Ongoing Surveillance for Lymphatic Filariasis in Togo: Assessment of Alternatives and Nationwide Reassessment of Transmission Status

Philip J. Budge Epidemic Intelligence Service Assigned to the Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Program for the Elimination of Lymphatic Filariasis, Ministry of Health, Lomé, Togo; Mectizan Donation Program, Atlanta, Georgia; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia; Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

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Ameyo M. Dorkenoo Epidemic Intelligence Service Assigned to the Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Program for the Elimination of Lymphatic Filariasis, Ministry of Health, Lomé, Togo; Mectizan Donation Program, Atlanta, Georgia; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia; Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

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Yao K. Sodahlon Epidemic Intelligence Service Assigned to the Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Program for the Elimination of Lymphatic Filariasis, Ministry of Health, Lomé, Togo; Mectizan Donation Program, Atlanta, Georgia; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia; Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

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Omofolarin B. Fasuyi Epidemic Intelligence Service Assigned to the Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Program for the Elimination of Lymphatic Filariasis, Ministry of Health, Lomé, Togo; Mectizan Donation Program, Atlanta, Georgia; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia; Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

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Els Mathieu Epidemic Intelligence Service Assigned to the Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Program for the Elimination of Lymphatic Filariasis, Ministry of Health, Lomé, Togo; Mectizan Donation Program, Atlanta, Georgia; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia; Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

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Tremendous progress has been made towards the goal of global elimination of lymphatic filariasis (LF) transmission by 2020. The number of endemic countries reducing LF transmission through mass drug administration continues to increase, and therefore, the need for effective post-intervention surveillance also continues to increase. Togo is the first sub-Saharan African country to implement LF surveillance, and it has 6 years of experience with this passive surveillance system. We herein report the results of a recent evaluation of the Togolese LF surveillance system, including an evaluation of blood donors as a surveillance population, and provide updated results of ongoing surveillance, including expansion in remote areas. Since implementation of LF surveillance in 2006, only three cases of positive Wuchereria bancrofti filaremia have been detected, suggesting that interruption of transmission has been sustained. Given the impracticality of validating the surveillance system in the absence of ongoing transmission, we confirmed the lack of transmission through a nationwide reassessment survey.

Author Notes

* Address correspondence to Els Mathieu, Center for Global Health, Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30333. E-mail: emm7@cdc.gov

Financial support: This study is made possible by the generous support of the American people through the U.S. Agency for International Development (USAID) and the ENVISION project under cooperative agreement No. AID-OAA-A-11-00048.

Authors' addresses: Philip J. Budge, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, E-mail: Philip.budge@vanderbilt.edu. Ameyo M. Dorkenoo, Program for the Elimination of Lymphatic Filariasis, Ministry of Health, Lomé, Togo, E-mail: monicadork@yahoo.fr. Yao K. Sodahlon, Mectizan Donation Program, Decatur, GA, E-mail: ysodahlon@taskforce.org. Omofolarin B. Fasuyi, Department of Family Medicine, Morehouse School of Medicine, East Point, GA, E-mail: OFasuyi@msm.edu. Els Mathieu, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: emm7@cdc.gov.

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