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Pietrzak D, Łuczak JW, Wiśniewski M. Beyond Tradition: Exploring Cutting-Edge Approaches for Accurate Diagnosis of Human Filariasis. Pathogens 2024; 13:447. [PMID: 38921745 PMCID: PMC11206659 DOI: 10.3390/pathogens13060447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
Filariasis is recognised as a global public health threat, particularly in tropical and subtropical regions. It is caused by infection with a nematode parasite of the superfamily Filarioidea, including Wuchereria bancrofti, Brugia malayi, Onchocerca volvulus, and Onchocerca lupi. Three main types of filariasis have been classified: lymphatic filariasis, subcutaneous filariasis, and serous cavity filariasis. The symptoms exhibited by individuals afflicted with filariasis are diverse and contingent upon several variables, including the species of parasite, the host's health and immune response, and the stage of infection. While many classical parasitological techniques are considered indispensable tools for the diagnosis of parasitic infections in humans, alternative methods are being sought due to their limitations. Novel tests based on host-parasite interactions offer a rapid, simple, sensitive, and specific diagnostic tool in comparison to traditional parasitological methods. This article presents methods developed in the 21st century for the diagnosis of filariasis caused by invasion from W. bancrofti, B. malayi, O. volvulus, and O. lupi, as well as techniques that are currently in use. The development of modern diagnostic methods based on molecular biology constitutes a significant advancement in the fight against filariasis.
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Affiliation(s)
- Damian Pietrzak
- Division of Parasitology and Parasitic Diseases, Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences—SGGW, 02-786 Warsaw, Poland;
| | - Julia Weronika Łuczak
- Faculty of Animal Breeding, Bioengineering and Conservation, Warsaw University of Life Sciences—SGGW, 02-786 Warsaw, Poland;
| | - Marcin Wiśniewski
- Division of Parasitology and Parasitic Diseases, Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences—SGGW, 02-786 Warsaw, Poland;
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Camard M, Labeyrie C, Bessis S, Beaudonnet G, Beauvais D. Sensorimotor deficit: To worm information out of white blood cell count! Rev Neurol (Paris) 2024; 180:469-470. [PMID: 38311526 DOI: 10.1016/j.neurol.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/25/2023] [Accepted: 11/15/2023] [Indexed: 02/06/2024]
Affiliation(s)
- M Camard
- Department of Neurology, Bicêtre Hospital, AP-HP, University Paris Sud Saclay, Le Kremlin-Bicêtre, France.
| | - C Labeyrie
- Department of Neurology, Bicêtre Hospital, AP-HP, University Paris Sud Saclay, Le Kremlin-Bicêtre, France
| | - S Bessis
- Department of Infectious Diseases, Bicêtre Hospital, AP-HP, University Paris Sud Saclay, Le Kremlin-Bicêtre, France
| | - G Beaudonnet
- Department of Neurology, Bicêtre Hospital, AP-HP, University Paris Sud Saclay, Le Kremlin-Bicêtre, France; Department of Neurophysiology and Epileptology Department, Bicêtre Hospital, AP-HP, University Paris Sud Saclay, Le Kremlin-Bicêtre, France
| | - D Beauvais
- Department of Neurology, Bicêtre Hospital, AP-HP, University Paris Sud Saclay, Le Kremlin-Bicêtre, France
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Mehta PK, Maharjan M. Assessment of antigenemia among children in four hotspots of filarial endemic districts of Nepal during post-MDA surveillance. Trop Med Health 2023; 51:47. [PMID: 37620918 PMCID: PMC10464004 DOI: 10.1186/s41182-023-00538-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Sixty-three out of 77 districts reported lymphatic filariasis (LF) endemic in Nepal. Mass drug administration (MDA) with diethylcarbamazine (DEC) and albendazole (ALB) treatment program was continued for 6 to 11 rounds in these districts. Nepal government has stopped the MDA program based on the transmission assessment survey (TAS) report of 2014 and 2018 indicating Wuchereria bancrofti antigenemia prevalence < 2%. But the persistence of low levels of the circulating filarial antigen (CFA) in some foci of four endemic districts of Central Nepal, i.e., 0.4% in Dhading, 0.7% in Mahottari, 0.21% in Lalitpur and 1.2% in Bara district could responsible for enhancing the risk of infection resurgence. Hence the present study was designed to assess antigenic prevalence using Filariasis Test Strip (Alere, Scarborough ME) in children born after MDA in hotspot areas of four endemic districts of Central Nepal. RESULTS The present study covers 70% children of the eligible population. The result revealed significantly high CFA prevalence in hotspots of Mahottari district belonging to the Terai region and Dhading district belonging to the hilly region, i.e., 13% and 10%, respectively, compared to baseline prevalence and TAS report. While in Lalitpur district and Bara district CFA prevalence was still found to be less than 2%. A higher number of MDA rounds covered in hotspots were found significantly associated with the low antigenic prevalence of W. bancrofti. Whereas median treatment coverage and inter-quartile range (IQR) in study districts were not found significantly associated with CFA prevalence. Although the clinical manifestation of hydrocele (1%) was found in all four study districts, it was not due to the W. bancrofti infection. CONCLUSIONS Two hotspot regions, one each from the Terai (Mahottari) and hilly (Dhading) districts were found highly prevalent with CFA and significantly associated with the number of MDA rounds but were not associated with treatment coverage and IQR. Higher CFA prevalence was observed in hotspots where baseline prevalence was high together indicating that rounds of MDA program need to be extended further in these hotspot regions of endemic districts.
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Affiliation(s)
- Pramod Kumar Mehta
- Central Department of Zoology, Institute of Science and Technology, Tribhuvan University, Kirtipur, Nepal.
| | - Mahendra Maharjan
- Central Department of Zoology, Institute of Science and Technology, Tribhuvan University, Kirtipur, Nepal.
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Balasubramaniyan M, Santhanam M, Vinayagam V, Perumal K. Immunomodulatory effects of chitosan nanoparticles as vaccine delivery agent against lymphatic filariasis through mucosal immunization. Int J Biol Macromol 2022; 222:2392-2398. [DOI: 10.1016/j.ijbiomac.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/18/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
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Gurung S, Karki S, Kharal K, Thapa S, Thapa S, Baral S. Filariasis Diagnosed by Real-Time Ultrasound Scanning as Filarial Dance Sign - A Case Report. IDCases 2022; 30:e01621. [PMID: 36210858 PMCID: PMC9539772 DOI: 10.1016/j.idcr.2022.e01621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/12/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Lymphatic filariasis (LF) is a vector-borne illness caused due to Wuchereria bancrofti. Genital abnormalities may result from chronic inflammation of the lymphatic vessels and obstruction of the afferent vessels in Bancroftian filariasis. Doxycycline, albendazole, diethylcarbamazine, and ivermectin are among the treatments available. Case A 16-year male presented to our OPD with a complaint of left inguinal swelling for the past 6 Months. Examination of the swelling revealed a left-sided inguinal swelling of 5 × 4 cm with intact overlying skin. A provisional diagnosis of inguinal lymph varix was made, and real-time ultrasound scanning along with FNAC was performed. Swelling resolved after conservative management. Discussion Ultrasonography can easily observe adult worms due to their size and fast movements. Using pulsed-wave doppler mode, the characteristic movement profile of adult worms in pulsed-wave doppler mode can be distinguished from other movements (e.g., blood in venous vessels). Conclusion Ultrasound is the imaging modality of choice to detect filarial worms/microfilaria in the lymphatic system, which produces the classic twirling of microfilaria in the lymphatic system, known as the "filarial dance sign".
