Implementing a Test-and-Treat Program for Lymphatic Filiriasis (LF) in a Public Health Clinic Setting

Objective. To develop a program to screen and treat patients from endemic areas for Lymphatic Filiriasis (LF) in a community setting. This required a partnership between the Centers for Disease Control (CDC) and the Palm Beach County Health Department. Background. Lymphatic filariasis (LF), the disease caused by infection with Wuchereria bancrofti, can lead to extreme limb, scrotal, and breast enlargement. An estimated 10,000 immigrants enter the US harboring this mosquito-borne parasite each year and based on the 2000 census, more than 4 million immigrants from LF-endemic countries reside in the U.S. Neither the test nor medication used for LF have FDA approval, making screening and treatment limited in the US. Method. Following a three year process to obtain all necessary IRB approval, the CDC and Riviera Beach Health Center began to educate and offer patients screening for the disease within the clinic. The NOW® rapid filariasis immunochromatographic card test is used to diagnose cases of LF. Those testing positive who do not have contraindications will be offered DEC treatment. Results. Between April and December of 2009, 175 clients from LF-endemic countries were screened under this research protocol. 11 patients (6%) tested positive for the parasite, and all of these individuals were treated for the disease. Conclusion. New immigrants from LF-endemic areas may harbor the disease, and may not have access to screening or treatment while in the US. It is possible to implement a test-and-treat program for research, however it is time consuming and has limited scope. Grants. PB-CHD supported