Molecular xenomonitoring highlights post-MDA surveillance priorities for sustained Wuchereria bancrofti elimination in Burkina Faso

Abstract

The study by Nikièma et al. demonstrates the absence of Wuchereria bancrofti infection in Anopheles mosquitoes a decade after cessation of mass drug administration (MDA) in Burkina Faso. This rare longitudinal evidence underscores the utility of molecular xenomonitoring (MX) as a sensitive early-warning tool that complements traditional transmission assessment surveys (TAS). MX enables detection of recrudescence earlier than human-based diagnostics, particularly in low-prevalence settings, and offers opportunities for integration with malaria vector surveillance. Ethical and operational challenges associated with human landing catches highlight the need for alternative trapping methods to maintain MX sensitivity safely. Sustaining lymphatic filariasis elimination globally will depend on institutionalizing MX alongside TAS, ensuring robust surveillance, and safeguarding long-term programmatic gains.