In December 2023, the Government of Maldives spearheaded a screening program focused on the migrant population residing in Haa Dhaalu Atoll Kulhudhuffushi Island. This initiative, part of the World AIDS Day activities, aimed to test for specific communicable diseases including lymphatic filariasis using Filaria Testing Strip (FTS) kits, as well as offering other public health services such as COVID-19 vaccination. Out of 233 individuals tested, 17 were found to be positive for lymphatic filariasis, prompting further screenings which revealed a total of 32 positive cases. All of the affected individuals were migrants from filaria-endemic countries. This event was particularly significant because the Maldives had previously been certified as free of lymphatic filariasis in 2016. The detection of new cases highlighted the importance of maintaining vigilance and robust surveillance systems, even in countries that have successfully eliminated the disease.
Following World Health Organization (WHO)’s technical guidance, treatment was promptly initiated for all antigen-positive cases, and immediate control measures were implemented.
Recognizing the urgency of the situation, the Government of Maldives launched a nationwide screening program for lymphatic filariasis. This initiative aimed to better understand the prevalence of the disease among both local residents and migrants, with the results intended to guide future public health actions, including potential need for Mass Drug Administrations (MDA). Concurrently, vector control and clean-up efforts were intensified across various islands, while the Health Protection Agency, with the support of WHO conducted extensive training and awareness sessions for healthcare workers across all atolls. In collaboration with the Maldivian Red Crescent (MRC), efforts were also underway to translate all Information, Education, and Communication (IEC) materials into multiple foreign languages, such as Bangla, Sinhalese, and Hindi, to effectively reach the migrant population.
WHO’s response was rapid and comprehensive, mobilizing all three layers of the organization within hours of the initial request to deliver urgent support. This prompt action included the provision of 25,000 rapid diagnostic test kits and substantial quantities of antifilarial medication: Albendazole 400mg (1,400 tablets), Ivermectin 3mg (3,000 tablets) and Diethyl Carbamazine 100mg (3,000 tablets initially, followed by a further 84,000 tablets upon request from the government). These resources were swiftly handed over to the Health Protection Agency for immediate distribution and deployment in response efforts.
WHO's support extended beyond just technical guidance; it included facilitating capacity building for field teams and laboratory staff on the use of FTS rapid diagnostic test kits, offering technical assistance for planning and implementing the screening program, and supporting in development of messages for FAQs and other IEC materials. Moreover, WHO ensured the provision of rapid diagnostic test kits and ant filarial medication beyond the initially requested amounts, demonstrating steadfast commitment to managing the lymphatic filariasis situation in the Maldives. The support is still ongoing, reflecting the commitment to prioritizing and bolstering operational-level response in the Maldives. WHO has consistently supported the government of Maldives with development of country capacity for disease surveillance and control as well as health emergency response, aiding in risk communication and community engagement by disseminating information in various languages. This comprehensive support includes capacity building through vector control training, clinical guidance for healthcare professionals, and medical entomology training, demonstrating WHO’s dedication to maintaining robust public health systems.
“The Filaria response was a critical reminder of the need for resilient and adaptable public health systems. It also highlighted the importance of ongoing monitoring to maintain disease elimination status.” Said Ms Sarah Jamal, National Professional Officer (Communicable Diseases), WHO Maldives, “By working together with the Government, we were able to rapidly deploy necessary resources, provide technical guidance and support implementation of effective control measures.”
As a trusted partner to the Government of Maldives, the timely support provided was pivotal in enhancing surveillance, reporting, and the overall response to lymphatic filariasis in the Maldives, showcasing WHO’s commitment to public health and support for affected communities.