayati M1 aBhattacharyya K1 aBhutta ZA1 aBijani A1 aBisanzio D1 aBockarie MJ1 aBohlouli S1 aBohluli M1 aButt ZA1 aCano J1 aCarvalho F1 aChattu VK1 aChavshin AR1 aCormier NM1 aDamiani G1 aDandona L1 aDandona R1 aDarwesh AM1 aDaryani A1 aDash AP1 aDeribe K1 aDeshpande A1 aDessu BK1 aDhimal M1 aDianatinasab M1 aDiaz D1 aDo HT1 aEarl L1 aEl Tantawi M1 aFaraj A1 aFattahi N1 aFernandes E1 aFischer F1 aFoigt NA1 aForoutan M1 aGuo Y1 aHailu GB1 aHasaballah AI1 aHassankhani H1 aHerteliu C1 aHidru HDD1 aHole MK1 aHon J1 aHossain N1 aHosseinzadeh M1 aHouseh M1 aHumayun A1 aIlesanmi OS1 aIlic IM1 aIlic MD1 aIqbal U1 aIrvani SSN1 aIslam MM1 aJha R1 aJi JS1 aJohnson KB1 aJozwiak JJ1 aKabir A1 aKalankesh LR1 aKalhor R1 aKarami Matin B1 aKarch A1 aKarimi SE1 aKasaeian A1 aKayode GA1 aKazemi Karyani A1 aKelbore AG1 aKhafaie MA1 aKhalilov R1 aKhan J1 aKhatab K1 aKhater MM1 aKhodayari MT1 aKianipour N1 aKim YJ1 aKinyoki DK1 aKumar GA1 aKusuma D1 aLa Vecchia C1 aLansingh VC1 aLee PH1 aLeGrand KE1 aLevine AJ1 aLi S1 aMaleki S1 aMansournia MA1 aMartins-Melo FR1 aMassenburg BB1 aMayala BK1 aMeitei WB1 aMendoza W1 aMengistu DT1 aMereta ST1 aMestrovic T1 aMihretie KM1 aMiller-Petrie MK1 aMohammadian-Hafshejani A1 aMohammed S1 aMokdad AH1 aMoradi M1 aMoradzadeh R1 aMoraga P1 aMorrison SD1 aMosser JF1 aMousavi SM1 aMunro SB1 aMuthupandian S1 amwingira UJ1 aNaderi M1 aNagarajan AJ1 aNaik G1 aNegoi I1 aNguyen TH1 aNguyen HLT1 aOlagunju AT1 aOmar Bali A1 aOsarenotor O1 aOsei FB1 aPasupula DK1 aPirsaheb M1 aPourjafar H1 aRathi P1 aRawaf DL1 aRawaf S1 aRawassizadeh R1 aReiner RC1 aReta MA1 aRezapour A1 aRibeiro AI1 aRostami A1 aSabesan S1 aSadeghi E1 aSajadi SM1 aSamy AM1 aSartorius B1 aSchaeffer LE1 aShaikh MA1 aSharafi K1 aSharafi Z1 aSharifi H1 aShibuya K1 aShin JI1 aSoheili A1 aSoltani S1 aSpotin A1 aStolk W1 aTesfay BE1 aTopor-Madry R1 aTran KB1 aTran BX1 aUllah I1 aUnnikrishnan B1 aVasseghian Y1 aVinkeles Melchers NVS1 aViolante FS1 aYamada T1 aYaya S1 aYazdi-Feyzabadi V1 aYip P1 aYonemoto N1 aZaki L1 aZaman SB1 aZamanian M1 aZangeneh A1 aZhang Z1 aZhang Y1 aZiapour A1 aKing J1 aHay SI00aThe global distribution of lymphatic filariasis, 2000–18: a geospatial analysis  uhttps://reader.elsevier.com/reader/sd/pii/S2214109X20302862?token=F07E426B1AF5BAAAFA2922DE4E9AB43112658F6A3812B00D0AD0966F7220D8559ED9C4537B118E1498F89D7EDE3C3BDD  ae1186-e11940 v83 aBackground<br>
Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.<br>

<br>Methods<br>
A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected.<br>

<br>Findings<br>
We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination.<br>

<br>Interpretation<br>
Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease.  a2214-109X