{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T18:55:41Z","timestamp":1780944941492,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Poverty"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To secure the gains of lymphatic filariasis (LF) elimination programs, attention is needed to the \u2018residual microfilaremia phase\u2019, in which high-risk populations may be crucial. The present study documents the impact of mass drug administration (MDA) in the urban Indian setting of Surat City, with high rates of in-migration.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Epidemiological assessment included National Filaria Control Program (NFCP) and World Health Organization recommended routine and pre-MDA microfilaremia surveys respectively. Routine filaria surveys were conducted around the year in approximately 2000\u20134000 people per month, while pre-MDA surveys were carried out annually among approximately 4000 people from four fixed and four random sites. In 2016, Transmission Assessment Survey (TAS) was done in primary school children. The outcomes were microfilaremia (Mf) and antigen prevalence; more specifically, microfilaremia according to place of birth, in pre-MDA and routine night blood smears (NBS) collected from 2008 to 2015. Prevalence ratios and confidence intervals were calculated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 25 480 pre-MDA and 306 198 routine NBS were examined during the study. In 2008, the Mf prevalence in the routine survey was 63\/18\u00a0814 (0.33%), declining to 23\/39\u00a0717 (0.06%) in 2016. Pre-MDA surveys showed a similar decrease from 47\/4184 (1.1%) in 2008 to 12\/4042 (0.3%) in 2015. In those born outside Surat, microfilaremia decreased below transmission thresholds, but remained more than treble that of the remainder of the population, in both the pre-MDA surveys [prevalence ratio: 3.17, 95% confidence interval (CI): 1.15\u20138.72], and the routine surveys (3.31, 95% <jats:italic>CI<\/jats:italic>: 1.47\u20137.48). Though the TAS results indicated that MDA endpoints had been reached, sub-group analysis identified that 90% of antigenemic children were from families of high-risk groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Extensive long-term epidemiological monitoring suggests that all the urban population, including high-risk groups, have benefitted from the ELF program. To prevent re-establishment of infection in large urban areas with unsanitary conditions conducive to filarial vector breeding, there is need to identify residual microfilaremia by customized surveys in addition to pre-MDA monitoring and TAS. The present findings can be used to develop strategies to prioritize screening, surveillance and plan treatment of high-risk groups after achieving MDA endpoints.<\/jats:p>\n                \n              <\/jats:sec>","DOI":"10.1186\/s40249-021-00856-x","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T10:04:34Z","timestamp":1621332274000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Lymphatic filariasis elimination endgame in an urban Indian setting: the roles of surveillance and residual microfilaremia after mass drug administration"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2058-0722","authenticated-orcid":false,"given":"Anjali","family":"Modi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshav G.","family":"Vaishnav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailash","family":"Kothiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-7876","authenticated-orcid":false,"given":"Neal","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"issue":"6","key":"856_CR1","doi-asserted-by":"publisher","first-page":"e214","DOI":"10.1016\/S1473-3099(18)30069-0","volume":"18","author":"BG Koudou","year":"2018","unstructured":"Koudou BG, de Souza DK, Biritwum NK, Bougma R, Aboulaye M, Elhassan E, et al. Elimination of lymphatic filariasis in west African urban areas: is implementation of mass drug administration necessary? Lancet Infect Dis. 