Noguchi Memorial Institute for Medical Research
Strategies for the ENdgame: Targeting Infections among Non-compliants in the Elimination of Lymphatic filariasis (SENTINEL)
Non-compliance is a primary barrier to attaining elimination goals. This study aims to utilize data captured in MDA registers to address non-compliance in the Ahanta West District of Ghana, which has been identified as a hotspot of LF transmission with >1% microfilaria (mf) prevalence after 15-16 rounds of MDA. On the basis of information identified in the register, this study proposes to deploy two strategies:
- Engage and Treat individuals who were ill, missed treatment, or were unable to participate during the last MDA, and
- Test and Treat for individuals who might be systemically non-compliant or afraid of adverse events. The use of MDA registers to assist in locating non-compliant individuals is novel and would provide valuable evidence for other programs and represents an alternative strategy for countries struggling with the end game. It may also help provide insight as to whether systematically non-compliant individuals truly serve as a reservoir for LF in areas designated as hotspots. Qualitative data collection will aid in understanding reasons for systematic non-compliance and may lead to changes in social mobilization strategies.
Determination of the prevalence of LF infection in districts not included in LF control activities and of the basis for integrated implementation of LF - onchocerciasis elimination strategies in potentially co-endemic areas
Field validation of the diagnostic performance of the Wb123/Ov16 biplex rapid diagnostic test and Wb123 ELISA, compared to the filariasis test strip (FTS) in a setting initially found to be non-endemic for lymphatic filariasis, in which clinical cases have been identified.
Laboratory analysis of Ov16 ELISA and Skin snip PCR to support surveillance activities in National programs. Multi-country comparison of diagnostic tools to detect Onchocerca volvulus.
To compare the performance of the diagnostic tools currently available for O. volvulus in terms of their relative sensitivity, species-specificity and practical use by countries. Comparison of the utility of these tools for mapping and surveillance in settings with different levels of endemicity for onchocerciasis (Oncho), lymphatic filariasis (LF) and/or loiasis.