title: Clinical case estimates of lymphatic filariasis in an endemic district of Bangladesh after a decade of mass drug administration.
abstract: BACKGROUND
  Bangladesh has a high burden of lymphatic filariasis (LF) disease. This survey estimated the current number of clinical cases in a historically endemic district after a decade of mass drug administration (MDA).
  
  
  METHODS
  A cluster survey was conducted in 30 villages of Nilphamari District. Ten households per village were randomly selected, and individuals with LF clinical conditions identified. Hydrocoele and lymphoedema (leg, arm, breast) cases were quantified and mapped, and differences by sex, age, severity of disease and episodes of acute dermatolymphangioadenitis attacks (ADLA) examined.
  
  
  RESULTS
  From 1242 surveyed >10 years old 55 individuals (4.4%) with LF clinical conditions were identified. Males were mostly affected by hydrocoeles, and females by leg lymphoedema. Higher prevalence and more advanced stages of disease were found in older age groups.
  
  
  CONCLUSIONS
  Overall low prevalence of severe clinical disease was found, which has positive implications for the elimination goal. Future planning of MMDP strategies will need to address the varying clinical conditions, severity of disease and impact of ADLAs affecting different sub-groups of the population. It will also be important to monitor for new cases, and examine the shift in age distribution of cases over time.
authors.affiliation: Filarial Programmes Support Unit-Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Israt
authors.initials: I
authors.lastname: Hafiz
authors.affiliation: Australian Institute of Tropical Health and Medicine and College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Graves
authors.affiliation: Filariasis Elimination Program, Directorate General of Health Services, Dhaka, Bangladesh.
authors.forename: Rouseli
authors.initials: R
authors.lastname: Haq
authors.affiliation: National Institute of Preventive and Social Medicine, Dhaka, Bangladesh.
authors.forename: Meerjady Sabrina
authors.initials: MS
authors.lastname: Flora
authors.affiliation: Filarial Programmes Support Unit-Liverpool School of Tropical Medicine, Liverpool, UK Australian Institute of Tropical Health and Medicine and College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia Louise.Kelly-Hope@lstmed.ac.uk.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Kelly-Hope
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000977:Antiparasitic Agents / Q000008:administration & dosage*; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D003140:Communicable Disease Control / Q000458:organization & administration*; D021821:Communicable Diseases, Emerging / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission; D018562:Disease Transmission, Infectious; D004334:Drug Administration Schedule; D004605:Elephantiasis, Filarial / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012720:Severity of Illness Index; D006848:Testicular Hydrocele / Q000453:epidemiology* / Q000469:parasitology
chemical_list: D000977:Antiparasitic Agents
keywords: Bangladesh; Elephantiasis; Hydrocoele; Lymphatic filariasis; Lymphoedema; Mass drug administration