title: The Leogane, Haiti demonstration project: decreased microfilaremia and program costs after three years of mass drug administration.
abstract: To support the global program to eliminate lymphatic filariasis (LF), well-monitored demonstration projects are important for defining the relationship between coverage and reductions in microfilaremia. We are using mass treatment with diethylcarbamazine (DEC) and albendazole in an effort to eliminate LF from Leogane, Haiti. Wuchereria bancrofti microfilaremia prevalence at baseline ranged from 0.8% to 15.9% in four sentinel sites. After three rounds of DEC-albendazole mass drug administration (MDA), both microfilaremia prevalence and intensity decreased dramatically. Mild and moderate adverse reactions after treatment were common, especially after the first MDA, but decreased after subsequent MDAs. Drug coverage for the first year was estimated to be 72%, but concerns about adverse reactions appeared to decrease drug coverage in the second MDA. As a result of community education efforts that focused on providing a greater understanding of adverse reactions, coverage increased dramatically for the third round. Program efficiency increased substantially; the costs per person treated for three rounds of MDA were 2.23 US dollars, 1.96 US dollars, and 1.30 US dollars per person, respectively. The Leogane experience highlights the importance of adapting community education and mobilization campaigns to achieve and maintain good coverage.
authors.affiliation: Hopital Ste. Croix, Leogane, Haiti.
authors.forename: Madsen Beau
authors.initials: MB
authors.lastname: de Rochars
authors.forename: Sanjat
authors.initials: S
authors.lastname: Kanjilal
authors.forename: Abdel N
authors.initials: AN
authors.lastname: Direny
authors.forename: Jeanne
authors.initials: J
authors.lastname: Radday
authors.forename: Jack G
authors.initials: JG
authors.lastname: Lafontant
authors.forename: Els
authors.initials: E
authors.lastname: Mathieu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Rheingans
authors.forename: Anne C
authors.initials: AC
authors.lastname: Haddix
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Streit
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Beach
authors.forename: David G
authors.initials: DG
authors.lastname: Addiss
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Lammie
mesh_terms: D015766:Albendazole / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D000818:Animals; D004049:Diethylcarbamazine / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D005369:Filaricides / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D006078:Government Programs / Q000191:economics; D006205:Haiti; D006266:Health Education; D006801:Humans; D008842:Microfilariae / Q000187:drug effects / Q000254:growth & development; D015397:Program Evaluation; D018571:Sentinel Surveillance; D014958:Wuchereria bancrofti / Q000187:drug effects
chemical_list: D005369:Filaricides; D015766:Albendazole; D004049:Diethylcarbamazine