Expanding the Treatment Goals of Lymphatic Filariasis Beyond Missed 2020 Deadline
By admin October 19, 2015

LymphThe 2015 publication by Kastner, Stone, Steinmann, Tanner, and Tedios demonstrated in four different Lymphatic Filariasis (LF), or Elephantiasis, scenarios that the current World Health Organization (WHO) strategy, even if dramatically increased, would not eradicate Lymphatic Filariasis until 2028 at the earliest due to systematic difficulties, delays in implementation, in lack of access to necessary medications. Moreover, additional reports have come out explaining that treating Neglected Tropical  Diseases (NTDs) like LF also require attention be given to the mental health burden placed on sufferers and their caretakers.

The WHO 2020 goal rests on 2 components, namely preventing transmission of the parasite using preventative chemotherapy, so the fact that several countries identified as Lymphatic Filariasis ridden have yet to receive access to the cocktail further supports the conclusion that the 2020 goal is unattainable at this point.

Lymphatic Filariasis (LF), otherwise known as Elephantiasis is a Neglected Tropical Disease (NTD) prevalent in 73 of the world’s poorest countries and threatening 1.28 billion people. it is spread by mosquitoes transmitting nematode-like parasitic worms to humans. These worms- Wuchereria bancrofti for 90% of the cases , Brugia malayi for ~10% of cases, and B.Timori- nestle in the human lymphatic system, producing more parasites to be transmitted by mosquitos when next that individual is bitten, turning the sufferer into an incubator. The disruption further upsets the balance of the lymphatic system, a symptom which manifests itself in extreme vasodilation and localized swelling. If left untreated the swelling can become permanent, debilitating the sufferer for the rest of their lives.

In light of all of this, LF was deemed a disease that is not only treatable but eradicable by the WHO. In 1997, the goal was made to eradicate LF. The creation of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) followed these actions, with a refined eradication date set for 2020, in the 2012 WHO NTD Roadmap.

Although the eradication goal currently escapes us, it is within our means to address the mental health burden LF places on its sufferers and caretakers. The mental health burden of LF doubles the current global health burden, measured in Disability Adjusted Life Years (DALY), of the disease from 2.78 Million DALYs to 5.09 Million DALYS, roughly 230,000 DALYs belonging to caretakers. LF sufferers report depressive illnesses, understandably so when the illness destroys job prospects, marriage prospects, child-rearing, and community engagement opportunities.

WHO experimented with LF Support Groups in 1998 in Haiti; the Carter Center also implemented Support Groups for LF sufferers in Nigeria, once the most LF riddled country in Africa. Individuals reported relief engaging with individuals who could relate to their suffering and experience, giving them desires to try engaging their communities, in spite of their LF.

WHO has not yet standardized support groups as part of its care delivery package for LF eradication. But, the health burden of LF is greatly exaggerated by its mental health implications, and the task of eradicating LF must include targeting all aspects of the disease. WHO admits the 2020 goal, at their current trajectory, will not be realized, and more engagement will be required. If this is the case, then officials are within their means to include mental health support groups as part of their overall relief.

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