{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:34:29Z","timestamp":1792132469968,"version":"4.4.0"},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,5]]},"abstract":"<jats:p>The Sri Lankan Anti-Filariasis campaign distributed five rounds of mass drug administration (MDA with diethylcarbamazine plus albendazole) to some 10 million people in eight districts between 2002 and 2006. Sri Lanka was recognized by the WHO for having eliminated lymphatic filariasis (LF) as a public health problem in 2016. However, recent studies by our group documented pockets with persistent LF in coastal Sri Lanka, especially in Galle district. The present study was performed to reexamine an area previously identified as a potential hotspot for persistent LF (Balapitiya Public Health Inspector area, population 17,500). A community survey documented high rates for circulating filarial antigenemia (3%, confidence interval [CI]: 1.8\u20134.9) and microfilaremia (1%, CI: 0.5\u20132.5%). Circulating filarial antigenemia rates were 2.8-fold higher in males than females. High prevalence was also observed for anti-filarial antibodies in young children (5.7%, CI: 3.7\u20138.4%) and for filarial DNA in vector mosquitoes (5.2%, CI: 4.2\u20136.3%). Spatial data showed that persistent LF was dispersed across the entire study area. Other studies showed that persistent LF was not limited to Balapitiya and not solved by additional rounds of MDA. Molecular xenomonitoring studies conducted in 2016 in 22 of 168 Public Health Midwife areas in the coastal Galle evaluation unit (approximate population 600,000) found that 179 of 660 (27%) pools of <jats:italic>Culex<\/jats:italic> collected from all areas were positive for <jats:italic>Wuchereria bancrofti<\/jats:italic> DNA by quantitative polymerase chain reaction; the estimated infection rate in mosquitoes was 1.26%, CI: 1.0\u20131.5%. Interventions other than routine MDA will be required to remove LF hotspots in Balapitiya and in other areas in coastal Sri Lanka.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0169","type":"journal-article","created":{"date-parts":[[2018,7,17]],"date-time":"2018-07-17T07:00:27Z","timestamp":1531810827000},"page":"735-742","source":"Crossref","is-referenced-by-count":44,"title":["Comprehensive Assessment of a Hotspot with Persistent Bancroftian Filariasis in Coastal Sri Lanka"],"prefix":"10.4269","volume":"99","author":[{"given":"Ramakrishna U.","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya D.","family":"Samarasekera","sequence":"additional","affiliation":[{"name":"Ministry of Health, Anti-Filariasis Campaign, Colombo, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumara C.","family":"Nagodavithana","sequence":"additional","affiliation":[{"name":"Ministry of Health, Anti-Filariasis Campaign, Colombo, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles W.","family":"Goss","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjula W.","family":"Punchihewa","sequence":"additional","affiliation":[{"name":"Regional Anti-Filariasis Unit, Galle, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tharanga D. M.","family":"Dassanayaka","sequence":"additional","affiliation":[{"name":"Ministry of Health, Anti-Filariasis Campaign, Colombo, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udaya S. B.","family":"Ranasinghe","sequence":"additional","affiliation":[{"name":"Ministry of Health, Anti-Filariasis Campaign, Colombo, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devika","family":"Mendis","sequence":"additional","affiliation":[{"name":"Ministry of Health, Anti-Filariasis Campaign, Colombo, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary J.","family":"Weil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Am J Trop Med Hyg","first-page":"519","article-title":"Age, sex, and house distribution of Wuchereria bancrofti microfilaremia in Ceylon","volume":"15","author":"Abdulcader","year":"1966"},{"key":"b2","author":"Sasa","year":"1976"},{"key":"b3","series-title":"Ecol Dis","first-page":"309","article-title":"Filarial diseases in Ceylon: a geographic and historical analysis","volume":"2","author":"Schweinfurth","year":"1983"},{"key":"b4","series-title":"Ann Trop Med Parasitol","first-page":"123","article-title":"Filariasis in Ceylon then (1961) and in Sri Lanka now (1990-30 years on)","volume":"85","author":"Dissanaike","year":"1991"},{"key":"b5","author":"WHO"},{"key":"b6","author":"WHO","year":"2012"},{"key":"b7","series-title":"Wkly Epidemiol Rec","first-page":"489","article-title":"Global programme to eliminate lymphatic filariasis: progress report, 2014","volume":"90","author":"WHO","year":"2015"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e2584","article-title":"Transmission assessment surveys (TAS) to define endpoints for