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Kaur A, Kandari S, Saini S, Dhoot DK, Kandari A. Chyluria Associated With Nephrotic-Range Proteinuria. Cureus 2022; 14:e26690. [PMID: 35959171 PMCID: PMC9359605 DOI: 10.7759/cureus.26690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2022] [Indexed: 11/29/2022] Open
Abstract
Chyluria is the presence of chyle in the urine and is associated with some degree of proteinuria. We report two patients with chyluria who presented with milky urine, weight loss, and edema and were found to have nephrotic-range proteinuria. Although filarial antigen was detected in only one of the patients, flexible cystoscopy could demonstrate chyle efflux from the left ureter in first patient and from both the ureters in the second patient. Both patients received endoscopic sclerotherapy with 0.2% povidone-iodine, which resulted in the clearance of milky urine in three to five days and complete resolution of nephrotic-range proteinuria on follow-up. They remained symptom-free until the six-month follow-up. We deferred renal biopsy in both patients, as proteinuria was confirmed to be non-glomerular in origin.
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Bartenjev MS, Hrvatin Stančič B, Bartenjev I. Subcutaneous parasitic infection in Slovenia: a case report. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2022. [DOI: 10.15570/actaapa.2022.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wangdi K, Sheel M, Fuimaono S, Graves PM, Lau CL. Lymphatic filariasis in 2016 in American Samoa: Identifying clustering and hotspots using non-spatial and three spatial analytical methods. PLoS Negl Trop Dis 2022; 16:e0010262. [PMID: 35344542 PMCID: PMC8989349 DOI: 10.1371/journal.pntd.0010262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 04/07/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND American Samoa completed seven rounds of mass drug administration from 2000-2006 as part of the Global Programme to Eliminate Lymphatic Filariasis (LF). However, resurgence was confirmed in 2016 through WHO-recommended school-based transmission assessment survey and a community-based survey. This paper uses data from the 2016 community survey to compare different spatial and non-spatial methods to characterise clustering and hotspots of LF. METHOD Non-spatial clustering of infection markers (antigen [Ag], microfilaraemia [Mf], and antibodies (Ab [Wb123, Bm14, Bm33]) was assessed using intra-cluster correlation coefficients (ICC) at household and village levels. Spatial dependence, clustering and hotspots were examined using semivariograms, Kulldorf's scan statistic and Getis-Ord Gi* statistics based on locations of surveyed households. RESULTS The survey included 2671 persons (750 households, 730 unique locations in 30 villages). ICCs were higher at household (0.20-0.69) than village levels (0.10-0.30) for all infection markers. Semivariograms identified significant spatial dependency for all markers (range 207-562 metres). Using Kulldorff's scan statistic, significant spatial clustering was observed in two previously known locations of ongoing transmission: for all markers in Fagali'i and all Abs in Vaitogi. Getis-Ord Gi* statistic identified hotspots of all markers in Fagali'i, Vaitogi, and Pago Pago-Anua areas. A hotspot of Ag and Wb123 Ab was identified around the villages of Nua-Seetaga-Asili. Bm14 and Bm33 Ab hotspots were seen in Maleimi and Vaitogi-Ili'ili-Tafuna. CONCLUSION Our study demonstrated the utility of different non-spatial and spatial methods for investigating clustering and hotspots, the benefits of using multiple infection markers, and the value of triangulating results between methods.
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Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
| | | | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences and Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Colleen L. Lau
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
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Vasuki V, Hoti SL, Subramanian S, Khan AM, Thenmozhi V, Ananganallur NS, Mahapatra N, Balasubramaniyan R. Multi-centric evaluation of a stage-specific reverse transcriptase-polymerase chain reaction assay as a xenomonitoring tool for the detection of infective (L 3) stage Wuchereria bancrofti in vectors. Indian J Med Res 2021; 154:132-140. [PMID: 34782539 PMCID: PMC8715687 DOI: 10.4103/ijmr.ijmr_713_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background & objectives: An infective stage specific reverse transcriptase-polymerase chain reaction (RT-PCR) assay utilizing the abundant larval transcript-3 (Alt-3) gene of Wuchereria bancrofti was developed at ICMR-VCRC, Puducherry and found to be stage specific, and sensitive upon validation in the laboratory. This study was aimed at independently evaluating this assay for its utility as a monitoring/surveillance tool in the operational programme for elimination of lymphatic filariasis (LF) by four national research laboratories. Methods: Evaluation of the assay was carried out in a multi-centric mode in three phases. In phase I, a workshop was conducted to impart hands-on training to the scientists from the collaborating centres on the RT-PCR assay and in Phase II the assay was evaluated for specificity and sensitivity in detecting the infective (L3) stage larvae of W. bancrofti in its vector, Culex quinquefasciatus, using 50 coded pooled samples. Phase III evaluation was done on wild-caught mosquito vectors from selected endemic areas of Assam and Bhubaneswar States and Andaman Nicobar islands. Results: Phase I data indicated that the assay was able to detect all the pools of mosquito samples contaning L3 stage larvae of W. bancrofti as positive, even in the presence of other vector stages of the parasite indicating its stage specificity (100%). The assay was found highly sensitive (100%), detecting all the infected pools as positive and specific detecting all uninfected pools as negative. The results of phase II showed inter-laboratory variation. Phase III evaluation from all the centres suggested that the infectivity rate determined for pooled mosquitoes by the RT-PCR assay (0.5%) was comparable to that by dissection method (1.2%) (95% confidence interval overlaps). Interpretation & conclusions: Overall, the results from three of the four participating centres indicated that the assay is at least as sensitive and stage specific as the conventional mosquito dissection technique, and hence, may be useful as a xenomonitoring tool for Transmission Assessment Survey in Mass Drug Administration programmes for LF.
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Affiliation(s)
| | | | | | | | | | | | - Namita Mahapatra
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Won KY, Gass K, Biamonte M, Dagne DA, Ducker C, Hanna C, Hoerauf A, Lammie PJ, Njenga SM, Noordin R, Ramaiah KD, Ramzy R, Scholte RGC, Solomon AW, Souza AA, Tappero J, Toubali E, Weil GJ, Williams SA, King JD. Diagnostics to support elimination of lymphatic filariasis-Development of two target product profiles. PLoS Negl Trop Dis 2021; 15:e0009968. [PMID: 34780503 PMCID: PMC8629375 DOI: 10.1371/journal.pntd.0009968] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/29/2021] [Accepted: 11/03/2021] [Indexed: 11/19/2022] Open
Abstract
As lymphatic filariasis (LF) programs move closer to established targets for validation elimination of LF as a public health problem, diagnostic tools capable of supporting the needs of the programs are critical for success. Known limitations of existing diagnostic tools make it challenging to have confidence that program endpoints have been achieved. In 2019, the World Health Organization (WHO) established a Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases tasked with prioritizing diagnostic needs including defining use-cases and target product profiles (TPPs) for needed tools. Subsequently, disease-specific DTAG subgroups, including one focused on LF, were established to develop TPPs and use-case analyses to be used by product developers. Here, we describe the development of two priority TPPs for LF diagnostics needed for making decisions for stopping mass drug administration (MDA) of a triple drug regimen and surveillance. Utilizing the WHO core TPP development process as the framework, the LF subgroup convened to discuss and determine attributes required for each use case. TPPs considered the following parameters: product use, design, performance, product configuration and cost, and access and equity. Version 1.0 TPPs for two use cases were published by WHO on 12 March 2021 within the WHO Global Observatory on Health Research and Development. A common TPP characteristic that emerged in both use cases was the need to identify new biomarkers that would allow for greater precision in program delivery. As LF diagnostic tests are rarely used for individual clinical diagnosis, it became apparent that reliance on population-based surveys for decision making requires consideration of test performance in the context of such surveys. In low prevalence settings, the number of false positive test results may lead to unnecessary continuation or resumption of MDA, thus wasting valuable resources and time. Therefore, highly specific diagnostic tools are paramount when used to measure low thresholds. The TPP process brought to the forefront the importance of linking use case, program platform and diagnostic performance characteristics when defining required criteria for diagnostic tools.
