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Anti Filariasis Campaign

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Lymphatic Filariasis is a vector borne disease caused by the parasite Wucheraria banorofti, the adult of which lives usually in the lymphatic system of a person. The adult produce live embryos or   microfilaria which find their way into the blood stream.

The only recognized insect vector responsible for the spread of urban filariasis in Sri Lanka is the Culex quinquefasciatus mosquito, which serves as the intermediate host. This mosquito breeds in highly polluted collections of water, such as blocked drains, damage septic tanks, and latrine pitas etc, which are abound in urban habitats. In Sri Lanka, Filariasis is endemic only in Western, Southern and North Western provinces.  Few cases of rural filariasis caused by the parasite Brugia malayi whose vector is the Mansonia mosquito has been reported from Puttalam district.

Lymphatic Filariasis (LF), one of the most disfiguring diseases in the world is the second leading cause of permanent disability leading to social stigma and economic loss with a heavy burden on health systems.

The history of LF in Sri Lanka dates back to the 400 B.C. Lymphodema of legs or elephantiasis has been reported in ancient chronicles written during the period of Gampola Kingdom. However, the first authentic description  was found in 1936 when a survey carried out then revealed  a Microfilaria Rate (MF rate) - percentage of blood films taken in the night positive for microfilaria - of 25%.  Activities i.e. vector and parasite surveillance, implemented since the inception of  Anti Filariasis Campaign (AFC) in 1947,  have resulted in very low MF rate and the disease was on the verge of elimination target with dawn of millennium.   

The Mass Drug Administration (MDA) (one day treatment with Diethyl Carbamazine and Albendazole) implemented annually for 5 -6 years from 2002 with 80% coverage of population in seven endemic districts enabled Sri Lanka to reach the elimination level for LF i.e. Microfilaria rate  of <1% . At the end of 2009, it remains at 0.03%. Subsequent studies carried out with the financial and logistic support from WHO and international agencies such as Global Alliance for Elimination of Lymphatic Filariasis, have confirmed the low level transmission of LF in Sri Lanka. However, there were few hot spots in the districts of Colombo and Gampaha.

The vision of the Anti Filariasis Campaign is “Sri Lanka, free of Filariasis and associated complications, including stigma” with a mission to achieve the zero transmission by controlling parasites and vectors. Its general objectives are to sustain elimination of lymphatic filariasis by interrupting the transmission and also to alleviate suffering of patients affected with disabilities.

LF is difficult to identify in the early stages due to vague symptoms. Most of the patients diagnosed by the routine night blood filming do not have any symptoms. Mild fever, myalgia, painful red spots under the skin, lymphangitis and lymphadenitis are some of the early clinical presentations. In addition, hydrocoeles among males, edematous breasts in females, chronic nocturnal cough with high eoisinophil count is suggestive of LF.  Two weeks treatment with DEC cures the disease. Elephantiasis of leg is a chronic sequel of LF and is incurable. However, no microfilaria is found among these patients.  Nevertheless, prompt treatment of cellulites in the edematous legs prevents further increase of odema.

The traditional diagnostic test currently using in Sri Lanka is blood smear conducted   in the night to find presence of microfilaria. Though positive antibody test in not a diagnostic, a patient with positive antibody presents along with other clinical features may be treated with DEC, the traditional treatment of LF.  People living in endemic districts are advised to visit night blood film centers in the major hospital if they have any of the symptoms mutinied above (Table shows the venues and days of night blood film clinics in 7 endemic districts).

Two indicators are used to monitor the disease burden. They are the microfilaria rate and the infective mosquito rate (percentage of mosquitoes with infective larval stage). These tests are performed in the laboratories by the Public Health Laboratory Technicians on the blood smears collected in the night by Public Health Field Officers and on the mosquitoes collected early hours in the morning by Entomological Assistants.

