226519 Testing and treating immigrants for lymphatic filariasis in south Florida

Monday, November 8, 2010

Angela Keller, MA , Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Joanna Drowos, DO, MPH, MBA , RBHC Refugee Clinic, Riviera Beach Health Center, Riviera Beach, FL
Mary Anne Duncan, DVM , Division of Health Studies, ATSDR, Atlanta, GA
F. Arguello , RBHC Refugee Clinic, Riviera Beach Health Center, Riviera Beach, FL
Kim Won, MS , Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Cynthia Treadwell, RN, MSN , RBHC Refugee Clinic, Riviera Beach Health Center, Riviera Beach, FL
Ninon Desouvre, RN , RBHC Refugee Clinic, Riviera Beach Health Center, Riviera Beach, FL
Alina Alonso, MD , RBHC Refugee Clinic, Riviera Beach Health Center, Riviera Beach, FL
Patrick Lammie, PhD , Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Els Mathieu, MD, MPH , Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Lymphatic filariasis (LF) is a mosquito-borne infection caused by the parasite Wuchereria bancrofti. Approximately 120 million people carry LF in 81 countries, 40 million of whom may develop extreme limb or scrotal enlargement. A global effort to eliminate LF includes using mass drug administration to reach 1.3 billion persons at risk of infection; in 2008, 496 million people were treated with antifilarial drugs. There are over 4 million immigrants from LF endemic countries in the U.S. and an estimated 10,000 people have LF. Like many orphan diseases, treatment for LF is readily available in endemic countries. In the U.S., treatment is only available through Centers for Disease Control and Prevention (CDC). CDC has partnered with the Palm Beach County Health Department to implement a pilot program in a refugee clinic to test and treat immigrants at risk of LF. This pilot program took over three years to come to fruition; both the rapid diagnostic test and the drug treatment are not FDA approved and require IRB approval for use in the U.S. Currently, 184 people have been tested for LF in south Florida, of whom 13(7.1%) tested positive and 12 patients were treated. Of the people tested, 182(98.9%) stated their country of origin was Haiti. No adverse events were reported from testing or treatment. The staff and patients highly regard this program and its success. There are plans to expand to additional health centers in Florida; however, additional regulatory review is required to expand the program to other states.

Learning Areas:
Diversity and culture
Program planning
Provision of health care to the public

Learning Objectives:
Learners will be able to describe what lymphatic filariasis (LF) is and what the Florida test and treat program for US immigrants is for. They will also be able to discuss how a lack of diagnostic tests and treatments for LF in the US will impact global LF eradication efforts.

Keywords: Immigrants, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a part of the Testing and Treating of Immigrants for LF in south Florida program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.