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Assessment of the Endemicity of Filariasis in Four Health Areas of the Melong Health District, after 16 Years of Mass Drug Administration with Ivermectin

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Human filariasis is a group of tropical disease caused by eight species of nematodes which are located in blood, lymphatic tissue and other tissues. While in some area only one of the filaria species may be found, sometimes you may have two or three of them coexisting in some bioecological zone. Community directed treatment with Ivermectin has been carried out (through a strategy known as mass drug administration) in the Melong health district for 16 years. Questions are being raised concerning the feasibility of filariasis elimination using this strategy alone. As a result this study was aimed at assessing endemicity levels of filariasis despite these long term application of the strategy and which diagnostic tool can best be used to determine the actual prevalence of filariasis during and after such a program. We also aim to to establish the relation between ivermectin adherence and parasitological indices of onchocerciasis. In this study, a total of 1748 participants were recruited from whom skin snips and capillary blood was collected.DNA was then extracted from randomly selected 210 skin snip sample and Quantified using the QubitTM4 flouorometer. The DNA samples were then used to perform O-150 colorimetric LAMP assay and the OvwFtsZ/OvActin Duplex Real-time PCR. Amongst the 1748 participants from whom skin snips were collected, 85 (4.9%) were
found to be microfilaridermic for Onchocerca volvulus with 14.7% nodule prevalence, (2.9%) were microfilaremic for Loa loa   and 25 (1.4%) were microfilaraemic for Mansonella perstans microfilaria. Melong health district as a whole is still endemic for filariasis though with low level of endemicity <30% described as Hypoendemic. LAMP (sensitivity 84.4%) is more sensitive than qPCR (sensitivity 69.7%) whereas qPCR (specificity 96.6) is more specific than LAMP (specificity 93.8%). In this study those who have taken Ivermectin >15 were amicrofilaridemic for onchocerciasis.

Key words: Endemicity, ivermectin, Assessment, Filariasis Microfilaridemia, Microfilaraemia, Microscopy, Real-time PCR, LAMP,  Adherence

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