Lymphatic filariasis in Fiji: progress towards elimination, 1997-2007

Area of Science:

• Tropical medicine
• Infectious disease epidemiology
• Public health interventions

Background:

• Lymphatic filariasis (LF) remains a significant public health issue in Fiji, transmitted by Aedes mosquitoes.
• Despite prior elimination efforts, Fiji continued to face endemic LF challenges before 1999.
• Fiji joined the Pacific Programme for Elimination of LF (PacELF) and the Global Programme to Eliminate LF in 1999.

Purpose of the Study:

• To review and analyze historical LF data in Fiji from 1997 to 2007.
• To assess the impact of mass drug administration (MDA) on LF prevalence in Fiji.
• To inform future strategies for LF elimination in the region.

Main Methods:

• A comprehensive review of published and unpublished LF data from 1997-2007.
• Analysis of baseline and follow-up surveys, including antigen and microfilaria prevalence.
• Evaluation of mass drug administration (MDA) coverage and impact through various survey types.

Main Results:

• Baseline LF prevalence in Fiji was high (16.6% antigen positive, 6.3% microfilaria positive).
• Five annual rounds of MDA (2002-2006) reduced national antigen prevalence to 9.5% and microfilaria prevalence to 1.4% by 2007.
• Despite significant reductions, the 1% prevalence threshold for stopping MDA was not met nationwide.

Conclusions:

• Nationwide MDA in Fiji achieved substantial reductions in LF prevalence between 2002 and 2006.
• Challenges including population distribution and program consistency impacted optimal coverage.
• Fiji realigned its LF elimination strategy post-2007, focusing on stratified programs and improved coverage to progress towards validation.