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DOLF Making an Impact

Earlier today WHO published new guidelines for alternative MDA regimens for LF in the Weekly Epidemiological Record. The new guidelines recommend:

• Triple drug therapy (IDA) for use in countries using diethylcarbamazine + albendazole (DA) in special settings
• Annual ivermectin + albendazole (IA) rather than biannual IA in countries endemic for LF and onchocerciasis, except in areas already distributing biannual ivermectin for onchocerciasis
• Biannual albendazole rather than annual ablendazole in implementation units where LF is coendemic with loiasis and ivermectin has not already been distributed

DOLF studies provided important evidence to support these guidelines. The guidelines are tangible evidence that DOLF is making a policy impact that will hopefully translate to programmatic impact and the ultimate elimination of LF. Many people have worked on these studies. I was reminded of this as I prepared the long list of investigators, administrators, advisors, and consultants who would receive this email. And there are many more people whose emails I do not have, but whose hours of work collecting night blood, preparing blood smears, staring at microscopes and entering or analyzing data were crucial to our work. Congratulations to all of you and your colleagues as we continue to work towards a world free of LF!


DOLF Scientists Test New Scanner for Measuring Leg Swelling due to Filariasis

In March of 2017, DOLF researchers, Ramakrishna Rao and Philip Budge traveled to Galle, Sri Lanka to test a new portable scanner with the potential to revolutionize the measurement of limbs affected by lymphatic filariasis (LF). The scanner, which is produced by the Atlanta-based startup, LymphaTech, uses infrared scanning technology similar to that found in Microsoft’s X-Box Kinect, to create highly accurate virtual 3D reconstructions of solid objects. After meeting the scanner’s creators at national meeting in the fall, Doctors Budge and Rao wanted to see if this simple, portable scanner, which consists of an infrared sensor mounted on an iPad, could provide precise and accurate limb measurements for patients afflicted by LF. So, they worked with Dr. Channa Yahathugoda, who directs a filariasis clinic in Galle, Sri Lanka, to design a study comparing the scanner to the gold-standards for measuring LF-affected limbs: tape measurements and water displacement.

What they found was highly encouraging. Working together with a team of local physicians in Dr. Yahathugoda’s clinic, they found that the LymphaTech scanner could provide measurements of leg volume and multiple circumferences that were as precise as those obtained by tape measure or water displacement, but in only a fraction of the time, and with much less inconvenience to the patients. This can be a huge step forward for those who study and treat patients with lymphedema, the type of leg swelling caused by LF, because many of these patients have such severe disease that they have difficulty placing their limbs in a water tank to measure water displacement. In addition, affected legs often have open wound that make it more difficult to take tape measurements. Many patients often have great difficulty traveling from their homes to the clinic to have their measurements taken. This new tool should make it possible to take extremely accurate limb measurements in the patients’ homes or villages without cumbersome equipment. The ability to rapidly get these measurements will make it much easier to monitor patients with lymphedema, particularly in clinical trials of therapies for lymphedema, which are sorely needed. In fact, after sharing the data from their study with international collaborators, the scanner has been added as a measurement tool in an upcoming multi-site, international research study designed to determine whether the antibiotic, doxycycline, can reduce the severity lymphedema in patients with filariasis.

The Sri Lanka scanner study will soon be published in the American Journal Tropical Medicine and Hygeine.

Read the complete article in Washington University in St. Louis - The Record

A collaborator using the LymphaTech scanner to scan the legs of a patient in Galle, Sri Lanka

 

 

 

 

 

 

One example of the 3D model created by the LymphaTech scanner

 

 

 


DOLF Team Attends NTD Summit, Present IDA Results

Donors, endemic countries, researchers and program managers came together at the NTD Summit in Geneva, Switzerland between April 19-22 to celebrate progress and set a path towards meeting the 2020 goals for eliminating neglected tropical diseases.  Five members of the DOLF team attended the NTD Summit to share important results with the NTD community. The meeting was also an opportunity for DOLF researchers to canvas attendees about how the DOLF might serve as a platform to address key challenges faced by NTD elimination programs for 2020 and beyond.

There was a lot of interest at the meeting in triple drug treatment for lymphatic filariasis. DOLF Project clinical trials led by Dr. Chris King have shown a triple-drug combination (ivermectin plus DEC with albendazole, or IDA) is superior to standard two-drug combinations for treatment of lymphatic filariasis. IDA could be a game changer for the LF elimination program by reducing the time it takes to reach elimination targets.  However, safety studies are needed before IDA can be recommended for use by national filariasis elimination programs.  DOLF principal investigator Dr. Gary Weil presented at talk on IDA at the Global Alliance to Eliminate Lymphatic Filariasis (GAELF) meeting in Geneva. He shared encouraging results from a multicenter safety study with more than 23,000 participants that was recently conducted by DOLF partners in 4 countries.  The World Health Organization will convene an expert committee to consider the potential value of IDA for the Global Programme to Eliminate Lymphatic Filariasis later this year.


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