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Affiliation(s)
- Kimberly Y. Won
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Katherine Gass
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Marco Biamonte
- Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States of America
| | - Daniel Argaw Dagne
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Camilla Ducker
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Christopher Hanna
- Global Project Partners, Oakland, California, United States of America
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany
- German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Patrick J. Lammie
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Reda Ramzy
- National Nutrition Institute, Cairo, Egypt
| | - Ronaldo G. Carvalho Scholte
- Neglected, Tropical and Vector-Borne Diseases Unit, Pan American Health Organization, World Health Organization, Washington, D.C., United States of America
| | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Ashley A. Souza
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Jordan Tappero
- Global Health, Bill and Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Emily Toubali
- Neglected Tropical Diseases Division, United States Agency for International Development, Washington, D.C., United States of America
| | - Gary J. Weil
- Infectious Diseases Division, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Steven A. Williams
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, United States of America
| | - Jonathan D. King
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Nancy K, Lillian W, Wilkinson M, Claire M, Luna K, Dorcas W, Rosemary G, Japheth L, Christine I, Emily W, Jim K. Optimization of a Loop-Mediated Isothermal Amplification Assay as a Point-of-Care Tool for the Detection of Wuchereria bancrofti in Human Blood in Tana River Delta, Kenya. J Parasitol Res 2021; 2021:6650870. [PMID: 34367688 PMCID: PMC8337116 DOI: 10.1155/2021/6650870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Accurate detection of filarial parasites in humans and vectors is essential for the implementation and evaluation of Global and National Programs to eliminate lymphatic filariasis. Immunological methods to detect infection are available; however, cross-reactivity issues have been reported in most of them. Nucleic acid-based molecular assays offer high levels of specificity and sensitivity and can be used to detect the infections. METHODS In this study, we evaluated loop-mediated isothermal amplification (LAMP) tests to amplify Wuchereria bancrofti DNA in patients' blood. The amplicons were tested by both pH-sensitive dyes for enhanced visual detection and agarose gel electrophoresis. A closed-tube LAMP assay was also evaluated. Cohen's Kappa statistics was used for statistical analysis of the assays. 125 patients consented for blood sampling which were used for clinical analysis of LAMP assays with the PCR method used as the "gold standard." RESULTS The sensitivity of the evaluated Wuchereria bancrofti LAMP was 92.3%, with a specificity of 97.3% and kappa statistics value of 0.84, which is in a strong agreement. CONCLUSION In this study, LAMP assays coupled with fluorescence dye detection have been found to be suitable for diagnosis and monitoring of Wuchereria bancrofti infections in the Kenyan population.
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Affiliation(s)
- Kinyatta Nancy
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Wambua Lillian
- School of Biological Science, University of Nairobi, 30772-00100, Nairobi, Kenya
| | - Mutahi Wilkinson
- School of Biological Science, University of Nairobi, 30772-00100, Nairobi, Kenya
| | - Mugasa Claire
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University Kampala, 7062 Kampala, Uganda
| | - Kamau Luna
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Wachira Dorcas
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Githae Rosemary
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Lusweti Japheth
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Ichugu Christine
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Waigi Emily
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
| | - Kagai Jim
- Kenya Medical Research Institute, Centre for Biotechnology Research and Development, P.O. Box 54840-00200, Nairobi, Kenya
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Melo PFAS, Silva MAL, Oliveira MRG, Araújo J, Fernandes A, Diniz GTN, Brandão E, Rocha A, Maciel MA. [Evaluation of the Filaria Detect™ IgG4 kit employing recombinant Wb123 antigen for diagnosis of lymphatic filariasis in BrazilEvaluación del estuche Detect™ para pruebas de anticuerpos antifiláricos IgG4, fabricado con el antígeno recombinante Wb123, para el diagnóstico de la filariasis linfática en Brasil]. Rev Panam Salud Publica 2021; 45:e87. [PMID: 34249122 PMCID: PMC8260883 DOI: 10.26633/rpsp.2021.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/08/2021] [Indexed: 11/24/2022] Open
Abstract
O Plano Global de Eliminação da Filariose Linfática, lançado pela Organização Mundial da Saúde em 2000, propõe o uso de testes de detecção de antígeno circulante filarial como ferramenta diagnóstica para avaliação e monitoramento das ações de controle da parasitose. Entretanto, esses testes, apesar de apresentarem alta sensibilidade, não conseguem detectar com eficiência a infecção em seu estágio inicial, quando ainda não existe a presença de helmintos adultos. Considerando essa limitação, a pesquisa de anticorpos antifilariais tem sido apontada como uma alternativa, uma vez que os anticorpos produzidos contra as larvas infectantes do parasito são detectados antes da presença de antígeno circulante filarial. O objetivo deste estudo foi definir o ponto de corte e avaliar a acurácia do kit Filaria Detect™ IgG4 produzido com o antígeno recombinante Wb123 para diagnóstico da filariose linfática no Brasil. Para isso, foi realizado um estudo de avaliação de teste diagnóstico, no qual foram utilizadas 256 amostras de soro: 79 (30,9%) obtidas de indivíduos microfilarêmicos e 177 (60,1%), de indivíduos amicrofilarêmicos e que testaram negativo para os testes imunológicos Bm14 CELISA e Og4C3 ELISA. A definição do ponto de corte ideal, bem como da acurácia do kit Filaria Detect™ IgG4, foi obtida através da construção de curvas ROC, sendo a densidade óptica de 0,239 aquela na qual o teste obteve melhor desempenho, com sensibilidade de 81,0% e especificidade de 96,6%. Os resultados obtidos demonstraram que o kit Filaria Detect™ IgG4 é uma ferramenta promissora para investigação e monitoramento de áreas submetidas ao tratamento em massa para filariose linfática.