2018;18(6):e214\u201320. https:\/\/doi.org\/10.1016\/S1473-3099(18)30069-0.","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"856_CR2","doi-asserted-by":"publisher","first-page":"e1603","DOI":"10.1371\/journal.pntd.0001603","volume":"6","author":"A Gazzinelli","year":"2012","unstructured":"Gazzinelli A, Correa-Oliveira R, Yang GJ, Boatin BA, Kloos H. A research agenda for helminth diseases of humans: social ecology, environmental determinants, and health systems. PLoS Negl Trop Dis. 2012;6(4):e1603. https:\/\/doi.org\/10.1371\/journal.pntd.0001603.","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"856_CR3","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s00436-012-3226-x","volume":"112","author":"PE Simonsen","year":"2013","unstructured":"Simonsen PE, Mwakitalu ME. Urban lymphatic filariasis. Parasitol Res. 2013;112(1):35\u201344. https:\/\/doi.org\/10.1007\/s00436-012-3226-x.","journal-title":"Parasitol Res"},{"key":"856_CR4","unstructured":"World Health Organization: Monitoring and epidemiological assessment of mass drug administration in the global programme to eliminate lymphatic filariasis: a manual for national elimination programmes. Geneva: World Health Organization; 2011."},{"key":"856_CR5","unstructured":"World Health Organization: Lymphatic filariasis: a handbook of practical entomology for national lymphatic filariasis elimination programmes. Geneva: World Health Organization; 2013."},{"issue":"43","key":"856_CR6","first-page":"509","volume":"95","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. Global programme to eliminate lymphatic filariasis: progress report, 2019. Wkly Epidemiol Rec. 2020;95(43):509\u201324.","journal-title":"Wkly Epidemiol Rec"},{"issue":"40","key":"856_CR7","first-page":"594","volume":"92","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. Global programme to eliminate lymphatic filariasis: progress report, 2016. Wkly Epidemiol Rec. 2017;92(40):594\u2013608.","journal-title":"Wkly Epidemiol Rec"},{"key":"856_CR8","unstructured":"National Vector Borne Disease Control Programme. Accelerated plan for elimination of lymphatic filariasis. 2018. https:\/\/nvbdcp.gov.in\/WriteReadData\/l892s\/1031567531528881007.pdf. Accessed 21 Apr 2021."},{"issue":"4","key":"856_CR9","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/S0377-1237(06)80109-7","volume":"62","author":"V Agrawal","year":"2006","unstructured":"Agrawal V, Sashindran V. Lymphatic filariasis in India: problems, challenges and new initiatives. Med J Armed Forces India. 2006;62(4):359\u201362.","journal-title":"Med J Armed Forces India"},{"issue":"12","key":"856_CR10","doi-asserted-by":"publisher","first-page":"e2584","DOI":"10.1371\/journal.pntd.0002584","volume":"7","author":"BK Chu","year":"2013","unstructured":"Chu BK, Deming M, Biritwum NK, Bougma WR, Dorkenoo AM, El-Setouhy M, et al. Transmission assessment surveys (TAS) to define endpoints for lymphatic filariasis mass drug administration: a multicenter evaluation. PLoS Negl Trop Dis. 2013;7(12):e2584. https:\/\/doi.org\/10.1371\/journal.pntd.0002584.","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"856_CR11","doi-asserted-by":"publisher","first-page":"e1926","DOI":"10.1371\/journal.pntd.0001926","volume":"6","author":"S Swaminathan","year":"2012","unstructured":"Swaminathan S, Perumal V, Adinarayanan S, Kaliannagounder K, Rengachari R, Purushothaman J. Epidemiological assessment of eight rounds of mass drug administration for lymphatic filariasis in India: implications for monitoring and evaluation. PLoS Negl Trop Dis. 2012;6(11):e1926. https:\/\/doi.org\/10.1371\/journal.pntd.0001926.","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"856_CR12","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1111\/j.1365-3156.2008.02002.x","volume":"13","author":"C Huppatz","year":"2008","unstructured":"Huppatz C, Durrheim D, Lammie P, Kelly P, Melrose W. Eliminating lymphatic filariasis\u2014the surveillance challenge. Trop Med Int Health. 