Lymphatic filariasis

Morbidity management and disability prevention (MMDP)

Monitoring and Epidemiological Evaluation

An estimated 40 million people worldwide suffer from clinically significant manifestations of the lymphatic filariasis (LF), predominately lymphedema, elephantiasis and hydrocele. These conditions can lead to impairments, reduced economic productivity, and discrimination.

In 1997, the World Health Assembly adopted Resolution WHA 50.29, which called on Member States to initiate steps towards elimination of lymphatic filariasis as a public health problem. In response to this call, WHO launched the Global Programme to Eliminate Lymphatic Filariasis in 2000. The recommended elimination strategy has two components: (i) to stop the spread of infection (interrupting transmission); and (ii) to alleviate the suffering of affected populations (controlling morbidity).

Stopping the spread of infection through preventive chemotherapy will prevent new cases of disease. However, to achieve the aims of the second component as outlined in the 2011 morbidity management and disability prevention (MMDP) position statement, a minimum package of care for every person with lymphedema, elephantiasis or hydrocele must be available in all areas of known patients where LF is endemic.

This recommended minimum package of care includes:

  • MDA or individual treatment to destroy any remaining adult parasites and microfilaria
  • Surgery for hydrocoele (in W. bancrofti endemic areas)
  • Teatment for episodes of adenolymphangitis (ADL)
  • Management of lymphoedema to prevent both progression of disease and episodes of ADL.
Courtesy of Nepal and GSK/The basic management of lymphoedema involves simple, self-care hygiene and exercise measures. However, care must be continued throughout patients’ lives. Strengthening health care systems and increasing availability of WASH can improve MMDP for LF.

To ensure full geographic coverage of morbidity-management and disability prevention services, programmes must first understand the number and geographic distribution of patients. With this knowledge, programs can ensure facilities are providing services in all areas with known patients and work to ensure the quality of those services.

Countries claiming to have eliminated LF as a public health problem should clearly document the following information concerning care for LF patients:

  • the number of patients (lymphedema and hydrocele) estimated by the implementation unit;
  • the number of facilities designated to provide recommended care serving implementation units with known cases;
  • an assessment of the readiness and quality of services provided in designated facilities

To learn more on how countries can implement MMDP activities please see link below