By Samuel Oyejola
As children in Plateau and Nasarawa states test negative to Lymphatic Filariasis (LF) infection, Nigeria prepares to join the league of countries with little or no threat of Lymphatic Filariasis.
The exercise is what the Carter Center needed to find out if the younger generation may not experience LF. Since 2015, children in Nasarawa and Plateau states between the ages of 6 and 7 have been tested for possible infection. The result indicated that the children and their peers may never have to worry about being disabled by LF. Of all those tested none has shown any trace of infection.
“Eliminating lymphatic filariasis as a public health problem in Plateau and Nasarawa states is a significant achievement that challenges everyone to broaden their appreciation of what is possible,” said Dr. Frank O. Richards Jr., director of the Carter Center’s Lymphatic Filariasis Elimination Program. “Success in these two states not only protects the 7 million people who live there, but it also sets a pattern for similar success throughout the rest of Nigeria, as well as in other highly endemic countries.”
LF, is caused by parasitic worms transmitted from infected persons to others by mosquito bites. The worms impair the lymphatic system, resulting in periodic fevers, fluid collection in the tissues (most commonly the limbs and genitalia), and severe swelling often known as elephantiasis. In addition to pain and reduced mobility, people disfigured by LF often experience crushing social stigma and chronic economic hardship that has a ripple effect across entire families and communities through lost productivity.
Nasarawa and Plateau states got the attention of the Carter Center with the endemic nature of LF in both states. “With over 120 million people at risk nationwide, Nigeria is the most endemic country in Africa for the parasitic disease and second most endemic in the world, behind only India,” according to the Carter Center.
The center assisted the national program and community health workers in the distribution and proper use of bed nets to protect against the night-biting Anopheles mosquitoes that can carry both LF and malaria.
Lymphatic filariasis in the two North-Central states is a public health problem over the years. To tackle the disease in the two states’ 30 local government areas, community-selected volunteers mobilized to educate their neighbors and annually distributed a combination of free medications — albendazole, and Mectizan donated by GSK and Merck &Co., Inc. in Plateau and Nasarawa alone, more than 36 million drug treatments for lymphatic filariasis were delivered between 2000 and 2012 alone. Mectizan is also used to fight river blindness, another parasitic disease in the two states.
However, the silence impacts of the Insecticide Treated Nets (ITNs) is enormous, this intervention places the states as the top beneficiaries of the nationwide distribution programme.
In both states, Clarke Cares Foundation/Clarke Mosquito Control donated more than 140,000 bed nets. Across the whole federation, more about 12 million ITNs were distributed with contribution from Vestergaard; and The Global Fund to fight AIDS, Tuberculosis, and Malaria for the protection against mosquitoes.
The intervention contributed not little to fight LF, especially for those who are not eligible to take the medications, such as children under 5 years old and pregnant women.
“Together with The Carter Center and our many other valuable partners, we are gaining the advantage over a terrible disease that has plagued good people for far too long,” said Dr. Yisa A. Saka, Director of Neglected Tropical Disease Programs with Nigeria’s Federal Ministry of Health.
The long term partnership between the Nigeria government through its Ministry of Health and the Carter Center has may have hit a goldmine in this fight against LF! The collaboration of the two countries resulted in the successful distribution of about 12 million insecticide treated nets across the country to battle malaria, the major non-communicable killer disease in the country.
“This definitive outcome is a testament to the foresight of those who launched the program, believing that elimination was possible in one of the world’s most endemic countries,” says Dr. Gregory Noland, health program epidemiologist at The Carter Center.
The Carter Center and its partners over the years continuously monitor the effectiveness of the program until it reduced the infection level in Plateau and Nasarawa states to the point where community-wide drug treatment could be discontinued in 2012. The program then moved into its next phase, called post-treatment surveillance, with financial support from the ENVISION Project, based at RTI International and funded by the U.S. Agency for International Development.
Nolan explained that a series of rigorous epidemiological surveys have been conducted throughout the two states to confirm transmission has been interrupted. Researchers examine finger-prick blood samples from children for evidence of the parasites in their blood. If transmission has been interrupted, those children’s tests should come back negative.