Criteria to Stop Mass Drug Administration for Lymphatic Filariasis Have Been Achieved Throughout Plateau and Nasarawa States, Nigeria

Abel Eigege The Carter Center, Jos, Plateau State, Nigeria;

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Darin S. Evans The Carter Center, Atlanta, Georgia;
United States Agency for International Development (USAID), Washington, District of Columbia;

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Gregory S. Noland The Carter Center, Atlanta, Georgia;

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Emmanuel Davies Federal Ministry of Health, Abuja, Nigeria;

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John Umaru The Carter Center, Jos, Plateau State, Nigeria;

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Solomon E. Adelamo The Carter Center, Jos, Plateau State, Nigeria;

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Bulus Mancha The Carter Center, Jos, Plateau State, Nigeria;

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Jonathan D. King The Carter Center, Atlanta, Georgia;
Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland

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Emmanuel S. Miri The Carter Center, Jos, Plateau State, Nigeria;

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Bridget Okoeguale Federal Ministry of Health, Abuja, Nigeria;

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Emily P. Griswold The Carter Center, Atlanta, Georgia;

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Frank O. Richards Jr. The Carter Center, Atlanta, Georgia;

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Nigeria has the largest population at risk for lymphatic filariasis (LF) in Africa. This study used a transmission assessment survey (TAS) to determine whether mass drug administration (MDA) for LF could stop in 21 districts, divided into four evaluation units (EUs), of Plateau and Nasarawa States, Nigeria, after 8–12 years of annual albendazole–ivermectin treatment. A total of 7,131 first- and second-year primary school children (approximately 6–7 years old) were tested for LF antigen by immunochromatographic test (ICT) from May to June 2012. The target sample size of 1,692 was exceeded in each EU (range = 1,767–1,795). A total of 25 (0.4%) individuals were ICT positive, with the number of positives in each EU (range = 3–11) less than the TAS cutoff of 20, meaning that LF transmission had been reduced below sustainable levels. As a result, 3.5 million annual albendazole–ivermectin treatments were halted in 2013. Combined with the previous halt of MDA for LF in other parts of Plateau and Nasarawa, these are the first Nigerian states to stop LF MDA statewide. Posttreatment surveillance is ongoing to determine if LF transmission has been interrupted.

Author Notes

Address correspondence to Gregory S. Noland, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307. E-mail: gregory.noland@cartercenter.org

Authors’ addresses: Abel Eigege, John Umaru, Solomon E. Adelamo, Bulus Mancha, and Emmanuel S. Miri, The Carter Center, Jos, Plateau State, Nigeria, E-mails: abel.eigege@cartercenter.org, john.umaru@cartercenter.org, solomon.adelamo@cartercenter.org, bulus.mancha@cartercenter.org, and emmanuel.miri@cartercenter.org. Darin S. Evans, United States Agency for International Development (USAID), Washington, DC, E-mail: daevans@usaid.gov. Gregory S. Noland, Emily P. Griswold, and Frank O. Richards Jr., The Carter Center, Atlanta, GA, E-mails: gregory.noland@cartercenter.org, emily.griswold@cartercenter.org, and frank.richards@cartercenter.org. Emmanuel Davies and Bridget Okoeguale, Federal Ministry of Health, Abuja, Nigeria, E-mails: enimed2003@yahoo.com and bridgeclinic2002@yahoo.com. Jonathan D. King, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland, E-mail: kingj@who.int.

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