lymphatic filariasis mass drug administration: a multicenter evaluation","volume":"7","author":"Chu","year":"2013"},{"key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e3281","article-title":"A comprehensive assessment of lymphatic filariasis in Sri Lanka six years after cessation of mass drug administration","volume":"8","author":"Rao","year":"2014"},{"key":"b10","author":"WHO","year":"2016"},{"key":"b11","author":"WHO","year":"2016"},{"key":"b12","series-title":"Proc Biol Sci","first-page":"20172253","article-title":"Understanding heterogeneities in mosquito-bite exposure and infection distributions for the elimination of lymphatic filariasis","volume":"285","author":"Irvine","year":"2018"},{"key":"b13","series-title":"BMC Med","first-page":"14","article-title":"Heterogeneous dynamics, robustness\/fragility trade-offs, and the eradication of the macroparasitic disease, lymphatic filariasis","volume":"14","author":"Michael","year":"2016"},{"key":"b14","series-title":"PLoS Negl Trop Dis","first-page":"e0006066","article-title":"Reassessment of areas with persistent lymphatic filariasis nine years after cessation of mass drug administration in Sri Lanka","volume":"11","author":"Rao","year":"2017"},{"key":"b15","series-title":"PLoS Negl Trop Dis","first-page":"e0004722","article-title":"Programmatic use of molecular xenomonitoring at the level of evaluation units to assess persistence of lymphatic filariasis in Sri Lanka","volume":"10","author":"Rao","year":"2016"},{"key":"b16","series-title":"Trends Parasitol","first-page":"78","article-title":"Diagnostic tools for filariasis elimination programs","volume":"23","author":"Weil","year":"2007"},{"key":"b17","series-title":"Acta Trop","first-page":"S19","article-title":"A multicenter evaluation of a new antibody test kit for lymphatic filariasis employing recombinant Brugia malayi antigen Bm-14","volume":"120","author":"Weil","year":"2011"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"826","article-title":"A real-time PCR-based assay for detection of Wuchereria bancrofti DNA in blood and mosquitoes","volume":"74","author":"Rao","year":"2006"},{"key":"b19","series-title":"J Infect Dis","first-page":"1414","article-title":"Determining the prevalence of Onchocerca volvulus infection in vector populations by polymerase chain reaction screening of pools of black flies","volume":"172","author":"Katholi","year":"1995"},{"key":"b20","series-title":"Am J Trop Med Hyg","first-page":"779","article-title":"Important experimental parameters for determining infection rates in arthropod vectors using pool screening approaches","volume":"74","author":"Katholi","year":"2006"},{"key":"b21","series-title":"Parasit Vectors","first-page":"369","article-title":"A comparison of two tests for filarial antigenemia in areas in Sri Lanka and Indonesia with low-level persistence of lymphatic filariasis following mass drug administration","volume":"8","author":"Yahathugoda","year":"2015"},{"key":"b22","author":"WHO","year":"2017"},{"key":"b23","series-title":"PLoS Negl Trop Dis","first-page":"e3297","article-title":"Seroprevalence and spatial epidemiology of lymphatic filariasis in American Samoa after successful mass drug administration","volume":"8","author":"Lau","year":"2014"},{"key":"b24","series-title":"PLoS Negl Trop Dis","first-page":"e0005108","article-title":"Lymphatic filariasis elimination in American Samoa: evaluation of molecular xenomonitoring as a surveillance tool in the endgame","volume":"10","author":"Lau","year":"2016"},{"key":"b25","series-title":"Parasit Vectors","first-page":"466","article-title":"The global distribution and transmission limits of lymphatic filariasis: past and present","volume":"7","author":"Cano","year":"2014"},{"key":"b26","series-title":"PLoS Negl Trop Dis","first-page":"e0005914","article-title":"Detecting and confirming residual hotspots of lymphatic filariasis transmission in American Samoa 8 years after stopping mass drug administration","volume":"11","author":"Lau","year":"2017"},{"key":"b27","series-title":"PLoS Negl Trop Dis","first-page":"e0005610","article-title":"Detecting infection hotspots: modeling the surveillance challenge for elimination of lymphatic filariasis","volume":"11","author":"Harris","year":"2017"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/3\/article-p735.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/3\/article-p735.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/3\/article-p735.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T19:51:55Z","timestamp":1722455515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/3\/article-p735.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,5]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0169","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,5]]}}}