The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?

摘要

Lymphatic filariasis (LF) is a significant public health problem across the developing world and is highly prevalent in Papua New Guinea (PNG) with 16 out of 20 provinces recorded as endemic areas. This paper provides a comprehensive overview and discussion of various strategies to eliminate LF, explores the use of appropriate antifilarial drugs and examines the ways they can be taken to develop the most effective method for PNG. A systematic search of English literature was conducted using the National Library of Medicine (PubMed) and Science Direct databases between 1980 and 2012. Due to lack of high level research evidence, narrative as opposed to systematic review was conducted to identify major emerging themes. More than 1.3 billion people in 72 countries including PNG are threatened by LF. Over 120 million people worldwide are currently infected, with about 40 million disfigured and incapacitated. In 2000, the PNG National Department of Health (NDOH) began preparatory studies for a national program for LF elimination, but lack of commitment and funding has curtailed any significant progress and the disease remains highly prevalent in this country. Challenges and opportunities for elimination of LF in PNG exist and the authors predict that a combination of methods specifically tailored for PNG will have the greatest chance of success. There is an emphasis on calling for more research in a range of areas but this should not delay or compromise the introduction of a nation-wide LF elimination program or deny access to treatment for those afflicted with LF.