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Articles

Elimination of parasitic infections

Edited by: Dr David Rollinson

Collection published: 10 February 2011

Last updated: 28 March 2013

The idea that elimination of parasites and vectors in certain settings is achievable is gaining momentum. This is being driven, in part, by an increasing awareness that much can be done to reduce the morbidity and mortality caused by parasite infections by deploying existing tools, often based on drug donations from the pharmaceutical industry. In the past, targeted local elimination in isolated or island populations has been achieved, for example, hydatid disease (echinococcosis) in Iceland, Cyprus and New Zealand or sleeping sickness in São Tomé and Principe.

Encouraging examples of successful control and elimination of parasites and their vectors are now being reported in other settings and at a larger scale, including filariasis in China, Sri Lanka and the Republic of Korea and onchocerciasis in the Americas and in some settings in West Africa. Whilst successful control may be restricted initially to isolated pockets within an endemic area, or to the boundaries of a parasite’s range, where the life cycle may be more easily disrupted and where the prospect of reintroduction is limited, epidemiological evidence suggests that local elimination can be achieved. The role of animal reservoir hosts can be a critical factor for the prospects of elimination of some diseases and reservoir hosts may severely limit the chances of success.

In some cases, as with dracunculiasis, global eradication is the goal, that is the permanent certified reduction of incidence to zero globally. Dracunculiasis is now only endemic in 5 countries in Africa, transmission having been eliminated from Asia. Most importantly, there is a commitment from national health authorities in endemic countries to subscribe to World Health Assembly Resolutions for elimination of parasitic infections. This commitment, together with improved methods of vector and transmission control, wider availability of existing treatments, better health education, improved water quality and sanitation, increased knowledge of parasite and vector interactions, are all contributing to driving down prevalence and incidence of many parasitic infections and thus reducing disease morbidity and mortality.

In this Series, we aim to feature articles that highlight some of the important steps that need to be taken to eliminate both parasites and vectors in different regions of the world, and by bringing together these important contributions, we hope to illustrate how much can be achieved in reducing the burden of parasitic diseases.

