The Carter Center currently works with national ministries of health to eliminate the debilitating parasitic disease of lymphatic filariasis — a leading cause of permanent and long-term disability worldwide — from areas of Ethiopia, Nigeria, and the island of Hispaniola.
What is lymphatic filariasis?
A leading cause of permanent and long-term disability worldwide, lymphatic filariasis is caused by thin worms transmitted to humans by the bites of mosquitoes in tropical and subtropical regions.
These worms cause blockage in the lymphatic system resulting in fluid collection in the tissues (most commonly the legs and genitalia), severe swellings, and periodic fevers from bacterial infections of the collected fluids.
A long-standing infection with lymphatic filariasis results in an irreversible condition called elephantiasis, in which there is a marked enlargement and hardening of the limbs so that they resemble those of an elephant.
How widespread is the problem?
Approximately 120 million people are infected by lymphatic filariasis, and 1.1 billion are at risk of infection. In endemic communities, as many as 10 percent of women can be affected with swollen limbs and 50 percent of men can suffer from the mutilating disease in the legs and genitals.
These conditions have a devastating effect on the quality of life of victims, impacting them not only physically but also emotionally and economically. Two of the countries where the Center has fought lymphatic filariasis — Nigeria and Ethiopia — are among the most endemic worldwide.
The Center distributes the drugs Mectizan®, donated by Merck, and albendazole, donated by GlaxoSmithKline, taken in combination to fight the disease.
The Center also has distributed long-lasting insecticidal bed nets (LLINs) to protect pregnant women and children who cannot take drug treatment. LLINs have the added benefit of protecting against other mosquito-borne diseases, such as malaria.
Results and Impact
In Nigeria: Between 2000 and 2011, The Carter Center and the Nigeria Federal Ministry of Health worked together to stop transmission of lymphatic filariasis in Plateau and Nasarawa states through community health education, delivery of bed nets and 33 million drug treatments between 2000 and 2011. In 2012, it was confirmed that transmission had stopped. Post-treatment surveillance is currently underway.
In 2014, with support from The Carter Center, the Nigeria Federal Ministry of Health issued a detailed set of co-implementation guidelines for a new effort to eliminate malaria and lymphatic filariasis. The first articulated guidelines of the kind in Africa, the plan takes advantage of shared interventions such as health education, distribution of long-lasting insecticidal bed nets, and mass drug administration.
In Ethiopia: In the Gambella Region in 2009, The Carter Center began integrating mass drug administration to prevent lymphatic filariasis with river blindness and malaria control. In 2012, the program expanded from one to four districts and delivered more than 800,000 treatments. The success of the joint programs has demonstrated that one community-based health education and drug distribution system can support the control and elimination of multiple diseases.
In Hispaniola: The Carter Center is working to encourage cooperation between health agencies in Haiti and the Dominican Republic to eliminate both lymphatic filariasis and malaria from the island the nations share.