Integrated mapping of lymphatic filariasis and podoconiosis: lessons learnt from Ethiopia

Type Journal Article - Parasites & Vectors
Title Integrated mapping of lymphatic filariasis and podoconiosis: lessons learnt from Ethiopia
Volume 7
Issue 1
Publication (Day/Month/Year) 2014
Page numbers 397
Background: The World Health Organization (WHO), international donors and partners have emphasized the
importance of integrated control of neglected tropical diseases (NTDs). Integrated mapping of NTDs is a first step
for integrated planning of programmes, proper resource allocation and monitoring progress of control. Integrated
mapping has several advantages over disease specific mapping by reducing costs and enabling co-endemic areas
to be more precisely identified. We designed and conducted integrated mapping of lymphatic filariasis (LF) and
podoconiosis in Ethiopia; here we present the methods, challenges and lessons learnt.

Methods: Integrated mapping of 1315 communities across Ethiopia was accomplished within three months. Within
these communities, 129,959 individuals provided blood samples that were tested for circulating Wuchereria bancrofti
antigen using immunochromatographic card tests (ICT). Wb123 antibody tests were used to further establish
exposure to LF in areas where at least one ICT positive individual was detected. A clinical algorithm was used to
reliably diagnose podoconiosis by excluding other potential causes of lymphoedema of the lower limb.

Results: A total of 8110 individuals with leg swelling were interviewed and underwent physical examination.
Smartphones linked to a central database were used to collect data, which facilitated real-time data entry and
reduced costs compared to traditional paper-based data collection approach; their inbuilt Geographic Positioning
System (GPS) function enabled simultaneous capture of geographical coordinates. The integrated approach led to
efficient use of resources and rapid mapping of an enormous geographical area and was well received by survey
staff and collaborators. Mobile based technology can be used for such large scale studies in resource constrained
settings such as Ethiopia, with minimal challenges.

Conclusions: This was the first integrated mapping of podoconiosis and LF globally. Integrated mapping of
podoconiosis and LF is feasible and, if properly planned, can be quickly achieved at nationwide scale

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