The World Health Organization (WHO) has reported that Maldives and Sri Lanka have eliminated lymphatic filariasis (also known as elephantiasis). This disease has crippled people for decades, forcing them to lead a life of stigma, discrimination and poverty. “The achievement by Maldives and Sri Lanka demonstrates the resolve of these countries and the WHO South-East Asia Region as a whole to eliminate all neglected tropical diseases, which have no reason to continue and mar the lives of people,” Dr Poonam Khretrapal Singh, Regional Director, WHO South-East Asia Region, said.
The success in Maldives and Sri Lanka is attributed to intensified efforts at mosquito control; treatment of the infected population, disability prevention and control; strengthening of surveillance; and close monitoring and evaluation. Together, these efforts helped to eliminate lymphatic filariasis as a public health problem.
Lymphatic filariasis, commonly known as elephantiasis, is a neglected tropical disease caused by infection with roundworms classified as nematodes of the family Filariodidea. The roundworms are transmitted to humans by Culex, Anopheles and Aedes mosquitoes when they ingest infected blood when biting an infected host.
The disease is believed to have been endemic in Maldives since 12th and 13th century and is traced back to much earlier in Sri Lanka, with the mosquitoes transmitting the bug found in abundance across the two countries. Infection is usually acquired in childhood causing hidden damage to the lymphatic system.
It can then result in an altered lymphatic system and the abnormal enlargement of body parts, causing pain and severe disability These visible disfiguring abnormal enlargement include lymphoedema, elephantiasis and scrotal swelling and they lead to permanent disability. Involvement of breasts and genital organs is common. Infected individuals are not only physically disabled, but suffer mental, social and financial hardship contributing to stigma and poverty.
Currently, 1.10 billion people in 55 countries are living in areas that require preventive chemotherapy to stop the spread of infection. Approximately 80% of these people are living in the following 10 countries: Angola, Cameroon, Côte d’Ivoire , Democratic Republic of the Congo, India, Indonesia, Mozambique, Myanmar, Nigeria and the United Republic of Tanzania. In 2000, over 120 million people were infected, with about 40 million disfigured and incapacitated by the disease. Globally, an estimated 25 million men suffer with genital disease and over 15 million people are afflicted with lymphoedema. Eliminating lymphatic filariasis can prevent unnecessary suffering and contribute to the reduction of poverty globally.
In 2012, the WHO neglected tropical diseases roadmap set the year 2020 as a target for achieving elimination of lymphatic filariasis as a public health problem.
In the South-East Asia Region, WHO has been prioritizing finishing the task of eliminating diseases on the verge of elimination. Following Maldives and Sri Lanka’s success, LF-endemic countries working towards elimination is now reduced to seven in the Region.