After reaching the elimination, the main priority of the AFC is to sustain it by constant monitoring and strict surveillance. The traditional tests conducts at present are time consuming and their specificity and sensitivity are very low.  New sensitive techniques based on DNA technology are being developed in research centers and in the recent past international experts have conducted multi centered studies including Sri Lanka. They were found to be effective in measuring the impact of elimination activities.

Recently Sri Lanka signed a memorandum of understanding with Centre for Neglected Tropical Disease, Liverpool, UK to strengthen the PCR lab facilities at the central office with providing a real-time PCR machine and other equipments. Further, they will provide all reagents for a period of five years.

A research project on the use of advanced techniques to assess the Elimination and Interruption of Transmission of Lymphatic Filariasis in Sri Lanka is to be conducted jointly by AFC and the Infectious Disease Division of the Washington University School of Medicine, Missouri, USA in 2011. Ethical Clearance has already obtained from the University of Kelaniya and the National Institute of Health, USA.

With the technical and financial support from internationally reputed research centers AFC will be further strengthened to sustain elimination by realistic assessment of epidemiological burden.

Organization of the Anti Filariais Campaign

Anti Filariasis Campaign headed by the director is the central organization of the Health Ministry responsible for filariais preventive and control activities in the country. The program acts as the technical nodal point. The activities of the program are decentralized and it functions cordially with regional health services and community organizations.

Contact details and Clinic Schedules of Anti Filariasis Campaign

Clinic centre
Address Contact Number
AFC Central Office 555/5 Elvitigala mawatha, Colombo 5. +94 112501310
Kalubowila
Teaching Hospital Kalubowila. +94 112519284
Homagama
Base Hospital, Homagama. +94 112519284
Moratuwa
Town Council, Moratuwa. +94 112519284
Nugegoda
MOH office, Gangodawila, Nugegoda. +94 112519284
Boralesgamuwa
AFU, Werahera, Boralesgamuwa. +94 112519284
Kiribathgoda
AFU, Government Hospital, Kiribathgoda. +94 112917900
Peliyagoda
Central Dispensary, Peliyagoda. +94 112917900
Gampaha
District General Hospital. +94 112917900, +94 332222261
Negambo
District General Hospital. +94 112917900, +94 312222261
Ragama
Teaching Hospital. +94 112917900, +94 112959261
Wathupitiwala
Base Hospital .
+94 112917900, +94 332280261
Attanagalla
MOH Office.
+94 112917900, +94 332287278
Kalutara
AFU, District Secretariat office, Kaluthara. +94 342222145
Kalutara
General Hospital, Kalutara. +94 342222145
Panadura
MOH office, Panadura. +94 342222145
Panadura
Base Hospital, Panadura. +94 342222145
Horana
Base Hospital, Horana.
+94 342222145
Mathugama
District Hospital, Mathugama. +94 342222145
Meegahatenna
Government Hospital, Meegahatenna. +94 342222145
Ittepana
Government Hospital, Ittepana. +94 342222145
Pimbura
Government Hospital, Pimbura. +94 342222145
Beruwala
District Hospital, Beruwala. +94 342222145
Aluthgama
District Hospital, Aluthgama. +94 342222145
Darga Town
Government Hospital, Darga Town. +94 342222145
Gonaduwa
Government Hospital, Gonaduwa. +94 342222145
Galpatha
Government Hospital +94 342222145
Benthota
District Hospital, Benthota. +94 342222145
Galle
Cassim Chest Clinic, Galle. +94 912234078
Ahangama
Pradeshiya Sabha, Ahangama. +94 912234078
Ambalangoda
MOH Office, Ambalangoda. +94 912234078
Matara
Linda road, Pallamulla, Matara. +94 412222004
Weligama
Town Council, Weligama. +94 412222004
Kurunegala
AFU, Suwamedura Health complex. +94 372221356
Polgahawela
District hospital. +94 372221356
Chilaw
AFU, Chilaw ( Next to Base hospital). +94 322247261
Last update on : 2011-01-07 10:36:14