		Research Challenges for malaria elimination in Zanzibar: pyrethroid resistance in malaria vectors and poor performance of long-lasting insecticide nets Khamis A Haji, Bakari O Khatib, Stephen Smith, Abdullah S Ali, Gregor J Devine, Maureen Coetzee, Silas Majambere Parasites & Vectors 2013, 6:82 (28 March 2013) Abstract \| Full text \| PDF \| ePUB \| PubMed \| Cited on BioMed Central \| Editor’s summary Durability of LLINs and emerging insecticide resistance pose a problem for the Zanzibar malaria control programme. Image: Used bed nets on Zanzibar.
		Review Factors impacting on progress towards elimination of transmission of schistosomiasis japonica in China Yi-Biao Zhou, Song Liang, Qing-Wu Jiang Parasites & Vectors 2012, 5:275 (3 December 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary This review summarizes some factors that may pose great obstacles towards transmission interruption of Schistosoma japonicum, and assesses potential roles of these factors in the transmission and implications for the current China¿s control strategy. Image: Water buffaloes pastured in the snail-inhabited marshland areas.
		Review Lymphatic filariasis in Brazil: epidemiological situation and outlook for elimination Gilberto Fontes, Anderson Leite, Ana Rachel Vasconcelos de Lima, Helen Freitas, John Ehrenberg, Eliana Maria Mauricio da Rocha Parasites & Vectors 2012, 5:272 (26 November 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary This paper reviews the available literature on the lymphatic filariasis epidemiological situation in Brazil, explores the current status of this parasitic disease and the outlook for its elimination in the country. Image: Wuchereria bancrofti microfilaria in Giemsa stained thick blood smear.
		Review Diversity and transmission competence in lymphatic filariasis vectors in West Africa, and the implications for accelerated elimination of Anopheles-transmitted filariasis Dziedzom K de Souza, Benjamin Koudou, Louise A Kelly-Hope, Michael D Wilson, Moses J Bockarie, Daniel A Boakye Parasites & Vectors 2012, 5:259 (14 November 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary In areas where the vector species transmitting Wuchereria bancrofti are Anopheles mosquitoes, it is feasible to eliminate Lymphatic Filariasis (LF) using Mass Drug Administration alone. This review outlines the differences in the diversity and transmission competence in the An. gambiae vectors of LF in West Africa, and the challenges it poses to the 2020 elimination goal. It calls for a better understanding of the vector competence of mosquitoes infected with W. bancrofti in different areas and a supplementation of MDA activities with vector control. Image: Anopheles head and mouth parts.
		Research Malaria transmission after five years of vector control on Bioko Island, Equatorial Guinea Hans J Overgaard, Vamsi P Reddy, Simon Abaga, Abrahan Matias, Michael R Reddy, Vani Kulkarni, Christopher Schwabe, Luis Segura, Immo Kleinschmidt, Michel A Slotman Parasites & Vectors 2012, 5:253 (12 November 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary In spite of five years of malaria control and a general reduction in malaria, foci of high transmission persist on Bioko Island. Innovative, locally adapted vector control interventions are needed to further control malaria in such hotspots. Image: Map of Bioko Island, Equatorial Guinea.
		Review The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination Kebede Deribe, Kadu Meribo, Teshome Gebre, Asrat Hailu, Ahmed Ali, Abraham Aseffa, Gail Davey Parasites & Vectors 2012, 5:240 (24 October 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Neglected tropical diseases (NTDs) are significant public health problems in Ethiopia. Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo in Sub-Saharan Africa. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. To achieve success in integrated control of NTDs, integrated mapping, rapid scale-up of interventions and operational research into co-implementation of intervention packages will be crucial. . Image: Podoconiosis patient.
		Review Elimination of Rhodnius prolixus in Central America Ken Hashimoto, Christopher J Schofield Parasites & Vectors 2012, 5:45 (22 February 2012) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary This review traces changes in the geographical distribution of Rhodnius prolixus, the main vector of Chagas disease in Central America, through surveillance and control interventions leading to its apparent elimination from mesoamerica. Image: Rhodnius prolixus Vth instar nymph feeding (photo courtesy Dr Carlos Ponce).
		Review Onchocerciasis in the Americas: from arrival to (near) elimination Ken Gustavsen, Adrian Hopkins, Mauricio Sauerbrey Parasites & Vectors 2011, 4:205 (25 October 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Onchocerciasis (river blindness) is a public health threat for millions worldwide. This article charts the course of onchocerciasis in the Western Hemisphere and discusses the prospects for elimination of the disease. Image: Using a dose pole to determine the correct dosage for onchocerciasis treatment.
		Research Progress towards the eradication of Tsetse from the Loos islands, Guinea Moise S Kagbadouno, Mamadou Camara, Jérémy Bouyer, Fabrice Courtin, Mory F Onikoyamou, Chris J Schofield, Philippe Solano Parasites & Vectors 2011, 4:18 (10 February 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Several control methods have been used against Glossina palpalis gambiensis, the main vector of sleeping sickness in West Africa,in Loos islands in Guinea. Present results show the absence of tsetse in the sentinel traps used for monitoring, which is a crucial step to achieve the ultimate goal of eradication. Image: Loos islands archipelago, Republic of Guinea, where an eradication project against Glossina palpalis gambiensis, vector of sleeping sickness, is ongoing.

