Ghana has broken transmission of Lymphatic Filariasis infections commonly known as elephantiasis in 109 districts across the country, leaving only seven districts under the Mass Drug Administration (MDA) exercise. This means that lymphatic filariasis or elephantiasis is no longer a health threat in those districts or the level of prevalence has reduced to a minimal level.
The Mass Drug Administration is the distribution of drugs to vaccinate people in endemic communities for the prevention of the disease also known as (Preventive Chemotherapy) and is a routine exercise conducted by the Ghana Health Service under the Neglected Tropical Diseases Programme (NTDP) being implemented with partners such as the World Health Organisation (WHO).
Lymphatic Filariasis is one of a group of 20 infectious and parasitic diseases which affect over one billion people worldwide, most of whom live in extreme poverty and are concentrated in remote rural areas, urban slums, and conflict zones.
The other NTDs Ghana is working to eliminate are Onchocerciases, Schistosomiasis, Soil Transmitted Helminthes, Trachoma, Buruli Ulcer, Dracunculiasis, Leprosy, Rabies, Human African Trypanosomiases, Leishmaniases and Yaws.
Others are Cysticercosis, Echinococcosis, Dengue, Chaga’s disease, Foodborne Trematode Infections, Mycetoma, Scabies and snakebite Envenoming.
According to the Ghana Health Service (GHS), Ghana is endemic for all five Preventive Chemotherapy (PC NTDs) and it employs the MDA approach to control, Lymphatic filariasis was endemic in 116 districts in 12 regions whiles onchocerciases are endemic in 137 districts in 15 regions, Trachoma was endemic in 44 districts in four regions.
Lymphatic Filariasis is an infectious disease caused by Wuchereria bancrofti, a parasitic worm transmitted by the mosquito vector female anopheles, once infected it destroys lymphatics which are responsible for the maintenance of fluid balance and play a part in the immune system. The clinical manifestations of this disease include fever, chills, pain, redness of parts of the body, skin damage, swelling of affected limbs and lymphadenopathy.
Dr Kofi Asemanyi-Mensah, Manager of the Neglected Tropical Diseases Programme, in an interview at the national launching of this year’s Lymphatic Filariasis and Onchocerciasis integrated MDA and Trainer of Trainers in Koforidua, indicated that the mass drug administration exercise had been very successful considering the break in transmission in 109 districts.
Throwing more light on the Mass Drug Administration, Dr Asemanyi-Mensah explained that the drugs acted as vaccination to prevent transmission adding that, “the drug adherence rate has been very high, and the routine drug administration exercise has been very successful evident in the fact that transmission has been broken in the majority of the endemic districts.” The Mass Drug Administration provides a single dose medication to all eligible individuals once or twice a year and has been implemented over three to seven years by the GHS and its partners to reduce the burden of neglected tropical Diseases such as Lymphatic Filariases and Onchocerciases.
He noted that the disease could affect every part of the body including the scrotum and breast, but the commonly affected area is the leg, and due to its mode of transmission, everybody in the endemic areas could be affected. Infection is usually acquired in childhood causing hidden damage to the lymphatic system, “however, the painful and disfiguring visible manifestations of the disease lymphoedema or elephantiasis and scrotal swelling occur later in life and patients are not only physically disabled but suffer mental, social and financial losses,” Dr Asemanyi-Mensah indicated that apart from the drug administration to prevent transmission, the programme also does morbidity management and disability control of lymphoedema (treatment of affected limbs) and in some cases surgery to treat infection of the scrotum as well as education on best practices to prevent the infection.
“Since it’s transmitted by the anopheles mosquito which also causes malaria, another infectious disease, it is important for people to keep their surroundings clean to prevent the breeding of mosquitoes and also sleep under Insecticide treated nets to prevent mosquito bites,” he advised. As part of the process of eliminating Lymphatic filariasis and onchocerciases by the year 2030, the NTD programme is implementing this year’s mass drug administration in 76 oncho-endemic districts targeted at reaching about 5.4 million people and the remaining seven lymphatic filariasis endemic districts targeting 400,000 people.
In 2022, the GHS’s Neglected Tropical Disease Programme with support from all stakeholders achieved 83.8 per cent treatment coverage for lymphatic filariasis while treatment coverage for onchocerciases was 84.2 per cent and 83.4 per cent in the first and second rounds of treatment respectively. —GNA
