Bangladesh eliminates elephantiasis

In a boost to efforts to end neglected tropical diseases in WHO South-East Asia Region, Bangladesh has eliminated lymphatic filariasis, says the World Health Organization on Saturday (13 May).

This is a disease that cripples and has significant social and economic impact on the affected communities.

"Bangladesh's achievement is commendable and follows strong political commitment, tireless efforts by health authorities, partners and the communities. It is also a result of innovative approaches and meticulous implementation of elimination strategies," said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia, who has been prioritizing ending neglected tropical diseases (NTDs) in the Region as one of the flagship programs.

Lymphatic filariasis, also known as elephantiasis, occurs when filarial parasites are transmitted to humans through mosquito bites.

The infection is usually acquired in childhood with painful and disfiguring visible manifestations appearing much later in life, often in the form of enlargement of body parts causing pain, severe disability, and associated stigma.

Lymphatic filariasis was a major public health problem in Bangladesh.

In 2001 the country established its national programme to eliminate lymphatic filariasis which was endemic in 19 of the 64 districts. Between 2001 and 2015, high coverage mass drug administration campaigns were rolled out in all endemic districts.

Alongside, systematic and high-quality transmission assessment surveys were carried out by well-trained programme personnel between 2011 and 2021.

The Regional Director also complimented Bangladesh for its morbidity management and disability prevention programme which has been regularly updating data from the endemic districts. Using this database, over 31,000 patients have been trained on self-care and provided kits to manage their disease condition and improve quality of life.

For lymphatic filariasis elimination, WHO strategy is based on two key components - first, stopping spread of infection through large-scale annual treatment of entire populations at risk in an area or region where transmission is present; and second, alleviating the suffering caused by lymphatic filariasis through increased disease management and disability prevention measures.

As part of the validation process, Bangladesh submitted a dossier to WHO which was reviewed by a Regional Dossier Review Group.

After examining the dossier, the Regional Dossier Review Group recommended Bangladesh for validation of elimination of lymphatic filariasis as a public health problem.

"Strong partnership, several innovative operational research projects in surveillance methodologies and well-trained programme personnel have been key to the country's success and will continue to be critical for the country to sustain its status of lymphatic filariasis elimination," Dr Khetrapal Singh said.

Bangladesh's national strategic plan 2018-2025 focuses on post-validation surveillance strategy and response measures to prevent recrudescence of infection and progress towards elimination of transmission.

Bangladesh is the fourth country in WHO South-East Asia Region to eliminate lymphatic filariasis as a public health problem after Maldives, Sri Lanka and Thailand.

In 2014, Dr Khetrapal Singh identified ending neglected tropical diseases as one of her flagship priorities.

Besides lymphatic filariasis, there has been successes against other neglected tropical diseases. India has been certified for ending yaws and Nepal and Myanmar have eliminated trachoma as a public health problem.

"Neglected tropical diseases affect the marginalized and the vulnerable communities, aggravating their sufferings manifold. With low-cost and highly effective drugs and treatments we must end NTDs.

WHO remains committed to support efforts to eliminate these diseases to achieve a healthier, more equitable and sustainable future for everyone, everywhere," the Regional Director said.