		Research Challenges for malaria elimination in Zanzibar: pyrethroid resistance in malaria vectors and poor performance of long-lasting insecticide nets Khamis A Haji, Bakari O Khatib, Stephen Smith, Abdullah S Ali, Gregor J Devine, Maureen Coetzee, Silas Majambere Parasites & Vectors 2013, 6:82 (28 March 2013) Abstract \| Full text \| PDF \| ePUB \| PubMed \| Cited on BioMed Central \| Editor’s summary Durability of LLINs and emerging insecticide resistance pose a problem for the Zanzibar malaria control programme. Image: Used bed nets on Zanzibar.
		Review Factors impacting on progress towards elimination of transmission of schistosomiasis japonica in China Yi-Biao Zhou, Song Liang, Qing-Wu Jiang Parasites & Vectors 2012, 5:275 (3 December 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary This review summarizes some factors that may pose great obstacles towards transmission interruption of Schistosoma japonicum, and assesses potential roles of these factors in the transmission and implications for the current China¿s control strategy. Image: Water buffaloes pastured in the snail-inhabited marshland areas.
		Review Lymphatic filariasis in Brazil: epidemiological situation and outlook for elimination Gilberto Fontes, Anderson Leite, Ana Rachel Vasconcelos de Lima, Helen Freitas, John Ehrenberg, Eliana Maria Mauricio da Rocha Parasites & Vectors 2012, 5:272 (26 November 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary This paper reviews the available literature on the lymphatic filariasis epidemiological situation in Brazil, explores the current status of this parasitic disease and the outlook for its elimination in the country. Image: Wuchereria bancrofti microfilaria in Giemsa stained thick blood smear.
		Review Diversity and transmission competence in lymphatic filariasis vectors in West Africa, and the implications for accelerated elimination of Anopheles-transmitted filariasis Dziedzom K de Souza, Benjamin Koudou, Louise A Kelly-Hope, Michael D Wilson, Moses J Bockarie, Daniel A Boakye Parasites & Vectors 2012, 5:259 (14 November 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary In areas where the vector species transmitting Wuchereria bancrofti are Anopheles mosquitoes, it is feasible to eliminate Lymphatic Filariasis (LF) using Mass Drug Administration alone. This review outlines the differences in the diversity and transmission competence in the An. gambiae vectors of LF in West Africa, and the challenges it poses to the 2020 elimination goal. It calls for a better understanding of the vector competence of mosquitoes infected with W. bancrofti in different areas and a supplementation of MDA activities with vector control. Image: Anopheles head and mouth parts.
		Research Malaria transmission after five years of vector control on Bioko Island, Equatorial Guinea Hans J Overgaard, Vamsi P Reddy, Simon Abaga, Abrahan Matias, Michael R Reddy, Vani Kulkarni, Christopher Schwabe, Luis Segura, Immo Kleinschmidt, Michel A Slotman Parasites & Vectors 2012, 5:253 (12 November 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary In spite of five years of malaria control and a general reduction in malaria, foci of high transmission persist on Bioko Island. Innovative, locally adapted vector control interventions are needed to further control malaria in such hotspots. Image: Map of Bioko Island, Equatorial Guinea.
		Review The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination Kebede Deribe, Kadu Meribo, Teshome Gebre, Asrat Hailu, Ahmed Ali, Abraham Aseffa, Gail Davey Parasites & Vectors 2012, 5:240 (24 October 2012) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Neglected tropical diseases (NTDs) are significant public health problems in Ethiopia. Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo in Sub-Saharan Africa. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. To achieve success in integrated control of NTDs, integrated mapping, rapid scale-up of interventions and operational research into co-implementation of intervention packages will be crucial. . Image: Podoconiosis patient.
		Review Elimination of Rhodnius prolixus in Central America Ken Hashimoto, Christopher J Schofield Parasites & Vectors 2012, 5:45 (22 February 2012) Abstract \| Full text \| PDF \| PubMed \| Editor’s summary This review traces changes in the geographical distribution of Rhodnius prolixus, the main vector of Chagas disease in Central America, through surveillance and control interventions leading to its apparent elimination from mesoamerica. Image: Rhodnius prolixus Vth instar nymph feeding (photo courtesy Dr Carlos Ponce).
		Review Onchocerciasis in the Americas: from arrival to (near) elimination Ken Gustavsen, Adrian Hopkins, Mauricio Sauerbrey Parasites & Vectors 2011, 4:205 (25 October 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Onchocerciasis (river blindness) is a public health threat for millions worldwide. This article charts the course of onchocerciasis in the Western Hemisphere and discusses the prospects for elimination of the disease. Image: Using a dose pole to determine the correct dosage for onchocerciasis treatment.
		Research Progress towards the eradication of Tsetse from the Loos islands, Guinea Moise S Kagbadouno, Mamadou Camara, Jérémy Bouyer, Fabrice Courtin, Mory F Onikoyamou, Chris J Schofield, Philippe Solano Parasites & Vectors 2011, 4:18 (10 February 2011) Abstract \| Full text \| PDF \| PubMed \| Cited on BioMed Central \| Editor’s summary Several control methods have been used against Glossina palpalis gambiensis, the main vector of sleeping sickness in West Africa,in Loos islands in Guinea. Present results show the absence of tsetse in the sentinel traps used for monitoring, which is a crucial step to achieve the ultimate goal of eradication. Image: Loos islands archipelago, Republic of Guinea, where an eradication project against Glossina palpalis gambiensis, vector of sleeping sickness, is ongoing.