Lymphatic filariasis: Komi’s Story

The following story about “Komi” is inspired by the experiences of real people throughout the world.

Komi began farming at the age of eleven. He always loved the land in his village of Pouda in the Doufelgou district of Togo, West Africa. He took pride in providing for his wife and five children. The money “Komi” earned from farming was used to educate his children and to care for his house. But once “Komi’s” leg became swollen, cracked, and inflamed from lymphatic filariasis (LF), he was no longer able to work or even to walk. He felt isolated, and was ashamed that he could no longer farm his land or send his two oldest children to school.

The story of “Komi,” while not entirely real, is inspired by the very real experiences of the more than 120 million men and women who have LF. LF is one of a group of diseases known as Neglected Tropical Diseases (NTDs). NTDs affect the world’s poorest people, resulting in a tremendous amount of illness and death. LF, in particular, causes enormous suffering, forcing people to live with the daily struggles of disfigurement, debilitation, and stigma associated with the disease. Symptoms are severe and painful, including swelling of the arms, legs, and breasts (called lymphedema) or the scrotum (called hydrocele). Like “Komi,” the millions of people living with LF often feel useless and excluded from those around them.

Since 2003, the Centers for Disease Control and Prevention (CDC) has worked alongside Togo’s Ministry of Health (MOH) to improve the country’s programs on LF and other NTDs. Working to achieve the Global Health Initiative goals of elimination of LF by 2020 and a 50% reduction of NTD prevalence, CDC helped to implement a number of LF program components. These activities included publicizing the cause of and treatment for LF, training dispensary workers at each clinic nationwide to help patients manage their symptoms, and educating patients on lymphedema management including how to care for affected limbs. In addition, CDC has assisted the MOH in evaluating the progress and impact of mass drug administration, or MDA – treatment drugs given to at-risk populations annually, to stop the spread of infection.

At the onset of the program, 25% of the country’s people were living in areas where LF was present. After years of work, and with support from the United States Agency for International Development (USAID), LF in Togo is now thought to have been eliminated, and the country has been able to stop MDA interventions. Togo is the first country in Africa to have reached this milestone, and its program is serving as a model for programs in other African countries.

CDC has worked with the MOH to set up a sustainable surveillance system to ensure that any resurgence of LF is quickly detected. Additionally, by combating other NTDs along with LF, this integrated effort has had a substantial impact on the physical and cognitive development of children, mother and child health, and productivity in the workplace. Togolese program staff are now transferring the knowledge and capacity gained, and are providing assistance to Mali’s NTD program.

For “Komi” and others like him, the programs designed to fight LF and other NTDs have had a considerable effect on their lives. Since learning how to properly wash and elevate his foot, his swelling and pain have decreased. “Komi” is able to walk and recently resumed working in his farm.