2008;13(3):292\u20134. https:\/\/doi.org\/10.1111\/j.1365-3156.2008.02002.x.","journal-title":"Trop Med Int Health"},{"issue":"3","key":"856_CR13","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/s0035-9203(01)90233-0","volume":"95","author":"ND Alexander","year":"2001","unstructured":"Alexander ND, Bockarie MJ, Dimber ZB, Griffin L, Kazura JW, Alpers MP. Migration and dispersal of lymphatic filariasis in Papua New Guinea. Trans R Soc Trop Med Hyg. 2001;95(3):277\u20139. https:\/\/doi.org\/10.1016\/s0035-9203(01)90233-0.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"856_CR14","doi-asserted-by":"publisher","first-page":"e2079","DOI":"10.1371\/journal.pntd.0002079","volume":"7","author":"KD Ramaiah","year":"2013","unstructured":"Ramaiah KD. Population migration: implications for lymphatic filariasis elimination programmes. PLoS Negl Trop Dis. 2013;7:e2079.","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"856_CR15","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1002\/hpm.2570","volume":"33","author":"YS Kusuma","year":"2018","unstructured":"Kusuma YS, Babu BV. Migration and health: a systematic review on health and health care of internal migrants in India. Int J Health Plann Manag. 2018;33(4):775\u201393.","journal-title":"Int J Health Plann Manag"},{"key":"856_CR16","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1186\/s12889-015-2325-x","volume":"15","author":"T Toothong","year":"2015","unstructured":"Toothong T, Tipayamongkholgul M, Suwannapong N, Suvannadabba S. Evaluation of mass drug administration in the program to control imported lymphatic filariasis in Thailand. BMC Public Health. 2015;15:975. https:\/\/doi.org\/10.1186\/s12889-015-2325-x.","journal-title":"BMC Public Health"},{"issue":"4","key":"856_CR17","first-page":"457","volume":"14","author":"SP Ramakrishnan","year":"1960","unstructured":"Ramakrishnan SP, Raghavan NG, Krishnaswami AK, Nair CP, Basu PC, Singh D, et al. National Filaria Control Programme in India: a review (1955\u201359). Indian J Malariol. 1960;14(4):457\u201394.","journal-title":"Indian J Malariol"},{"key":"856_CR18","unstructured":"Directorate of National Vector Borne Disease Control Programme: elimination of lymphatic filariasis. National guidelines on transmission assessment survey\u20142013 (for district and state level health officials). In. Delhi: Government of India; 2013."},{"issue":"4","key":"856_CR19","first-page":"251","volume":"44","author":"KG Vaishnav","year":"2012","unstructured":"Vaishnav KG, Desai HS, Srivastava PK, Joshi PT, Kurian G, Thakor HG, et al. Impact of mass drug administration on elimination of lymphatic filariasis in Surat City. India J Commun Dis. 2012;44(4):251\u20139.","journal-title":"India J Commun Dis"},{"issue":"4","key":"856_CR20","doi-asserted-by":"publisher","first-page":"e0005476","DOI":"10.1371\/journal.pntd.0005476","volume":"11","author":"A Modi","year":"2017","unstructured":"Modi A, Gamit S, Jesalpura BS, Kurien G, Kosambiya JK. Reaching endpoints for lymphatic filariasis elimination\u2014results from mass drug administration and nocturnal blood surveys, South Gujarat, India. PLoS Negl Trop Dis. 2017;11(4):e0005476. https:\/\/doi.org\/10.1371\/journal.pntd.0005476.","journal-title":"PLoS Negl Trop Dis"},{"key":"856_CR21","first-page":"553","volume":"16","author":"NGS Raghavan","year":"1957","unstructured":"Raghavan NGS. Epidemiology of filariasis in India. Bull World Health Organ. 1957;16:553\u201379.","journal-title":"Bull World Health Organ"},{"key":"856_CR22","unstructured":"Sharma RS, Biswas H, Saxena NBL (eds.): National Filaria Control Programme Operational Manual: National Malaria Eradication Programme; 1995."},{"issue":"1","key":"856_CR23","doi-asserted-by":"publisher","first-page":"11","DOI":"10.4269\/ajtmh.13-0089","volume":"89","author":"GJ Weil","year":"2013","unstructured":"Weil GJ, Curtis KC, Fakoli L, Fischer K, Gankpala L, Lammie PJ, et al. Laboratory and field evaluation of a new rapid test for detecting Wuchereria bancrofti antigen in human blood. Am J Trop Med Hyg. 2013;89(1):11\u20135. https:\/\/doi.org\/10.4269\/ajtmh.13-0089.","journal-title":"Am J Trop Med Hyg"},{"key":"856_CR24","unstructured":"Surat Municipal Corporation: Vector Borne Disease Control Program Annual Report. In. Surat: Surat Municipal Corporation; 2016."