[The history of lymphatic filarlasis control programme in French Polynesia: lessons from a 50 years effort]

With a mean prevalence of microfilariaemia superior to 15% in the four archipelagos of the territory French Polynesia was confronted with a huge public health problem of Wuchereria bancrofti - associated filarias during the 50s. Supported by a strong US sponsoring, a large scale control campaign based on diethylcarbamazine (DEC) distribution was launched and led to the method of spaced doses (the most useful protocol being one annual DEC dose). Progressively applied to the whole Polynesian population since 1974, this very innovative programme had generated the idea of a possible eradication of the parasitosis. Meanwhile at laboratory level important progress in Immunology (mainly the validation of rapid diagnosis tests detecting a specific antigenemia) and later in Molecular Biology (with the main application being the follow-up of the infection status of the vector Aedes polynesiensis) questioned this optimistic concept (one lesson given by the study of Maupiti island, considered as a 0% reference island for a long time). More recently a regional WHO-sponsorized control programme, called PacELF, has for main objective the elimination of lymphatic filariasis as a public health problem in the South Pacific region near 2010. This objective argues for using a (DEC and albendazole) drug combination cumulating micro- and macro-filaricid activities. The dream of a lymphatic filariasis free Pacific is coming back again.