Eliminating lymphatic filariasis: the surveillance challenge (editorial)

Lymphatic filariasis (LF) is an important neglected tropical disease. Although many LF infections are asymptomatic, the long-term sequelae of elephantiasis, lymphoedema and hydrocoele can have devastating physical, psychological, social and economic consequences for individuals and for communities where this disease is endemic (Ottesen et al. 1997; Wynd et al. 2007). LF is one of the leading causes of disability worldwide and there are more than 119 million people infected (Michael et al. 1996). In 1997, WHO launched the Global Programme to Eliminate Lymphatic Filariasis, which aims to eliminate LF from 80 countries in which it is endemic, by the year 2020. The primary strategy is to use mass drug administration (MDA), with a combination of two drugs, given annually to the entire ‘at-risk’ population (World Health Organization 2000). In the Pacific region, several countries had recently completed their planned number of rounds of MDA and now need to make important programmatic decisions. Perhaps the most important of these decisions relates to future surveillance needs