Lessons from the Pacific programme to eliminate lymphatic filariasis: a case study of 5 countries

Lymphatic Filariasis (LF) is an important Neglected Tropical Disease, being a major cause of disability worldwide. The Global Programme to Eliminate Lymphatic Filariasis aims to eliminate LF as a public health problem by the year 2020, primarily through repeated Mass Drug Administration (MDA). The Pacific region programme commenced in 1999. By June 2007, five of the eleven countries classified as endemic had completed five MDA campaigns and post-MDA prevalence surveys to assess their progress. We review available programme data and discuss their implications for other LF elimination programs in developing countries. Reported MDA coverage and results from initial surveys and post-MDA surveys of LF using the immunochromatographic test (ICT) from these five Pacific Island countries (Tonga, Niue, Vanuatu, Samoa and Cook Islands) were analysed to provide an understanding of their quality and programme progress towards LF elimination. Denominator data reported by each country programme for 2001 was compared to official sources to assess the accuracy of MDA coverage data. Initial survey results from these five countries revealed an ICT prevalence of between 2.7 and 8.6 percent in individuals tested prior to commencement of the programme. Country MDA coverage results varied depending on the source of denominator data. Of the five countries in this case study, three countries (Tonga, Niue and Vanuatu) reached the target prevalence of <1% antigenaemia following five rounds of MDA. However, endpoint data could not be reliably compared to baseline data as survey methodology varied. It was concluded that accurate and representative baseline and post-campaign prevalence data is crucial for determining program effectiveness and the factors contributing to effectiveness. This is emphasised by the findings of this case study. While three of the five Pacific countries reported achieving the target prevalence of <1% antigenaemia, limitations in the data preclude identification of key determinants of this achievement

Minimizing Embankment Damage During Overtopping Flow

DTFH61-85-C-00131The hydraulic and erosional characteristics of overtopping flow are examined. Methods of protecting earth embankments of dams, levees, and roadways from damage during overtopping flow are investigated. Nineteen full-scale tests of bare earth embankments (unprotected) were conducted to derive baseline erosion rate relationships. Thirty-eight full-scale hydraulic tests examined the performance of selected commercially available embankment protection systems under various hydraulic conditions. These included vegetation, geotextiles, chemicals, cements, concrete blocks, gabions, and riprap. Failure modes and hydraulic stresses at the failure threshold were determined and compared to results from other investigators. Design and installation considerations are presented which address observed failure modes

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