A successful control programme for lymphatic filariasis in Hubei, China

This paper describes the epidemiology and control of human lymphatic filariasis in Hubei province, China from the 1950s to the 1990s. Brugia malayi, transmitted by Anopheles sinensis, and Wuchereria bancrofti, transmitted by Culex quinquefasciatus, were found in 69 of 78 counties and cities. The distribution of filaria species was distinct, with B. malayi endemic in the plains, mixed infections in hilly areas, and W. bancrofti in the mountains. Before 1979, the microfilaria rate (mfr) in some villages was as high as 30.69%. Since 1979, large scale control programmes have been carried out and 27,875,267 blood examinations have been made. Up to 1988, the mfr in all endemic villages decreased to below 1%. From 1989 to 1991 about 200,000 people had their blood examined yearly and few cases were detected. The continued use of mass blood examination for filariasis surveillance is not economic at such low levels of infection, and it is suggested that selective treatment of microfilaremic persons should be the main control measure at this stage.