},{"key":"856_CR25","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1111\/j.0006-341X.1999.00137.x","volume":"55","author":"MS Ridout","year":"1999","unstructured":"Ridout MS, Demetrio CGB, Firth D. Estimating intraclass correlation for binary data. Biometrics. 1999;55:137\u201348.","journal-title":"Biometrics"},{"issue":"3","key":"856_CR26","doi-asserted-by":"publisher","first-page":"469","DOI":"10.2307\/2530610","volume":"34","author":"D Katz","year":"1978","unstructured":"Katz D, Baptista J, Azen SP, Pike MC. Obtaining confidence intervals for the risk ratio in cohort studies. Biometrics. 1978;34(3):469\u201374. https:\/\/doi.org\/10.2307\/2530610.","journal-title":"Biometrics"},{"issue":"9","key":"856_CR27","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1093\/trstmh\/tru057","volume":"108","author":"BV Babu","year":"2014","unstructured":"Babu BV, Babu GR. Coverage of, and compliance with, mass drug administration under the programme to eliminate lymphatic filariasis in India: a systematic review. Trans R Soc Trop Med Hyg. 2014;108(9):538\u201349. https:\/\/doi.org\/10.1093\/trstmh\/tru057.","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"2","key":"856_CR28","doi-asserted-by":"publisher","first-page":"e2700","DOI":"10.1371\/journal.pntd.0002700","volume":"8","author":"DK de Souza","year":"2014","unstructured":"de Souza DK, Sesay S, Moore MG, Ansumana R, Narh CA, Kollie K, et al. No evidence for lymphatic filariasis transmission in big cities affected by conflict related rural-urban migration in Sierra Leone and Liberia. PLoS Negl Trop Dis. 2014;8(2):e2700.","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"856_CR29","doi-asserted-by":"publisher","first-page":"e1479","DOI":"10.1371\/journal.pntd.0001479","volume":"6","author":"K Gass","year":"2012","unstructured":"Gass K, Beau de Rochars MV, Boakye D, Bradley M, Fischer PU, Gyapong J, et al. A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis. PLoS Negl Trop Dis. 2012;6(1):e1479. https:\/\/doi.org\/10.1371\/journal.pntd.0001479.","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"856_CR30","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1046\/j.1365-3156.2003.01033.x","volume":"8","author":"IP Sunish","year":"2003","unstructured":"Sunish IP, Rajendran R, Mani TR, Gajanana A, Reuben R, Satyanarayana K. Long-term population migration: an important aspect to be considered during mass drug administration for elimination of lymphatic filariasis. Trop Med Int Health. 2003;8(4):316\u201321.","journal-title":"Trop Med Int Health"},{"key":"856_CR31","first-page":"166","volume":"104","author":"AN Shriram","year":"1996","unstructured":"Shriram AN, Sugunan AP, Murhekar MV, Sehgal SC. Little Andaman Island, a new focus of infection with nocturnally periodic Wuchereria bancrofti. Indian J Med Res. 1996;104:166\u201370.","journal-title":"Indian J Med Res"}],"container-title":["Infectious Diseases of Poverty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-021-00856-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40249-021-00856-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-021-00856-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T10:08:51Z","timestamp":1621332531000},"score":1,"resource":{"primary":{"URL":"https:\/\/idpjournal.biomedcentral.com\/articles\/10.1186\/s40249-021-00856-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["856"],"URL":"https:\/\/doi.org\/10.1186\/s40249-021-00856-x","relation":{},"ISSN":["2049-9957"],"issn-type":[{"value":"2049-9957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"31 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A written consent is not required for activities conducted under Indian national public health programs (ELF under NVBDCP for this study) considered beneficial for people. The oral consent from participants was documented by names on data collection form but all identifiers were removed for this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"73"}}