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Affiliation(s)
- Paula Fernanda A S Melo
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Medicina Tropical Recife (PE) Brasil Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Medicina Tropical, Recife (PE), Brasil
| | - Maria Almerice L Silva
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses, Recife (PE), Brasil
| | - Maria Rosângela G Oliveira
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses, Recife (PE), Brasil
| | - Josué Araújo
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses, Recife (PE), Brasil
| | - Amanda Fernandes
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses, Recife (PE), Brasil
| | - George Tadeu N Diniz
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães, Núcleo de Saúde Coletiva (IAM/NESC) Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães, Núcleo de Saúde Coletiva (IAM/NESC), Recife (PE), Brasil
| | - Eduardo Brandão
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses, Recife (PE), Brasil
| | - Abraham Rocha
- Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses Recife (PE) Brasil Fundação Oswaldo Cruz (Fiocruz), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia/Serviço de Referência Nacional em Filarioses, Recife (PE), Brasil
| | - Maria Amélia Maciel
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Medicina Tropical Recife (PE) Brasil Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Medicina Tropical, Recife (PE), Brasil
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Pryce J, Reimer LJ. Evaluating the Diagnostic Test Accuracy of Molecular Xenomonitoring Methods for Characterizing Community Burden of Lymphatic Filariasis. Clin Infect Dis 2021; 72:S203-S209. [PMID: 33906238 PMCID: PMC8201559 DOI: 10.1093/cid/ciab197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Molecular xenomonitoring (MX), the detection of pathogen DNA in mosquitoes, is a recommended approach to support lymphatic filariasis (LF) elimination efforts. Potential roles of MX include detecting presence of LF in communities and quantifying progress towards elimination of the disease. However, the relationship between MX results and human prevalence is poorly understood. Methods We conducted a systematic review and meta-analysis from all previously conducted studies that reported the prevalence of filarial DNA in wild-caught mosquitoes (MX rate) and the corresponding prevalence of microfilaria (mf) in humans. We calculated a pooled estimate of MX sensitivity for detecting positive communities at a range of mf prevalence values and mosquito sample sizes. We conducted a linear regression to evaluate the relationship between mf prevalence and MX rate. Results We identified 24 studies comprising 144 study communities. MX had an overall sensitivity of 98.3% (95% confidence interval, 41.5–99.9%) and identified 28 positive communities that were negative in the mf survey. Low sensitivity in some studies was attributed to small mosquito sample sizes (<1000) and very low mf prevalence (<0.25%). Human mf prevalence and mass drug administration status accounted for approximately half of the variation in MX rate (R2 = 0.49, P < .001). Data from longitudinal studies showed that, within a given study area, there is a strong linear relationship between MX rate and mf prevalence (R2 = 0.78, P < .001). Conclusions MX shows clear potential as tool for detecting communities where LF is present and as a predictor of human mf prevalence.
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Affiliation(s)
- Joseph Pryce
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Lisa J Reimer
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Potential strategies for strengthening surveillance of lymphatic filariasis in American Samoa after mass drug administration: Reducing 'number needed to test' by targeting older age groups, hotspots, and household members of infected persons. PLoS Negl Trop Dis 2020; 14:e0008916. [PMID: 33370264 PMCID: PMC7872281 DOI: 10.1371/journal.pntd.0008916] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 02/09/2021] [Accepted: 10/26/2020] [Indexed: 12/12/2022] Open
Abstract
Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted mass drug administration (MDA) from 2000-2006. Despite passing Transmission Assessment Surveys (TAS) in 2011/2012 and 2015, American Samoa failed TAS-3 in 2016, with antigen (Ag) prevalence of 0.7% (95%CI 0.3-1.8%) in 6-7 year-olds. A 2016 community survey (Ag prevalence 6.2% (95%CI 4.4-8.5%) in age ≥8 years) confirmed resurgence. Using data from the 2016 survey, this study aims to i) investigate antibody prevalence in TAS-3 and the community survey, ii) identify risk factors associated with being seropositive for Ag and anti-filarial antibodies, and iii) compare the efficiency of different sampling strategies for identifying seropositive persons in the post-MDA setting. Antibody prevalence in TAS-3 (n = 1143) were 1.6% for Bm14 (95%CI 0.9-2.9%), 7.9% for Wb123 (95%CI 6.4-9.6%), and 20.2% for Bm33 (95%CI 16.7-24.3%); and in the community survey (n = 2507), 13.9% for Bm14 (95%CI 11.2-17.2%), 27.9% for Wb123 (95%CI 24.6-31.4%), and 47.3% for Bm33 (95%CI 42.1-52.6%). Multivariable logistic regression was used to identify risk factors for being seropositive for Ag and antibodies. Higher Ag prevalence was found in males (adjusted odds ratio [aOR] 3.01), age ≥18 years (aOR 2.18), residents of Fagali'i (aOR 15.81), and outdoor workers (aOR 2.61). Ag prevalence was 20.7% (95%CI 9.7-53.5%) in households of Ag-positive children identified in TAS-3. We used NNTestav (average number needed to test to identify one positive) to compare the efficiency of the following strategies for identifying persons who were seropositive for Ag and each antibody: i) TAS of 6-7 year-old children, ii) population representative surveys of older age groups, and iii) targeted surveillance of subpopulations at higher risk of being seropositive (older ages, householders of Ag-positive TAS children, and known hotspots). For Ag, NNTestav ranged from 142.5 for TAS, to <5 for households of index children. NNTestav was lower in older ages, and highest for Ag, followed by Bm14, Wb123 and Bm33 antibodies. We propose a multi-stage surveillance strategy, starting with population-representative sampling (e.g. TAS or population representative survey of older ages), followed by strategies that target subpopulations and/or locations with low NNTestav. This approach could potentially improve the efficiency of identifying remaining infected persons and residual hotspots. Surveillance programs should also explore the utility of antibodies as indicators of transmission.
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15
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Al-Kubati AS, Al-Samie AR, Al-Kubati S, Ramzy RMR. The story of Lymphatic Filariasis elimination as a public health problem from Yemen. Acta Trop 2020; 212:105676. [PMID: 32828916 DOI: 10.1016/j.actatropica.2020.105676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
In 2000, Yemen joined the WHO global efforts to eliminate lymphatic filariasis (LF) as a public health problem by initiating a National LF Elimination Programme (NLFEP), that was fully integrated with the National Leprosy Elimination Programme (NLEP), the Ministry of Public Health and Population. This article reviews the NLFEP extensive efforts and interventions to eliminate LF in Yemen. LF mapping was started in 2000, followed by five annual rounds of mass drug administration (MDA) with ivermectin and albendazole in 8 implementation units (IUs) during 2002-2006. The epidemiological coverage for all MDA rounds was ≥80%. Based on WHO guidelines of 2005, MDA was stopped in 7 IUs, additional MDA rounds were continued in one IU until 2011. Microfilaremia monitoring and evaluation, and MDA stopping surveys were conducted based on WHO guidelines of 2005 and 2011. Information about the presence of patients suffering from lymphoedema/elephantiasis and hydrocele was collected, and basic care provided to all chronic cases by NLEP coordinators, trained on LF morbidity management and disability prevention (MMDP). As of 2017, a total of 610 lymphoedema patients were trained on self-management, and 31 hydrocele patients were referred to local General Hospitals for surgery. The NLFEP made excellent progress due to integration with NLEP, strong collaboration with national and international bodies, intensive training and supervision, and the use of robust advocacy for mobilization of endemic communities. Transmission assessment surveys (TAS), conducted in 2013 and 2016, indicated 0% antigenemia levels in schoolchildren in the 8 IUs. Thus, after almost two decades of sustained effort, Yemen met the WHO criteria for successful elimination of LF as a public health problem. In 2019, WHO validated Yemen as the second country in the WHO' Eastern Mediterranean Region to successfully eliminate LF as a public health problem.
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Affiliation(s)
- Abdul Samid Al-Kubati
- National Filariasis Elimination Programme, National Leprosy Elimination Programme- Taiz, Yemen
| | | | - Saeed Al-Kubati
- Skin and Venereal Disease Hospital, City of light, Taiz, Yemen
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes Cairo, Egypt..
