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Impact of Five Annual Rounds of Mass Drug Administration with Diethylcarbamazine and Albendazole on Wuchereria bancrofti Infection in American Samoa

American Samoa began a territory-wide mass drug administration (MDA) program with diethylcarbamazine and albendazole in 2000 after baseline surveys indicated that 16.5% of 2,989 residents were infected with Wuchereria bancrofti based on tests for circulating filarial antigen. Follow-up surveys were conducted in 2001, 2003, and 2006, using convenience samples of residents of sentinel villages. Antigenemia prevalence in 2001 (11.5%) and 2003 (13.5%) showed no change. After the 2003 sentinel assessment, improvements were made in the social mobilization and drug distribution strategies. In 2006, after a total of 5 years of MDA and 3 years of improved MDA participation, the antigenemia prevalence dropped from 11.5% (2001) to 0.95% (2006) (P < 0.0001). In 2006, antigenemia prevalence was greater in males (1.5%) than females (0.4%) (P = 0.04). The decline in antigenemia prevalence shows the effectiveness of MDA and changes made in social mobilization and drug distribution.

Received December 12, 2007. Accepted for publication February 27, 2008.

Acknowledgments: The authors thank the American Samoa Department of Health, the American Samoa Community College Nursing Program, LBJ Tropical Medical Center Department of Laboratory Services, PacELF, Steve McLaughlin, April Allman, Kathy Kudish, Susan Wilson, and Tom Burkot.

Financial support: Funding for this project was provided by the CDC’s Emerging Infectious Diseases Program.

^* Address correspondence to Patrick J. Lammie, Division of Parasitic Diseases MS-F36, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341. E-mail: PLammie{at}cdc.gov

Authors’ addresses: Jennifer L. Liang, DeKalb County Board of Health, 445 Winn Way, PO Box 987, Decatur, GA 30031, Tel: 404-294-3795, Fax: 404-508-7797, E-mail: JLiang{at}cdc.gov. Jonathan King, The Carter Center, 1149 Ponce de Leon, Atlanta, GA 30306, Tel: 404-420-3838, Fax: 404-874-5515, E-mail: jonathan.king{at}emory.edu. Kazuyo Ichimori, Department of Control of Neglected Tropical Diseases, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland, Tel: 41-22-791-20-95, Fax: 41-22-791-48-69, E-mail: ichimorik{at}who.int. Thomas Handzel, Division of Emergency and Environmental Health Services, MS E97, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, Tel: 404-498-0447, Fax: 404-498-0064, E-mail: THandzel{at}cdc.gov. Molisamoa Pa’au, American Samoa Department of Health, Pago Pago, American Samoa, Tel: 684-633-7224, Fax: 684-633-5379, E-mail: molipaau{at}yahoo.com. Patrick J. Lammie, Division of Parasitic Diseases, MS-F36, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, Tel: 770-488-4054, Fax: 770-488-4253, E-mail: PLammie{at}cdc.gov.