Community- and individual-level determinants of Wuchereria bancrofti infection in Leogane Commune, Haiti

We conducted a school-based assessment of the geographic distribution of Wuchereria bancrofti infection in Leogane Commune, Haiti, using the immunochromatographic test. In multivariate analyses performed using generalized linear mixed models, children attending schools in the foothills and plains were 3.95 (95% confidence interval [CI] = 1.28-12.23) and 23.56 (95% CI = 8.99-61.79) times as likely to be infected, respectively, as children attending mountain schools. Infection prevalence decreased with increasing altitude, but some local foci of infection were detected at higher altitudes. Higher school tuition, a marker of socioeconomic status (SES), was not associated with decreased infection prevalence. Our results indicate that although the force of infection in Leogane Commune is greatest below 70 meters above sea level, higher altitude communities are not exempt from infection. Lymphatic filariasis (LF) elimination programs should consider extending infection mapping activities to presumed non-LF altitudes. In addition, higher SES does not confer protection against W. bancrofti infection.