First ever programmatic implementation of triple drug therapy in the prevention of lymphatic filariasis in Haiti: lessons learned in improving the quality and coverage of locally led programming in lymphatic filariasis-persistent and conflict-affected endemic communes.

Although significant strides have been made towards lymphatic filariasis (LF) elimination in Haiti, which has experienced ongoing multidimensional crises, 19 out of 140 communes still require mass drug administration (MDA) despite multiple rounds using the two-drug regimen of diethylcarbamazine (DEC) and albendazole. This includes the commune of Limonade, which has experienced persistently high LF prevalence despite nine rounds of two-drug MDAs since 2010. In September and October 2023 and July 2024, the Haitian Ministry of Public Health and Population, with support from IMA World Health and the US Centers for Disease Control and Prevention, adapted the standard WHO strategy, proving the feasibility, acceptability and scalability of LF MDA with three drugs (ivermectin, DEC and albendazole [IDA]) through the successful implementation of two rounds of IDA MDA in Limonade.