TY - JOUR KW - General Medicine KW - Geospatial analysis KW - Global distribution AU - Cromwell EA AU - Schmidt CA AU - Kwong KT AU - Pigott DM AU - Mupfasoni D AU - Biswas G AU - Shirude S AU - Hill E AU - Donkers KM AU - Abdoli A AU - Abrigo MRM AU - Adekanmbi V AU - Adetokunboh OO AU - Adinarayanan S AU - Ahmadpour E AU - Ahmed MB AU - Akalu TY AU - Alanezi FM AU - Alanzi TM AU - Alinia C AU - Alipour V AU - Amit A AU - Anber NH AU - Ancuceanu R AU - Andualem Z AU - Anjomshoa M AU - Ansari F AU - Antonio CAT AU - Anvari D AU - Appiah SCY AU - Arabloo J AU - Arnold B AU - Ausloos M AU - Ayanore MA AU - Badirzadeh A AU - Baig AA AU - Banach M AU - Baraki AG AU - Bärnighausen TW AU - Bayati M AU - Bhattacharyya K AU - Bhutta ZA AU - Bijani A AU - Bisanzio D AU - Bockarie MJ AU - Bohlouli S AU - Bohluli M AU - Butt ZA AU - Cano J AU - Carvalho F AU - Chattu VK AU - Chavshin AR AU - Cormier NM AU - Damiani G AU - Dandona L AU - Dandona R AU - Darwesh AM AU - Daryani A AU - Dash AP AU - Deribe K AU - Deshpande A AU - Dessu BK AU - Dhimal M AU - Dianatinasab M AU - Diaz D AU - Do HT AU - Earl L AU - El Tantawi M AU - Faraj A AU - Fattahi N AU - Fernandes E AU - Fischer F AU - Foigt NA AU - Foroutan M AU - Guo Y AU - Hailu GB AU - Hasaballah AI AU - Hassankhani H AU - Herteliu C AU - Hidru HDD AU - Hole MK AU - Hon J AU - Hossain N AU - Hosseinzadeh M AU - Househ M AU - Humayun A AU - Ilesanmi OS AU - Ilic IM AU - Ilic MD AU - Iqbal U AU - Irvani SSN AU - Islam MM AU - Jha R AU - Ji JS AU - Johnson KB AU - Jozwiak JJ AU - Kabir A AU - Kalankesh LR AU - Kalhor R AU - Karami Matin B AU - Karch A AU - Karimi SE AU - Kasaeian A AU - Kayode GA AU - Kazemi Karyani A AU - Kelbore AG AU - Khafaie MA AU - Khalilov R AU - Khan J AU - Khatab K AU - Khater MM AU - Khodayari MT AU - Kianipour N AU - Kim YJ AU - Kinyoki DK AU - Kumar GA AU - Kusuma D AU - La Vecchia C AU - Lansingh VC AU - Lee PH AU - LeGrand KE AU - Levine AJ AU - Li S AU - Maleki S AU - Mansournia MA AU - Martins-Melo FR AU - Massenburg BB AU - Mayala BK AU - Meitei WB AU - Mendoza W AU - Mengistu DT AU - Mereta ST AU - Mestrovic T AU - Mihretie KM AU - Miller-Petrie MK AU - Mohammadian-Hafshejani A AU - Mohammed S AU - Mokdad AH AU - Moradi M AU - Moradzadeh R AU - Moraga P AU - Morrison SD AU - Mosser JF AU - Mousavi SM AU - Munro SB AU - Muthupandian S AU - mwingira UJ AU - Naderi M AU - Nagarajan AJ AU - Naik G AU - Negoi I AU - Nguyen TH AU - Nguyen HLT AU - Olagunju AT AU - Omar Bali A AU - Osarenotor O AU - Osei FB AU - Pasupula DK AU - Pirsaheb M AU - Pourjafar H AU - Rathi P AU - Rawaf DL AU - Rawaf S AU - Rawassizadeh R AU - Reiner RC AU - Reta MA AU - Rezapour A AU - Ribeiro AI AU - Rostami A AU - Sabesan S AU - Sadeghi E AU - Sajadi SM AU - Samy AM AU - Sartorius B AU - Schaeffer LE AU - Shaikh MA AU - Sharafi K AU - Sharafi Z AU - Sharifi H AU - Shibuya K AU - Shin JI AU - Soheili A AU - Soltani S AU - Spotin A AU - Stolk W AU - Tesfay BE AU - Topor-Madry R AU - Tran KB AU - Tran BX AU - Ullah I AU - Unnikrishnan B AU - Vasseghian Y AU - Vinkeles Melchers NVS AU - Violante FS AU - Yamada T AU - Yaya S AU - Yazdi-Feyzabadi V AU - Yip P AU - Yonemoto N AU - Zaki L AU - Zaman SB AU - Zamanian M AU - Zangeneh A AU - Zhang Z AU - Zhang Y AU - Ziapour A AU - King J AU - Hay SI AB - Background
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.

Methods
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.

Findings
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.

Interpretation
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. BT - The Lancet Global Health DO - 10.1016/s2214-109x(20)30286-2 IS - 9 LA - eng N2 - Background
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.

Methods
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.

Findings
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.

Interpretation
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. PB - Elsevier BV PY - 2020 SP - e1186 EP - e1194 T2 - The Lancet Global Health TI - The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis UR - https://reader.elsevier.com/reader/sd/pii/S2214109X20302862?token=F07E426B1AF5BAAAFA2922DE4E9AB43112658F6A3812B00D0AD0966F7220D8559ED9C4537B118E1498F89D7EDE3C3BDD VL - 8 SN - 2214-109X ER -