Dose Poles Simplify Elephantiasis Treatment

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SEATTLE, Washington — Lymphatic filariasis, commonly called elephantiasis, begins with a small mosquito bite. These mosquitos have the possibility of carrying the larvae of parasitic worms that enter into the bloodstream and disrupt the functions of the lymphatic system. Scientists have been using dose poles to battle lymphatic filariasis in poverty-stricken nations.

Spreading the Disease

In urban areas, the Culex mosquito is responsible for spreading the disease while in rural areas, it is the Anopheles mosquito. The larvae spread through the mosquitos migrate and develop into adult worms. These worms spread through the body through a person’s lymphatic system, living anywhere from six to eight years. Once in the vessels, they interrupt the human body’s pathway for removing fluids from tissues, causing elephantiasis to be fatal if untreated.

Elephantiasis has affected more than 120 million individuals globally and disfigured 40 million more since 2000. The disease is prominent in tropical nations and in countries in the equatorial belt. Thus, its treatment is often overlooked due to its absence in other regions of the world. This outlook has earned Elephantiasis the label of neglected tropical disease (NTD) by the World Health Organization (WHO).

WHO Response Strategy

Member States of the United Nations World Health Assembly were encouraged to eliminate elephantiasis as a public health issue in 2000. This is why WHO launched the Global Programme to Eliminate Lymphatic Filariasis. After 12 years, WHO reconfirmed that elimination will be achieved by 2020 as per the neglected the tropical disease roadmap.

Preventative chemotherapy, along with morbidity management, disability prevention and vector control, are the backbone of the World Health Organization’s response strategy. Furthermore, the organization also recommended triple-drug therapy in 2017. This is because of its research-proven effectivity and speed in treating elephantiasis when compared to the previously used regimens. Notably, all the above treatments have been successful in the fight against elephantiasis.

The Dose Pole

To battle neglected tropical diseases such as elephantiasis, communities in poverty-stricken nations are using a colorful pole called a dose pole. Ivermectin is a key ingredient in triple-drug therapy. To allow for the quick calculation of the required dosage of ivermectin to be given to a patient of elephantiasis, the dose pole is used. “This simple, light and universal device measures the heights of men, women, and children” through the clearly identified markings that it holds. These markings, separated by heights, make discerning the proper medication amount easy for distributors who do not have high levels of literacy to record the correct dosage for each patient.

The use of height as opposed to weight is more practical, especially in poverty-stricken regions. Using weighing scales to measure medication makes it more difficult to hand out. Due to a lack of resources that are needed for their calibration of the scales and the lack of power sources available, fewer people are able to seek treatment. Distributors of the dose pole are not delayed by their need to carry and configure scales, unlike their counterparts. Currently, dose poles are being used in equatorial nations such as Burkina Faso, Kenya, Nigeria, Sierra Leone, Sudan and India.

PATH In India

A global team of innovators called PATH partnered with the Indian government to supply and distribute the dose pole to areas where elephantiasis is a common phenomenon. The pole may be six-feet-tall, but it can be folded into four sections, making it compact and easy to carry. It is also color-coded into sections with each section corresponding to the dosage that the patient is to receive after his or her height is measured.

Healthcare providers use three easy steps to calculate dosage. First, measure the height of the individual. Second, match the height of the individual to the color on the pole. Lastly, dosage calculation is required. Through the support that PATH provided in India, the government’s National Vector Borne Disease Control Program developed the dose pole and provided guidelines for the proper use and training materials to allow for distributors and community health providers to administer triple-drug therapy.

Innovation for Future Use

India is one of the first countries to use triple-drug therapy and the dose pole for elephantiasis. However, the nation’s example of its use and effectivity proves that it can certainly be used for mass drug administration elsewhere. This venture is expected to reduce elephantiasis prevalence to less than 1 percent of the global population, making the WHO’s 2020 elimination goal more achievable.

It is exactly community-focused ventures like the dose pole that ensure communities are self-sustainable in combatting neglected tropical diseases such as elephantiasis. Dose poles also provide a long-term solution that can be used by generations to come. Lord Michael Bates, the Minister of State at the Department for International Development in the U.K., told SightSavers, a dose pole distributor in Uganda, that “the dose pole is a model of how things ought to continue.”

Monique Santos
Photo: Flickr

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