The impact of repeated rounds of mass drug administration with @entity6566 plus @entity3753 on XXXX in Papua New Guinea.

@entity3753 @entity1 @entity6565 @entity6566 @entity3754 @entity281 @entity1865
BACKGROUND: This study employed various monitoring methods to assess the impact of repeated rounds of mass drug administration ( @entity1865 ) on @entity6565 in Papua New Guinea, which has the largest filariasis problem in the Pacific region. METHODOLOGY/PRINCIPAL FINDINGS: Residents of rural villages near Madang were studied prior to and one year after each of three rounds of @entity1865 with @entity6566 plus @entity3753 administered per World Health Organization (WHO) guidelines. The mean @entity1865 compliance rate was 72.9%. Three rounds of @entity1865 decreased microfilaremia rates (Mf, 1 ml night blood by filter) from 18.6% pre- @entity1865 to 1.3% after the third @entity1865 (a 94% decrease). Mf clearance rates in infected @entity1 were 71%, 90.7%, and 98.1% after 1, 2, and 3 rounds of @entity1865 . Rates of filarial antigenemia assessed by card test (a marker for adult @entity281 ) decreased from 47.5% to 17.1% (a 64% decrease) after 3 rounds of @entity1865 . The filarial antibody rate (IgG(4) antibodies to Bm14, an indicator of @entity281 status and/or exposure to mosquito-borne infective larvae) decreased from 59.3% to 25.1% (a 54.6% decrease). Mf, antigen, and antibody rates decreased more rapidly in @entity1 <11 years of age (by 100%, 84.2%, and 76.8%, respectively) relative to older individuals, perhaps reflecting their lighter infections and shorter durations of exposure/infection prior to @entity1865 . Incidence rates for microfilaremia, filarial antigenemia, and antifilarial antibodies also decreased significantly after @entity1865 . Filarial DNA rates in Anopheles punctulatus mosquitoes that had recently taken a blood meal decreased from 15.1% to 1.0% (a 92.3% decrease). CONCLUSIONS/SIGNIFICANCE: @entity1865 had dramatic effects on all filariasis parameters in the study area and also reduced incidence rates. Follow-up studies will be needed to determine whether residual infection rates in residents of these villages are sufficient to support sustained transmission by the An. punctulatus vector. @entity3754 elimination should be feasible in Papua New Guinea if @entity1865 can be effectively delivered to endemic populations.
