Assessing the need to implement mass drug administration against Wuchereria bancrofti infection using both human serology and xenomonitoring in the urban conurbation of Monrovia, Liberia

Summary

The elimination of lymphatic filariasis as a public health problem is targeted through mass drug administration (MDA) and morbidity management. In low-prevalence and urban settings, decision-making is complicated by population density and operational challenges. This study assessed the need for MDA in four health districts of Monrovia using the World Health Organization (WHO) confirmatory mapping protocol and molecular xenomonitoring (XM). All districts exceeded the WHO serological threshold for MDA, though no infection was detected in over 19,000 mosquitoes. The authors highlight the need for optimised and spatially representative XM sampling strategies and adapted confirmatory mapping protocols tailored to urban contexts.

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