• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of bullwhoWHO Home PageBulletin Home PageBulletin Home PageAbout Bulletine-mail AlertSubmissions
Bull World Health Organ. 1997; 75(6): 491–503.
PMCID: PMC2487030

Strategies and tools for the control/elimination of lymphatic filariasis.


Lymphatic filariasis infects 120 million people in 73 countries worldwide and continues to be a worsening problem, especially in Africa and the Indian subcontinent. Elephantiasis, lymphoedema, and genital pathology afflict 44 million men, women and children; another 76 million have parasites in their blood and hidden internal damage to their lymphatic and renal systems. In the past, tools and strategies for the control of the condition were inadequate, but over the last 10 years dramatic research advances have led to new understanding about the severity and impact of the disease, new diagnostic and monitoring tools, and, most importantly, new treatment tools and control strategies. The new strategy aims both at transmission control through community-wide (mass) treatment programmes and at disease control through individual patient management. Annual single-dose co-administration of two drugs (ivermectin + diethylcarbamazine (DEC) or albendazole) reduces blood microfilariae by 99% for a full year; even a single dose of one drug (ivermectin or DEC) administered annually can result in 90% reductions; field studies confirm that such reduction of microfilarial loads and prevalence can interrupt transmission. New approaches to disease control, based on preventing bacterial superinfection, can now halt or even reverse the lymphoedema and elephantiasis sequelae of filarial infection. Recognizing these remarkable technical advances, the successes of recent control programmes, and the biological factors favouring elimination of this infection, the Fiftieth World Health Assembly recently called on WHO and its Member States to establish as a priority the global elimination of lymphatic filariasis as a public health problem.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Michael E, Bundy DA, Grenfell BT. Re-assessing the global prevalence and distribution of lymphatic filariasis. Parasitology. 1996 Apr;112(Pt 4):409–428. [PubMed]
  • Dreyer G, Norões J, Addiss D. The silent burden of sexual disability associated with lymphatic filariasis. Acta Trop. 1997 Jan;63(1):57–60. [PubMed]
  • Kim JS, No BU, Lee WY. Brugian filariasis: 10-year follow-up study on the effectiveness of selective chemotherapy with diethylcarbamazine on Che Ju island, Republic of Korea. Bull World Health Organ. 1987;65(1):67–75. [PMC free article] [PubMed]
  • Webber RH. Eradication of Wuchereria bancrofti infection through vector control. Trans R Soc Trop Med Hyg. 1979;73(6):722–724. [PubMed]
  • Evans DB, Gelband H, Vlassoff C. Social and economic factors and the control of lymphatic filariasis: a review. Acta Trop. 1993 Mar;53(1):1–26. [PubMed]
  • Ramu K, Ramaiah KD, Guyatt H, Evans D. Impact of lymphatic filariasis on the productivity of male weavers in a south Indian village. Trans R Soc Trop Med Hyg. 1996 Nov-Dec;90(6):669–670. [PubMed]
  • Ramaiah KD, Ramu K, Kumar KN, Guyatt H. Epidemiology of acute filarial episodes caused by Wuchereria bancrofti infection in two rural villages in Tamil, Nadu, south India. Trans R Soc Trop Med Hyg. 1996 Nov-Dec;90(6):639–643. [PubMed]
