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PLoS One

Title:		Low transmission of Wuchereria bancrofti in cross-border districts of Cote d'Ivoire: A great step towards lymphatic filariasis elimination in West Africa
Author(s):		Yokoly FN; Zahouli JBZ; Meite A; Opoku M; Kouassi BL; de Souza DK; Bockarie M; Koudou BG;
Address:		"Unite de Formation et de Recherche Sciences de la Nature, Universite Nangui Abrogoua, Abidjan, Cote d'Ivoire. Centre Suisse de Recherches Scientifiques en Cote d'Ivoire, Abidjan, Cote d'Ivoire. Centre d'Entomologie Medicale et Veterinaire, Universite Alassane Ouattara, Bouake, Cote d'Ivoire. Programme National de Lutte contre les Maladies Tropicales Negligees a Chimiotherapie Preventive, Ministere de la Sante, Abidjan, Cote d'Ivoire. Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana. European & Developing Countries Clinical Trials Partnership, Cape Town, South Africa. Department of Medicine, University of Cape Town, Cape Town, South Africa"
Journal Title:		PLoS One
Year:		2020
Volume:		20200413
Issue:		4
Page Number:		e0231541 -
DOI:		10.1371/journal.pone.0231541
ISSN/ISBN:		1932-6203 (Electronic) 1932-6203 (Linking)
Abstract:		"BACKGROUND: Lymphatic filariasis (LF) is widely endemic in Cote d'Ivoire, and elimination as public health problem (EPHP) is based on annual mass drug administration (MDA) using ivermectin and albendazole. To guide EPHP efforts, we evaluated Wuchereria bancrofti infection indices among humans, and mosquito vectors after four rounds of MDA in four cross-border health districts of Cote d'Ivoire. METHODOLOGY: We monitored people and mosquitoes for W. bancrofti infections in the cross-border health districts of Aboisso, Blolequin, Odienne and Ouangolodougou, Cote d'Ivoire. W. bancrofti circulating filarial antigen (CFA) was identified using filariasis test strips, and antigen-positive individuals were screened for microfilaremia. Moreover, filarial mosquito vectors were sampled using window exit traps and pyrethrum sprays, and identified morphologically at species level. Anopheles gambiae s.l. and Culex quinquefasciatus females were analyzed for W. bancrofti infection using polymerase chain reaction (PCR) technique. PRINCIPAL FINDINGS: Overall, we found a substantial decline in W. bancrofti infection indices after four rounds of MDA compared to pre-MDA baseline data. CFA prevalence fell from 3.38-5.50% during pre-MDA to 0.00-1.53% after MDA interventions. No subjects had detectable levels of CFA in Ouangolodougou. Moreover, post-MDA CFA prevalence was very low, and below the 1% elimination threshold in Aboisso (0.19%) and Odienne (0.49%). Conversely, CFA prevalence remained above 1% in Blolequin (1.53%). W. bancrofti microfilariae (Mf) were not found in Aboisso, Blolequin, and Ouangolodougou, except for Odienne with low prevalence (0.16%; n = 613) and microfilaremia of 32.0 Mf/mL. No An. gambiae s.l. and Cx. quinquefasciatus pools were infected with W. bancrofti in Blolequin and Ouangolodougou, while they exhibited low infection rates in Aboisso (1% and 0.07%), and Odienne (0.08% and 0.08%), respectively. CONCLUSIONS: In cross-border areas of Cote d'Ivoire, LF infection indices in humans and mosquito vectors substantially declined after four rounds of MDA. CFA prevalence fell under the World Health Organization (WHO)-established threshold (1%) in Aboisso, Ouangolodougou and Odienne. Moreover, W. bancrofti prevalence in mosquitoes was lower than WHO-established threshold (2%) in all areas. This might suggest the interruption of W. bancrofti transmission, and possible MDA cessation. However, a formal transmission assessment survey (TAS) and molecular xenomonitoring in mosquito vectors should be implemented before eventual MDA cessation. However, MDA should pursue in Blolequin where W. bancrofti infection prevalence remained above 1%. Our results provided important ramifications for LF control efforts towards EPHP in Cote d'Ivoire"
Keywords:		"Adolescent Adult Aged Animals Child Child, Preschool Cote d'Ivoire/epidemiology Disease Eradication Elephantiasis, Filarial/epidemiology/prevention & control/*transmission Female Geography, Medical Humans Male Mass Drug Administration Middle Aged Mosquito;"
Notes:		"MedlineYokoly, Firmain N Zahouli, Julien B Z Meite, Aboulaye Opoku, Millicent Kouassi, Bernard L de Souza, Dziedzom K Bockarie, Moses Koudou, Benjamin G eng Research Support, Non-U.S. Gov't 2020/04/14 PLoS One. 2020 Apr 13; 15(4):e0231541. doi: 10.1371/journal.pone.0231541. eCollection 2020"