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Hertz MI, Rush A, Nutman TB, Weil GJ, Bennuru S, Budge PJ. Characterization of glycan determinants that mediate recognition of the major Wuchereria bancrofti circulating antigen by diagnostic antibodies. Mol Biochem Parasitol 2020; 240:111317. [PMID: 32961208 PMCID: PMC11006022 DOI: 10.1016/j.molbiopara.2020.111317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/17/2022]
Abstract
The Global Program to Eliminate Lymphatic Filariasis (GPELF) relies heavily on a rapid diagnostic test (RDT) to a Wuchereria bancrofti circulating filarial antigen (Wb-CFA) to identify endemic areas and for determining when mass drug administration can stop. The antigen contains a carbohydrate epitope that is recognized by monoclonal antibody AD12. Og4C3, a monoclonal antibody that is used in a commercial ELISA for Wb-CFA recognizes the same moiety. Despite its diagnostic importance, little is known about the structure and function of this "AD12 epitope". It is also present on other W. bancrofti glycoproteins and on glycoproteins of other filarial worms, but such antigens are not detected in the sera of individuals with most other filarial infections. We report here functional and biochemical analyses that shed light on the interaction between filarial glycoproteins and AD12 and/or Og4C3. Binding of these monoclonal antibodies to a mammalian glycan array suggests the reactive moiety has structural similarity to terminal β-d-glucuronic acid in a 1-3 linkage to other hexoses. However, sera collected from individuals with patent W. bancrofti infection had very low or undetectable serum antibodies to the GlcA-containing array glycans. Unlike other filarial glycoproteins, the Wb-CFA is relatively resistant to protease digestion by pronase and trypsin and completely resistant to the mucinase O-sialoglycoprotein endopeptidase (OSGE). The protease resistance of the Wb-CFA may contribute to its consistent detection in Wb-infected sera.
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Affiliation(s)
- Marla I Hertz
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Amy Rush
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Gary J Weil
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Sasisekhar Bennuru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Philip J Budge
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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17
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Paulo R, Brito M, Van-Dunem P, Martins A, Novak RJ, Jacob B, Molyneux DM, Unnasch TR, Stothard JR, Kelly-Hope L. Clinical, serological and DNA testing in Bengo Province, Angola further reveals low filarial endemicity and opportunities for disease elimination. Parasite Epidemiol Control 2020; 11:e00183. [PMID: 33072898 PMCID: PMC7548300 DOI: 10.1016/j.parepi.2020.e00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/31/2020] [Accepted: 09/20/2020] [Indexed: 12/05/2022] Open
Abstract
The prevalence of Loa loa, Onchocerca volvulus and Wuchereria bancrofti infections in an under-surveyed area of Bengo Province, Angola, was determined by surveying 22 communities with a combination of clinical, serological and DNA diagnostics. Additional information was collected on participants' duration of residency, access to mass drug administration, knowledge of insect vectors and use of bednets. A total of 1616 individuals (38.1% male: 61.9% female), with an average age of 43 years, were examined. For L. loa, 6.2% (n = 100/16616) individuals were found to have eyeworm, based on the rapid assessment procedure for loiasis (RAPLOA) surveys, and 11.5% (n =178/1543) based on nested PCR analyses of venous blood. L. loa prevalences in long-term residents (>10 years) and older individuals (>60 years) were significantly higher, and older men with eyeworm were better informed about Chrysops vectors. For O. volvulus, 4.7% (n = 74/1567) individuals were found to be positive by enzyme-linked immunosorbent assay (Ov 16 ELISA), with only three individuals reporting to have ever taken ivermectin. For W. bancrofti, no infections were found using the antigen-based immunochromatographic test (ICT) and real-time PCR analysis; however, 27 individuals presented with lymphatic filariasis (LF) related clinical conditions (lymphoedema = 11, hydrocoele = 14, both = 2). Just under half (45.5%) of the participants owned a bednet, with the majority (71.1%) sleeping under it the night before. Our approach of using combination diagnostics reveals the age-prevalence of loiasis alongside low endemicity of onchocerciasis and LF. Future research foci should be on identifying opportunities for more cost-effective ways to eliminate onchocerciasis and to develop innovative surveillance modalities for clinical LF for individual disease management and disability prevention.
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Affiliation(s)
- Rossely Paulo
- Centro de Investigacao em Saude de Angola(CISA)/Health Research Centre of Angola, Caxito, Angola
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Miguel Brito
- Centro de Investigacao em Saude de Angola(CISA)/Health Research Centre of Angola, Caxito, Angola
- Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
| | - Pedro Van-Dunem
- National Directorate of Public Health, Ministry of Health, Angola
| | - António Martins
- Centro de Investigacao em Saude de Angola(CISA)/Health Research Centre of Angola, Caxito, Angola
| | - Robert J. Novak
- College of Public Health, University of South Florida, Florida, USA
| | - Benjamin Jacob
- College of Public Health, University of South Florida, Florida, USA
| | - David M. Molyneux
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Louise Kelly-Hope
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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18
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Beng AA, Esum ME, Deribe K, Njouendou AJ, Ndongmo PWC, Abong RA, Fru J, Fombad FF, Nchanji GT, Amambo G, Gandjui NTV, Biholong B, Nko'Ayissi G, Mbia P, Akame J, Enyong PI, Reid SD, Tougoue JJ, Zhang Y, Wanji S. Mapping lymphatic filariasis in Loa loa endemic health districts naïve for ivermectin mass administration and situated in the forested zone of Cameroon. BMC Infect Dis 2020; 20:284. [PMID: 32299374 PMCID: PMC7164349 DOI: 10.1186/s12879-020-05009-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/01/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The control of lymphatic filariasis (LF) caused by Wuchereria bancrofti in the Central African Region has been hampered by the presence of Loa loa due to severe adverse events that arise in the treatment with ivermectin. The immunochromatographic test (ICT) cards used for mapping LF demonstrated cross-reactivity with L. loa and posed the problem of delineating the LF map. To verify LF endemicity in forest areas of Cameroon where mass drug administration (MDA) has not been ongoing, we used the recently developed strategy that combined serology, microscopy and molecular techniques. METHODS This study was carried out in 124 communities in 31 health districts (HDs) where L. loa is present. At least 125 persons per site were screened. Diurnal blood samples were investigated for circulating filarial antigen (CFA) by FTS and for L. loa microfilariae (mf) using TBF. FTS positive individuals were further subjected to night blood collection for detecting W. bancrofti. qPCR was used to detect DNA of the parasites. RESULTS Overall, 14,446 individuals took part in this study, 233 participants tested positive with FTS in 29 HDs, with positivity rates ranging from 0.0 to 8.2%. No W. bancrofti mf was found in the night blood of any individuals but L. loa mf were found in both day and night blood of participants who were FTS positive. Also, qPCR revealed that no W. bancrofti but L.loa DNA was found with dry bloodspot. Positive FTS results were strongly associated with high L. loa mf load. Similarly, a strong positive association was observed between FTS positivity and L loa prevalence. CONCLUSIONS Using a combination of parasitological and molecular tools, we were unable to find evidence of W. bancrofti presence in the 31 HDs, but L. loa instead. Therefore, LF is not endemic and LF MDA is not required in these districts.
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Affiliation(s)
- Andrew A Beng
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Mathias E Esum
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Kebede Deribe
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, BN1 9PS, UK.
