Progress towards the control and elimination of neglected tropical diseases in Brazil.

The study by Aguiar-Santos et al.1 indicates that, in spite of several years of interventions aimed at eliminating lymphatic filariasis (LF) from Pernambuco, its transmission is still occurring at sustained levels (13.8% mf prevalence); the study also shows that soil-transmitted helminthiasis (STH) is still significantly prevalent among surveyed children (46.5% or 74/159). High prevalence of lymphatic filariasis (LF) is probably a reflection of the fact that the Pan American Health Organization (PAHO)/World Health Organization (WHO) recommendations2 related to mass drug administration (MDA) have only been partially followed in the past: this intervention has not been implemented in all endemic areas (individual case-management has instead been applied in low-prevalence areas), and a mono-therapy regimen of diethyl carbamazine (DEC) alone3 has been used instead of the recommended combination of DEC + albendazole.2 High-prevalence of STH is also a reflection of the fact that albendazole was not distributed in the framework of LF