  • Kumaraswami V, Ottesen EA, Vijayasekaran V, Devi U, Swaminathan M, Aziz MA, Sarma GR, Prabhakar R, Tripathy SP. Ivermectin for the treatment of Wuchereria bancrofti filariasis. Efficacy and adverse reactions. JAMA. 1988 Jun 3;259(21):3150–3153. [PubMed]
  • Moulia-Pelat JP, Glaziou P, Weil GJ, Nguyen LN, Gaxotte P, Nicolas L. Combination ivermectin plus diethylcarbamazine, a new effective tool for control of lymphatic filariasis. Trop Med Parasitol. 1995 Mar;46(1):9–12. [PubMed]
  • Cao WC, Van der Ploeg CP, Plaisier AP, van der Sluijs IJ, Habbema JD. Ivermectin for the chemotherapy of bancroftian filariasis: a meta-analysis of the effect of single treatment. Trop Med Int Health. 1997 Apr;2(4):393–403. [PubMed]
  • Dreyer G, Coutinho A, Miranda D, Noroes J, Rizzo JA, Galdino E, Rocha A, Medeiros Z, Andrade LD, Santos A, et al. Treatment of bancroftian filariasis in Recife, Brazil: a two-year comparative study of the efficacy of single treatments with ivermectin or diethylcarbamazine. Trans R Soc Trop Med Hyg. 1995 Jan-Feb;89(1):98–102. [PubMed]
  • Ottesen EA. Efficacy of diethylcarbamazine in eradicating infection with lymphatic-dwelling filariae in humans. Rev Infect Dis. 1985 May-Jun;7(3):341–356. [PubMed]
  • Dreyer G, Pires ML, de Andrade LD, Lopes E, Medeiros Z, Tenorio J, Coutinho A, Noroes J, Figueredo-Silva J. Tolerance of diethylcarbamazine by microfilaraemic and amicrofilaraemic individuals in an endemic area of Bancroftian filariasis, Recife, Brazil. Trans R Soc Trop Med Hyg. 1994 Mar-Apr;88(2):232–236. [PubMed]
  • Ottesen EA. Filarial infections. Infect Dis Clin North Am. 1993 Sep;7(3):619–633. [PubMed]
  • Gelband H. Diethylcarbamazine salt in the control of lymphatic filariasis. Am J Trop Med Hyg. 1994 Jun;50(6):655–662. [PubMed]
  • Reddy GS, Venkateswaralu N. Mass administration of DEC-medicated salt for filariasis control in the endemic population of Karaikal, south India: implementation and impact assessment. Bull World Health Organ. 1996;74(1):85–90. [PMC free article] [PubMed]
  • Meyrowitsch DW, Simonsen PE, Makunde WH. Mass diethylcarbamazine chemotherapy for control of bancroftian filariasis through community participation: comparative efficacy of a low monthly dose and medicated salt. Trans R Soc Trop Med Hyg. 1996 Jan-Feb;90(1):74–79. [PubMed]
  • Kimura E, Penaia L, Spears GF. The efficacy of annual single-dose treatment with diethylcarbamazine citrate against diurnally subperiodic bancroftian filariasis in Samoa. Bull World Health Organ. 1985;63(6):1097–1106. [PMC free article] [PubMed]
  • Partono F, Purnomo, Soewarta A, Oemijati S. Low dosage diethylcarbamazine administered by villagers for the control of timorian filariasis. Trans R Soc Trop Med Hyg. 1984;78(3):370–372. [PubMed]
  • Laigret J, Fagneaux G, Tuira E. Chimiothérapie de masse par la diéthylcarbamazine en doses espacées: effets obtenus à tahiti sur la microfilarémie à Wuchereria bancrofti, var. pacifica. Bull World Health Organ. 1980;58(5):779–783. [PMC free article] [PubMed]
  • Panicker KN, Krishnamoorthy K, Sabesan S, Prathiba J, Abidha Comparison of effects of mass annual and biannual single dose therapy with diethylcarbamazine for the control of Malayan filariasis. Southeast Asian J Trop Med Public Health. 1991 Sep;22(3):402–411. [PubMed]
  • Ottesen EA. Immunological aspects of lymphatic filariasis and onchocerciasis in man. Trans R Soc Trop Med Hyg. 1984;78 (Suppl):9–18. [PubMed]