- School of Public Health, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.
| | - Abdel J Njouendou
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Patrick W C Ndongmo
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Raphael A Abong
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Jerome Fru
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Fanny F Fombad
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Gordon T Nchanji
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Glory Amambo
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Narcisse T V Gandjui
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | | | | | | | - Julie Akame
- Helen Keller International, Yaoundé, Cameroon
| | - Peter I Enyong
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | | | | | - Yaobi Zhang
- Helen Keller International, New York, NY, USA
- Helen Keller International, Regional Office for Africa, Dakar, Senegal
| | - Samuel Wanji
- Department of Microbiology and Parasitology, Parasites and Vector Biology Research Unit (PAVBRU), University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
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Rahumatullah A, Lim TS, Yunus MH, Noordin R. Development of an Antigen Detection ELISA for Bancroftian Filariasis Using BmSXP-Specific Recombinant Monoclonal Antibody. Am J Trop Med Hyg 2020; 101:436-440. [PMID: 31162018 DOI: 10.4269/ajtmh.19-0034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Lymphatic filariasis is a mosquito-borne parasitic disease responsible for morbidity and disability that affects 1.2 billion people worldwide, mainly the poor communities. Currently, filarial antigen testing is the method of choice for the detection of bancroftian filariasis, and to date, there are two commonly used tests. In the present study, a recently reported recombinant monoclonal antibody (5B) specific to BmSXP filarial antigen was used in developing an ELISA for the detection of circulating filarial antigen in sera of patients with bancroftian filariasis. The performance of the ELISA was evaluated using 124 serum samples. The ELISA was positive with all sera from microfilaremic bancroftian filariasis patients (n = 34). It also showed 100% diagnostic specificity when tested with sera from 50 healthy individuals and 40 patients with other parasitic diseases. The developed assay using the novel 5B recombinant monoclonal antibody could potentially be a promising alternative antigen detection test for bancroftian filariasis.
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Affiliation(s)
- Anizah Rahumatullah
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Theam Soon Lim
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Muhammad Hafiznur Yunus
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
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20
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Ramzy RMR, Kamal HA, Hassan MA, Haggag AA. Elimination of lymphatic filariasis as a public health problem from the Arab Republic of Egypt. Acta Trop 2019; 199:105121. [PMID: 31400299 DOI: 10.1016/j.actatropica.2019.105121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022]
Abstract
Lymphatic filariasis (LF) has been known in Egypt since ancient times. By 1930s it was recognized to be a major public health problem in the Nile Delta, and to be caused by Wuchereria bancrofti and transmitted by Culex pipiens. Remarkably, as a result of widespread DEC treatment and intensive vector control by the Ministry of Health and Population (MoHP), the infection rate of LF declined in the 1960s. However, relaxation of these efforts resulted in resurgence of filariasis in the 1980s and 1990s. In 2000, Egypt was among the first countries to join the WHO global efforts to eliminate LF as a public health problem by initiating a national LF elimination programme (NLFEP). This article reviews the history of LF control activities and summarizes the NLFEP extensive interventions to eliminate LF in Egypt. Based on MoHP data, mass drug administration (MDA) with DEC and ALB was started in 2000 in 161 implementation units (IUs). Additional IUs were included in subsequent MDA rounds, with the last IU included in 2007. MDA stopping surveys were conducted based on WHO guidelines (2005; 2011). Information about the presence of those suffering from lymphoedema/elephantiasis and hydrocele patients was collected, and care provided to those needing care in five rural health units (RHU) by primary health care system providers who were given training on LF morbidity management and disability prevention (MMDP). The NLFEP made excellent progress due to strong collaboration between different ministries, through intensive training and supervision, and the use of advocacy for mobilization of endemic communities. The epidemiological coverage for all MDA rounds was effectively ≥80%. Antigenemia levels found in schoolchildren during transmission assessment surveys (TAS) in 166 IUs approximately 10 years after stopping MDA was 0%. In 2017, TAS conducted in additional 29 IUs indicated 0.1% antigenemia and 0% microfilaremia. In 2015, the registration of chronic LF patients was updated to 1472 lymphoedema and 18 hydrocele patients. Lymphoedema patients were trained on self-management, and hydrocele patients were referred to local General Hospitals for surgery. Thus, after over a decade of sustained effort, Egypt met the WHO criteria for successful elimination of LF as a public health problem. In December 2017, WHO validated Egypt as the first country in the Eastern Mediterranean Region to successfully achieve elimination.
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Affiliation(s)
- Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt.
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21
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Eneanya OA, Fronterre C, Anagbogu I, Okoronkwo C, Garske T, Cano J, Donnelly CA. Mapping the baseline prevalence of lymphatic filariasis across Nigeria. Parasit Vectors 2019; 12:440. [PMID: 31522689 PMCID: PMC6745770 DOI: 10.1186/s13071-019-3682-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction The baseline endemicity profile of lymphatic filariasis (LF) is a key benchmark for planning control programmes, monitoring their impact on transmission and assessing the feasibility of achieving elimination. Presented in this work is the modelled serological and parasitological prevalence of LF prior to the scale-up of mass drug administration (MDA) in Nigeria using a machine learning based approach. Methods LF prevalence data generated by the Nigeria Lymphatic Filariasis Control Programme during country-wide mapping surveys conducted between 2000 and 2013 were used to build the models. The dataset comprised of 1103 community-level surveys based on the detection of filarial antigenemia using rapid immunochromatographic card tests (ICT) and 184 prevalence surveys testing for the presence of microfilaria (Mf) in blood. Using a suite of climate and environmental continuous gridded variables and compiled site-level prevalence data, a quantile regression forest (QRF) model was fitted for both antigenemia and microfilaraemia LF prevalence. Model predictions were projected across a continuous 5 × 5 km gridded map of Nigeria. The number of individuals potentially infected by LF prior to MDA interventions was subsequently estimated. Results Maps presented predict a heterogeneous distribution of LF antigenemia and microfilaraemia in Nigeria. The North-Central, North-West, and South-East regions displayed the highest predicted LF seroprevalence, whereas predicted Mf prevalence was highest in the southern regions. Overall, 8.7 million and 3.3 million infections were predicted for ICT and Mf, respectively. Conclusions QRF is a machine learning-based algorithm capable of handling high-dimensional data and fitting complex relationships between response and predictor variables. Our models provide a benchmark through which the progress of ongoing LF control efforts can be monitored.
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Affiliation(s)
- Obiora A Eneanya
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
| | - Claudio Fronterre
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Tini Garske
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Jorge Cano
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Christl A Donnelly
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.,Department of Statistics, University of Oxford, Oxford, UK
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22
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Noordin R, Yunus MH, Robinson K, Won KY, Babu S, Fischer PU, Hisam S, Mahmud R. Laboratory Evaluation of a Rapid IgG4 Antibody Test (BLF Rapid™) for Bancroftian Filariasis. Am J Trop Med Hyg 2019; 99:1587-1590. [PMID: 30350768 DOI: 10.4269/ajtmh.18-0566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
At the end phase of the Global Programme to Eliminate Lymphatic Filariasis, antibody testing may have a role in decision-making for bancroftian filariasis-endemic areas. This study evaluated the diagnostic performance of BLF Rapid™, a prototype immunochromatographic IgG4-based test using BmSXP recombinant protein, for detection of bancroftian filariasis. The test was evaluated using 258 serum samples, comprising 96 samples tested at Universiti Sains Malaysia (in-house) and 162 samples tested independently at three international laboratories in the USA and India, and two laboratories in Malaysia. The independent testing involved 99 samples from Wuchereria bancrofti microfilaria or antigen positive individuals and 63 samples from people who were healthy or had other infections. The in-house evaluation showed 100% diagnostic sensitivity and specificity. The independent evaluations showed a diagnostic sensitivity of 84-100% and 100% specificity (excluding non-lymphatic filarial infections). BLF Rapid has potential as a surveillance diagnostic tool to make "Transmission Assessment Survey"-stopping decisions and conduct post-elimination surveillance.
