Community-directed treatment of lymphatic filariasis in Africa
Report of a multi-country study
Summary
High, sustainable treatment coverage is the main challenge for lymphatic filariasis elimination. However, in most endemic countries in Africa, sustained drug delivery to all affected communities is difficult to achieve.
This report describes the findings of a multicentre study in Ghana and Kenya. The study compared the feasibility, effectiveness and sustainability of two drug delivery strategies:
- mass treatment by the health care system,
- community-directed treatment (ComDT), incorporating the health services at the level of implementation.
ComDT - where communities have the responsibility for treating themselves - was developed by TDR for onchocerciasis treatment. It is now the principal drug delivery strategy of the onchocerciasis control programmes in Africa.
Results from the study showed that treatment coverage by the health care system was poor. In contrast, the ComDT approach achieved high levels of treatment coverage. Furthermore, ComDT was effectively implemented through the health services.
Based on these findings, the report recommends that community-directed treatment, implemented through the health services, be used as the drug delivery strategy for filariasis elimination in Africa.