Elimination of lymphatic filariasis and elimination and control of other neglected tropical diseases (NTDs) in an effort to improve the quality and coverage of local programs.

Description

Globally, neglected tropical diseases (NTDs) affect more than one billion people, primarily in the worlds poorest nations. CDC, together with other U.S. government and global partners, is supporting elimination/control of six NTDs (lymphatic filariasis, onchocerciasis, trachoma, soil-transmitted helminths, schistosomiasis, Guinea worm) through community mass drug administration (MDA), water filters, or other tool-ready public health interventions such as vector control or improved water, sanitation and hygiene (WASH). Among these, lymphatic filariasis (LF), a mosquito-borne disease that can lead to permanent disability from elephantiasis or hydrocele, was targeted for elimination by 2020. Although the global target was not met, 16 countries have eliminated LF as a public health problem, and many others are close to achieving elimination. Achieving global targets is challenging in many settings, such as highly urban areas. Control of LF usually depends on provision of antiparasitic drugs through MDA with high (>65%) community coverage for at least five years in order break the cycle of transmission. Locally relevant strategies ensuring sufficiently high MDA community coverage and low levels of systematic non-compliance are needed. New data support that addition of a third drug, ivermectin, in some settings to the traditional dual drug (dethylcarbamazine [DEC] plus albendazole) regimen can shorten the number of annual MDAs required for LF elimination if high community MDA coverage is achieved. After reaching MDA targets, country programs must develop feasible and sustainable surveillance systems able to identify LF recrudescence, as well as processes that effectively manage areas of persistent transmission in order to limit LF spread. Other NTDs have potential to be eradicated (Guinea worm), eliminated (onchocerciasis, trachoma) or controlled (schistosomiasis, soil transmitted helminths) through well-conducted quality community campaigns over a sustained period. The Division of Parasitic Diseases and Malaria (DPDM) at the Centers for Disease Control and Prevention (CDC) has provided technical assistance on NTD elimination/control for national programs in Africa, the Americas, Asia and the Pacific over many decades, working closely with the World Health Organization (WHO) and national health ministries. The purpose of this announcement is to support endemic countries in strengthening their program capacity for elimination/control of LF and other NTDs through achieving MDA coverage targets; establishing ongoing, systematic surveillance systems that can identify recrudescence of infection; establishing standard procedures for responding promptly to persistent or recrudescent transmission; and supporting integrated health services for LF and other NTDs within national health systems. For LF, measurable outcomes of the program will be: improved quality of, access to, and participation in MDA campaigns; better understanding of community participation (and non-participation) in MDAs by countries and other stakeholders; improved management of chronic disease in communities; identification of appropriate MDA stopping points and hotspot management; and establishment of feasible yet high-quality monitoring, evaluation and surveillance before, during and after MDAs. For other NTDs, measurable outcomes will be improved quality of MDAs; understanding of MDA starting and stopping points (e.g., onchocerciasis); high quality conduct of NTD monitoring, evaluation and surveillance, including post-elimination surveillance; and integration of NTD surveillance and services within existing health systems. This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be reviewed. For the definition of research, please see the CDC Web site at the following Internet address: http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf.

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