title: Integrated mapping of lymphatic filariasis and podoconiosis: lessons learnt from Ethiopia.
abstract: BACKGROUND
  The World Health Organization (WHO), international donors and partners have emphasized the importance of integrated control of neglected tropical diseases (NTDs). Integrated mapping of NTDs is a first step for integrated planning of programmes, proper resource allocation and monitoring progress of control. Integrated mapping has several advantages over disease specific mapping by reducing costs and enabling co-endemic areas to be more precisely identified. We designed and conducted integrated mapping of lymphatic filariasis (LF) and podoconiosis in Ethiopia; here we present the methods, challenges and lessons learnt.
  
  
  METHODS
  Integrated mapping of 1315 communities across Ethiopia was accomplished within three months. Within these communities, 129,959 individuals provided blood samples that were tested for circulating Wuchereria bancrofti antigen using immunochromatographic card tests (ICT). Wb123 antibody tests were used to further establish exposure to LF in areas where at least one ICT positive individual was detected. A clinical algorithm was used to reliably diagnose podoconiosis by excluding other potential causes of lymphoedema of the lower limb.
  
  
  RESULTS
  A total of 8110 individuals with leg swelling were interviewed and underwent physical examination. Smartphones linked to a central database were used to collect data, which facilitated real-time data entry and reduced costs compared to traditional paper-based data collection approach; their inbuilt Geographic Positioning System (GPS) function enabled simultaneous capture of geographical coordinates. The integrated approach led to efficient use of resources and rapid mapping of an enormous geographical area and was well received by survey staff and collaborators. Mobile based technology can be used for such large scale studies in resource constrained settings such as Ethiopia, with minimal challenges.
  
  
  CONCLUSIONS
  This was the first integrated mapping of podoconiosis and LF globally. Integrated mapping of podoconiosis and LF is feasible and, if properly planned, can be quickly achieved at nationwide scale.
authors.forename: Heven
authors.initials: H
authors.lastname: Sime
authors.affiliation: Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom. kebededeka@yahoo.com.
authors.forename: Kebede
authors.initials: K
authors.lastname: Deribe
authors.forename: Ashenafi
authors.initials: A
authors.lastname: Assefa
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Newport
authors.forename: Fikre
authors.initials: F
authors.lastname: Enquselassie
authors.forename: Abeba
authors.initials: A
authors.lastname: Gebretsadik
authors.forename: Amha
authors.initials: A
authors.lastname: Kebede
authors.forename: Asrat
authors.initials: A
authors.lastname: Hailu
authors.forename: Oumer
authors.initials: O
authors.lastname: Shafi
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.forename: Richard
authors.initials: R
authors.lastname: Reithinger
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Brooker
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Pullan
authors.forename: Jorge
authors.initials: J
authors.lastname: Cano
authors.forename: Kadu
authors.initials: K
authors.lastname: Meribo
authors.forename: Alex
authors.initials: A
authors.lastname: Pavluck
authors.forename: Moses J
authors.initials: MJ
authors.lastname: Bockarie
authors.forename: Maria P
authors.initials: MP
authors.lastname: Rebollo
authors.forename: Gail
authors.initials: G
authors.lastname: Davey
mesh_terms: D000818:Animals; D000947:Antigens, Helminth / Q000097:blood; D040421:Cell Phone; D016208:Databases, Factual; D004604:Elephantiasis / Q000453:epidemiology*; D004605:Elephantiasis, Filarial / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D005002:Ethiopia / Q000453:epidemiology; D006801:Humans; D011159:Population Surveillance; D012106:Research / Q000191:economics*; D012107:Research Design; D014958:Wuchereria bancrofti / Q000276:immunology
chemical_list: D000947:Antigens, Helminth