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Affiliation(s)
- Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Muhammad Hafiznur Yunus
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Keri Robinson
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Y Won
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Subash Babu
- National Institutes of Health-International Center for Excellence in Research, National Institute of Research in Tuberculosis, Chennai, India
| | - Peter U Fischer
- Infectious Diseases Division, Washington University School of Medicine, St. Louis, Missouri
| | - Shamilah Hisam
- Parasitology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Rohela Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Dietrich CF, Chaubal N, Hoerauf A, Kling K, Piontek MS, Steffgen L, Mand S, Dong Y. Review of Dancing Parasites in Lymphatic Filariasis. Ultrasound Int Open 2019; 5:E65-E74. [PMID: 31312785 PMCID: PMC6629997 DOI: 10.1055/a-0918-3678] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/04/2019] [Accepted: 05/01/2019] [Indexed: 02/07/2023] Open
Abstract
Lymphatic filariasis is an infection transmitted by blood-sucking mosquitoes with filarial nematodes of the species Wuchereria bancrofti, Brugia malayi und B. timori . It is prevalent in tropical countries throughout the world, with more than 60 million people infected and more than 1 billion living in areas with the risk of transmission. Worm larvae with a length of less than 1 mm are transmitted by mosquitoes, develop in human lymphatic tissue to adult worms with a length of 7-10 cm, live in the human body for up to 10 years and produce millions of microfilariae, which can be transmitted further by mosquitoes. The adult worms can be easily observed by ultrasonography because of their size and fast movements (the so-called "filarial dance sign"), which can be differentiated from other movements (e. g., blood in venous vessels) by their characteristic movement profile in pulsed-wave Doppler mode. Therapeutic options include (combinations of) ivermectin, albendazole, diethylcarbamazine and doxycycline. The latter depletes endosymbiotic Wolbachia bacteria from the worms and thus sterilizes and later kills the adult worms (macrofilaricidal or adulticidal effect).
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Affiliation(s)
| | - Nitin Chaubal
- Thane Ultrasound Centre, Thane Ultrasound Centre, Thane, India
| | - Achim Hoerauf
- Institut für Med. Mikrobiologie, Immunologie und Parasitologie (IMMIP), Universität Bonn, Bonn, Germany
| | - Kerstin Kling
- Department of Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
| | - Markus Schindler Piontek
- Caritas Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Medical Clinic 2, Bad Mergentheim, Germany
| | - Ludwig Steffgen
- Trainings-Zentrum Ultraschall-Diagnostik LS GmbH, Ultrasound, Mainleus, Germany
| | - Sabine Mand
- Institut für Med. Mikrobiologie, Immunologie und Parasitologie (IMMIP), Universität Bonn, Bonn, Germany
| | - Yi Dong
- Zhongshan Hospital, Ultrasound, Shanghai, China
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24
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Silva E, Xavier A, Silva E, Barbosa Júnior W, Rocha A, Freitas V, Oliveira P, Aguiar-Santos AM, Bonfim C, Medeiros Z. Evaluation of lymphatic filariasis in endemic area of Brazil where mass drug administration is not required. Pathog Glob Health 2019; 113:143-148. [PMID: 31138026 DOI: 10.1080/20477724.2019.1623546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Mass drug administration (MDA) is the main counter-transmission strategy of the Global Programme to Eliminate Lymphatic Filariasis. In endemic countries, there are areas where MDA is not required. However, there is no standard approach in these areas, and studies are important to evaluate the epidemiological status. This study aimed to investigate lymphatic filariasis and strategies developed for its control in an area where MDA is not required. Together with the 2018 morbidity evaluation, a survey was conducted using point-of-care immunochromatographic test-AD12 tests for diagnostic screening in an area where MDA is not required. The methodology also included desk research based on Health Department reports of the control activities for lymphatic filariasis during 2003-2016. Among the 934 cases investigated in 2018, there was a 0.64% prevalence of circulating filarial antigen positive, comprising five adults and one 2-year-old child. Six patients aged 39-63 years had filarial disease. Fourteen surveys have already been conducted as control activities, and since 2009, there have been no positive cases. This study showed that the prevalence of antigenemia decreased from 2.97% in 2003 to 0.64% in 2018. Moreover, the transmission of filariasis infection was under control in this area. Our study provides insights into the surveillance phase by identifying areas of low transmission and where MDA is not required. Although we have not identified cases of filarial infection, there is a need to provide services that will provide assist those already affected with morbidity and help reduce and prevent disability.
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Affiliation(s)
- Ellyda Silva
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Amanda Xavier
- b Programa de Pós-graduação em Ciências da Saúde , Universidade de Pernambuco (UPE) , Recife , Pernambuco , Brasil
| | - Elis Silva
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Walter Barbosa Júnior
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Abraham Rocha
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil.,d Secretaria de Saúde do Estado de Pernambuco , Laboratório do Hospital Otávio de Freitas , Recife , Pernambuco , Brazil
| | - Vania Freitas
- e Secretária Municipal de Saúde de Jaboatão dos Guararapes , Diretoria de Vigilância em Saúde , Jaboatão dos Guararapes , Pernambuco , Brazil
| | - Paula Oliveira
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Ana Maria Aguiar-Santos
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Cristine Bonfim
- f Diretoria de Pesquisas Sociais, Núcleo de Estudos em Estatísticas Sociais , Fundação Joaquim Nabuco (FUNDAJ) , Recife , Pernambuco , Brasil.,g Programa de Pós-graduação em Saúde Coletiva , Universidade Federal de Pernambuco (UFPE) , Recife , Pernambuco , Brasil
| | - Zulma Medeiros
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil.,b Programa de Pós-graduação em Ciências da Saúde , Universidade de Pernambuco (UPE) , Recife , Pernambuco , Brasil.,c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
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25
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Zaky WI, Tomaino FR, Pilotte N, Laney SJ, Williams SA. Backpack PCR: A point-of-collection diagnostic platform for the rapid detection of Brugia parasites in mosquitoes. PLoS Negl Trop Dis 2018; 12:e0006962. [PMID: 30462640 PMCID: PMC6281274 DOI: 10.1371/journal.pntd.0006962] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/05/2018] [Accepted: 10/30/2018] [Indexed: 11/25/2022] Open
Abstract
Background Currently, molecular xenomonitoring efforts for lymphatic filariasis rely on PCR or real-time PCR-based detection of Brugia malayi, Brugia timori and Wuchereria bancrofti in mosquito vectors. Most commonly, extraction of DNA from mosquitoes is performed using silica column-based technologies. However, such extractions are both time consuming and costly, and the diagnostic testing which follows typically requires expensive thermal cyclers or real-time PCR instruments. These expenses present significant challenges for laboratories in many endemic areas. Accordingly, in such locations, there exists a need for inexpensive, equipment-minimizing diagnostic options that can be transported to the field and implemented in minimal resource settings. Here we present a novel diagnostic approach for molecular xenomonitoring of filarial parasites in mosquitoes that uses a rapid, NaOH-based DNA extraction methodology coupled with a portable, battery powered PCR platform and a test strip-based DNA detection assay. While the research reported here serves as a proof-of-concept for the backpack PCR methodology for the detection of filarial parasites in mosquitoes, the platform should be easily adaptable to the detection of W. bancrofti and other mosquito-transmitted pathogens. Methodology/Principal findings Through comparisons with standard silica column-based DNA extraction techniques, we evaluated the performance of a rapid, NaOH-based methodology for the extraction of total DNA from pools of parasite-spiked vector mosquitoes. We also compared our novel test strip-based detection assay to real-time PCR and conventional PCR coupled with gel electrophoresis, and demonstrated that this method provides sensitive and genus-specific detection of parasite DNA from extracted mosquito pools. Finally, by comparing laboratory-based thermal cycling with a field-friendly miniaturized PCR approach, we have demonstrated the potential for the point-of-collection-based use of this entire diagnostic platform that is compact enough to fit into a small backpack. Conclusions/Significance Because this point-of-collection diagnostic platform eliminates reliance on expensive and bulky instrumentation without compromising sensitivity or specificity of detection, it provides an alternative to cost-prohibitive column-dependent DNA extractions that are typically coupled to detection methodologies requiring advanced laboratory infrastructure. In doing so, this field-ready system should increase the feasibility of molecular xenomonitoring within B. malayi-endemic locations. Of greater importance, this backpack PCR system also provides the proof-of-concept framework for the development of a parallel assay for the detection of W. bancrofti. Molecular xenomonitoring has demonstrated significant potential as a non-invasive means of providing reliable surveillance for the presence of lymphatic filariasis (LF)-causing parasites. Given the continuing successes of global mass drug administration efforts, the need for such non-invasive surveillance techniques is expanding. However, considering the significant infrastructural demands which such surveillance requires, the development of simplified surveillance methodologies will be fundamental to future programmatic implementation efforts. Accordingly, we have developed a novel, simplified diagnostic platform for point-of-collection-based detection of the LF-causing parasite, Brugia malayi in pools of mosquitoes. By coupling a rapid and inexpensive DNA extraction methodology with a field-friendly amplification platform and test strip-based detection assay, this backpack PCR system eliminates the need for expensive instrumentation and laboratory-based infrastructure. Furthermore, adaptation of the platform described here will allow for the straightforward and rapid development of a parallel assay for the detection of Wuchereria bancrofti, facilitating the increased use of xenomonitoring and enabling mosquito surveillance efforts in regions lacking sophisticated laboratory infrastructure.
