Progress towards, and challenges for, the elimination of filariasis from Pacific-island communities

The Pacific Programme for the Elimination of Lymphatic Filariasis (PacELF) - the first regional campaign to attempt to eliminate filariasis as a public-health problem - is using five, annual, mass drug administrations (MDA) of diethylcarbamazine (DEC) plus albendazole to stop transmission. In 2001, nine countries and territories covered by the programme had begun annual MDA campaigns, with population treatment coverages ranging from 52% to 95%. By the end of 2002, it is anticipated that 11 countries/territories will have begun such MDA campaigns. Even with high MDA coverage, the efficiency of Aedes polynesiensis as a vector of Wuchereria bancrofti may limit the effectiveness of the elimination campaigns in some countries. In areas of limited MDA coverage, additional strategies, such as vector control (as a adjunct to the MDA), or alternative approaches, such as the use of DEC-fortified salt, may be necessary to stop transmission.