Determining Lymphatic Filariasis Prevalence in an Eastern Burma Conflict Zone

The collapse of Burma's health system under decades of military rule has resulted in ongoing endemicity of lymphatic filarisis (LF). The situation is more severe for non-Burman ethnic populations of eastern Burma, where civil war, compounded by widespread human rights abuses, result in a complex humanitarian emergency, increasing the population's risk of diseases such as LF. To investigate and institute mass LF treatment programs along the Thai-Burma border, ethnic community-based organizations (CBOs), the sole source of healthcare in these conflict zones, conducted screening to determine LF prevalence.

To assess which areas had the highest morbidity, health workers administered questionnaires to key informants and counted cases of lymphedema and hydrocele in 7 potential program areas including 1 internally displaced persons (IDP) camp. In villages with the highest case counts and probability of program success, twelve health workers conducted systematical interval sampling to select households in which to perform immunochromatographic card tests to measure LF antigenemia.

Health workers tested 1104 people. In Karen State, 338 of 865 (39%) people tested positive; in the Shan IDP community, 11 of 239 (4.6%) screened were positive for LF antigenemia. 
 For displaced non-Burman populations in eastern Burma, government LF surveillance and reporting are inadequate and unreliable, rendering LF control impossible and threatening LF control efforts of neighboring countries. In such settings, CBOs are able to gauge disease prevalence using rapid diagnostic equipment. These screening results provide baseline data for the initiation of LF MDA programs in these underserved populations of eastern Burma.