  • Weil GJ, Jain DC, Santhanam S, Malhotra A, Kumar H, Sethumadhavan KV, Liftis F, Ghosh TK. A monoclonal antibody-based enzyme immunoassay for detecting parasite antigenemia in bancroftian filariasis. J Infect Dis. 1987 Aug;156(2):350–355. [PubMed]
  • Chanteau S, Moulia-Pelat JP, Glaziou P, Nguyen NL, Luquiaud P, Plichart C, Martin PM, Cartel JL. Og4C3 circulating antigen: a marker of infection and adult worm burden in Wuchereria bancrofti filariasis. J Infect Dis. 1994 Jul;170(1):247–250. [PubMed]
  • Lammie PJ, Hightower AW, Eberhard ML. Age-specific prevalence of antigenemia in a Wuchereria bancrofti-exposed population. Am J Trop Med Hyg. 1994 Sep;51(3):348–355. [PubMed]
  • McCarthy JS, Guinea A, Weil GJ, Ottesen EA. Clearance of circulating filarial antigen as a measure of the macrofilaricidal activity of diethylcarbamazine in Wuchereria bancrofti infection. J Infect Dis. 1995 Aug;172(2):521–526. [PubMed]
  • Chanteau S, Luquiaud P, Failloux AB, Williams SA. Detection of Wuchereria bancrofti larvae in pools of mosquitoes by the polymerase chain reaction. Trans R Soc Trop Med Hyg. 1994 Nov-Dec;88(6):665–666. [PubMed]
  • Gyapong JO, Adjei S, Gyapong M, Asamoah G. Rapid community diagnosis of lymphatic filariasis. Acta Trop. 1996 Mar;61(1):65–74. [PubMed]
  • Addiss DG, Eberhard ML, Lammie PJ. "Filarial" adenolymphangitis without filarial infection. Lancet. 1994 Mar 5;343(8897):597–597. [PubMed]
  • Freedman DO, de Almeida Filho PJ, Besh S, Maia e Silva MC, Braga C, Maciel A. Lymphoscintigraphic analysis of lymphatic abnormalities in symptomatic and asymptomatic human filariasis. J Infect Dis. 1994 Oct;170(4):927–933. [PubMed]
  • Dreyer G, Ottesen EA, Galdino E, Andrade L, Rocha A, Medeiros Z, Moura I, Casimiro I, Beliz F, Coutinho A. Renal abnormalities in microfilaremic patients with Bancroftian filariasis. Am J Trop Med Hyg. 1992 Jun;46(6):745–751. [PubMed]
  • Dreyer G, Addiss D, Noroes J, Amaral F, Rocha A, Coutinho A. Ultrasonographic assessment of the adulticidal efficacy of repeat high-dose ivermectin in bancroftian filariasis. Trop Med Int Health. 1996 Aug;1(4):427–432. [PubMed]
  • Hougard JM, Mbentengam R, Lochouarn L, Escaffre H, Darriet F, Barbazan P, Quillévéré D. Lutte contre Culex quinquefasciatus par Bacillus sphaericus: résultats d'une campagne pilote dans une grande agglomération urbaine d'Afrique équatoriale. Bull World Health Organ. 1993;71(3-4):367–375. [PMC free article] [PubMed]
  • Maxwell CA, Curtis CF, Haji H, Kisumku S, Thalib AI, Yahya SA. Control of Bancroftian filariasis by integrating therapy with vector control using polystyrene beads in wet pit latrines. Trans R Soc Trop Med Hyg. 1990 Sep-Oct;84(5):709–714. [PubMed]
  • Vasuki V, Rajavel AR. Beta-cyfluthrin, a synthetic pyrethroid for mosquito control. Southeast Asian J Trop Med Public Health. 1992 Jun;23(2):318–323. [PubMed]
  • Addiss DG, Beach MJ, Streit TG, Lutwick S, LeConte FH, Lafontant JG, Hightower AW, Lammie PJ. Randomised placebo-controlled comparison of ivermectin and albendazole alone and in combination for Wuchereria bancrofti microfilaraemia in Haitian children. Lancet. 1997 Aug 16;350(9076):480–484. [PubMed]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • Compound
    PubChem Compound links
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...