Ten years of managing the clinical manifestations and disabilities of lymphatic filariasis.

The aim of the Global Programme to Eliminate Lymphatic Filariasis is to eradicate one of the world's leading causes of permanent and long-term disability, at least as a public-health problem. The achievement of this goal is based on the interruption of the transmission of the causative parasites (so preventing new cases) and, as a 'second pillar', the prevention of disability in those who are infected. The disability is associated with the main clinical manifestations of human infection with Wuchereria or Brugia spp. (i.e. hydrocele, lymphoedema and/or 'acute attacks'). The World Health Organization and its partners have established strategies and activities both for managing lymphoedema, through community home-based care, and for increasing access to surgery for hydrocele. Over the last decade, there has been progress made in preventing the disability of lymphatic filariasis, the monitoring and evaluation of such disability and its control, and the integration of disability prevention with mass drug administrations and efforts to control other disabling diseases. That progress and the challenges that remain in the prevention of the morbidity and disability attributable to lymphatic filariasis are here reviewed.