THE LEOGANE, HAITI DEMONSTRATION PROJECT: DECREASED MICROFILAREMIA AND PROGRAM COSTS AFTER THREE YEARS OF MASS DRUG ADMINISTRATION

MADSEN BEAU DE ROCHARS Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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SANJAT KANJILAL Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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ABDEL N. DIRENY Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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JEANNE RADDAY Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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JACK G. LAFONTANT Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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ELS MATHIEU Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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RICHARD D. RHEINGANS Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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ANNE C. HADDIX Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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THOMAS G. STREIT Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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MICHAEL J. BEACH Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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DAVID G. ADDISS Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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PATRICK J. LAMMIE Hopital Ste. Croix, Leogane, Haiti; Lymphatic Filariasis Support Center, Emory University, Atlanta, Georgia; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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DOI:
https://doi.org/10.4269/ajtmh.2005.73.888
Volume/Issue:
Volume 73: Issue 5
Page(s):
888–894
Restricted access
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To support the global program to eliminate lymphatic filariasis (LF), well-monitored demonstration projects are important for defining the relationship between coverage and reductions in microfilaremia. We are using mass treatment with diethylcarbamazine (DEC) and albendazole in an effort to eliminate LF from Leogane, Haiti. Wuchereria bancrofti microfilaremia prevalence at baseline ranged from 0.8% to 15.9% in four sentinel sites. After three rounds of DEC-albendazole mass drug administration (MDA), both microfilaremia prevalence and intensity decreased dramatically. Mild and moderate adverse reactions after treatment were common, especially after the first MDA, but decreased after subsequent MDAs. Drug coverage for the first year was estimated to be 72%, but concerns about adverse reactions appeared to decrease drug coverage in the second MDA. As a result of community education efforts that focused on providing a greater understanding of adverse reactions, coverage increased dramatically for the third round. Program efficiency increased substantially; the costs per person treated for three rounds of MDA were $2.23, $1.96, and $1.30 per person, respectively. The Leogane experience highlights the importance of adapting community education and mobilization campaigns to achieve and maintain good coverage.

Author Notes

Copyright:
Copyright 2005 The American Society of Tropical Medicine 2005
Received:
25 Apr 2005
|
Accepted:
29 Jun 2005
|
Published Online:
Nov 2005
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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