Abstract:ABSTRACT Background: Lymphatic filariasis (LF) is a vector-borne neglected tropical disease that remains endemic in several regions of Malaysia, particularly in Sabah. The predominant causative species is Brugia malayi. Tuaran District had no previously recorded cases of LF until 2023. However, a sudden emergence of 40 confirmed cases in 2024 raised concerns regarding undetected transmission and limitations in local surveillance and early response efforts. Objectives: This study aimed to describe the epidemiological characteristics of LF cases in Tuaran District and to evaluate the public health response and preventive measures implemented during the outbreak. Methods: A retrospective cross-sectional assessment was conducted in July 2024 across four localities Kampung Bawang, Kampung Gayaratau, Kampung Kotunuan Baru, and Kampung Bungalio. Data sources included case notifications, field investigation records, community screening outcomes, and entomological surveillance findings. Results: No LF cases were reported from 2020 to 2022. The index case was detected in October 2023 in Kampung Gayaratau, followed by a second case in Kampung Kotunuan Baru in June 2024. Active case detection in July 2024 involved 366 residents across four localities, with 31 individuals testing positive (overall prevalence: 8.5%). Only 22.5% of positive cases received mass drug administration (MDA) due to limited drug supply and exclusion from the National Lymphatic Filariasis Elimination Programme (NLFEP) coverage. Entomological surveillance at two sites showed no active vector presence. Public health interventions focused on morbidity management, continuous case surveillance, and targeted community health education. Conclusion: This outbreak underscores significant gaps in the detection and response to LF in Tuaran District. Thus, to prevent continued transmission and support national LF elimination efforts, it is crucial to ensure consistent access to diagnostics and treatment, strengthen community-based entomological surveillance, and enhance the integration of local-level interventions within broader programmatic strategies.
Keywords: Health Systems and Universal Health Coverage (UHC), Lymphatic filariasis elimination, Morbidity management, Public health interventions