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Affiliation(s)
- Weam I Zaky
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, United States of America
| | - Francesca R Tomaino
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, United States of America
| | - Nils Pilotte
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, United States of America.,Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Sandra J Laney
- The Bill and Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Steven A Williams
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, United States of America.,Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts, United States of America
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26
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Dickson BFR, Graves PM, Aye NN, Nwe TW, Wai T, Win SS, Shwe M, Douglass J, Bradbury RS, McBride WJ. The prevalence of lymphatic filariasis infection and disease following six rounds of mass drug administration in Mandalay Region, Myanmar. PLoS Negl Trop Dis 2018; 12:e0006944. [PMID: 30419025 PMCID: PMC6258426 DOI: 10.1371/journal.pntd.0006944] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 11/26/2018] [Accepted: 10/24/2018] [Indexed: 11/19/2022] Open
Abstract
Lymphatic filariasis is widely endemic in Myanmar. Despite the establishment of an elimination program in 2000, knowledge of the remaining burden of disease relies predominantly on programmatic information. To assist the program, we conducted an independent cross-sectional household cluster survey to determine the prevalence of filariasis infection, morbidity and mass-drug administration coverage in four townships of the Mandalay Region: Amarapura, Patheingyi, Tada-U and Wundwin. The survey included 1014 individuals from 430 randomly selected households in 24 villages. Household members one year and older were assessed for antigenaemia using immunochromatographic test cards and if positive, microfilaraemia by night-time thick blood smear. Participants 15 years and older were assessed for filariasis morbidity by ultrasound-assisted clinical examination. The overall prevalence of infection was 2.63% by antigenaemia (95% confidence interval (CI) 1.71-4.04%) and 1.03% by microfilaraemia (95%CI 0.59-1.47%). The prevalence of hydrocoele in adult males was 2.78% (95%CI 1.23-6.15%) and of lymphoedema in both genders was 0% (95%CI 0-0.45%). These results indicate the persistence of filarial infection and transmission despite six rounds of annual mass drug administration and highlight the need for further rounds as well as the implementation of morbidity management programs in the country.
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Affiliation(s)
- Benjamin F. R. Dickson
- College of Medicine & Dentistry, Division of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
- James Cook University and World Health Organization Collaborating Centre for the Control of Lymphatic Filariasis, Soil Transmitted Helminths and Other Neglected Tropical Diseases, Cairns, Queensland, Australia
| | - Ni Ni Aye
- Vector Borne Disease Control Unit, Ministry of Health and Sport, Naypyitaw, Myanmar
| | - Thet Wai Nwe
- Vector Borne Disease Control Unit, Ministry of Health and Sport, Naypyitaw, Myanmar
| | - Tint Wai
- Regional Vector Borne Disease Control Unit, Ministry of Health and Sport, Mandalay, Myanmar
| | | | | | - Janet Douglass
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
- Center for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Richard S. Bradbury
- School of Health, Medical and Applied Sciences, Central Queensland University, North Rockhampton, Queensland, Australia
| | - William J. McBride
- College of Medicine & Dentistry, Division of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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27
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Michael E, Smith ME, Katabarwa MN, Byamukama E, Griswold E, Habomugisha P, Lakwo T, Tukahebwa E, Miri ES, Eigege A, Ngige E, Unnasch TR, Richards FO. Substantiating freedom from parasitic infection by combining transmission model predictions with disease surveys. Nat Commun 2018; 9:4324. [PMID: 30337529 PMCID: PMC6193962 DOI: 10.1038/s41467-018-06657-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/14/2018] [Indexed: 11/22/2022] Open
Abstract
Stopping interventions is a critical decision for parasite elimination programmes. Quantifying the probability that elimination has occurred due to interventions can be facilitated by combining infection status information from parasitological surveys with extinction thresholds predicted by parasite transmission models. Here we demonstrate how the integrated use of these two pieces of information derived from infection monitoring data can be used to develop an analytic framework for guiding the making of defensible decisions to stop interventions. We present a computational tool to perform these probability calculations and demonstrate its practical utility for supporting intervention cessation decisions by applying the framework to infection data from programmes aiming to eliminate onchocerciasis and lymphatic filariasis in Uganda and Nigeria, respectively. We highlight a possible method for validating the results in the field, and discuss further refinements and extensions required to deploy this predictive tool for guiding decision making by programme managers. The decision when to stop an intervention is a critical component of parasite elimination programmes, but reliance on surveillance data alone can be inaccurate. Here, Michael et al. combine parasite transmission model predictions with disease survey data to more reliably determine when interventions can be stopped.
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Affiliation(s)
- Edwin Michael
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Morgan E Smith
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Moses N Katabarwa
- Emory University and The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA, 30307, USA
| | | | - Emily Griswold
- Emory University and The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA, 30307, USA
| | | | - Thomson Lakwo
- Vector Control Division, Ministry of Health, 15 Bombo Road, P.O. Box 1661, Kampala, Uganda
| | - Edridah Tukahebwa
- Vector Control Division, Ministry of Health, 15 Bombo Road, P.O. Box 1661, Kampala, Uganda
| | - Emmanuel S Miri
- The Carter Center, Nigeria, 1 Jeka Kadima Street off Tudun Wada Ring Road, Jos, Nigeria
| | - Abel Eigege
- The Carter Center, Nigeria, 1 Jeka Kadima Street off Tudun Wada Ring Road, Jos, Nigeria
| | - Evelyn Ngige
- Federal Ministry of Health, Federal Sceretariat, Garki-Abuja, Nigeria
| | - Thomas R Unnasch
- Global Health Infectious Disease Research, College of Public Health, University of South Florida, 33620, Tampa, FL, USA
| | - Frank O Richards
- Emory University and The Carter Center, One Copenhill, 453 Freedom Parkway, Atlanta, GA, 30307, USA
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28
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Prado IC, Mendes VG, Souza AL, Dutra RF, De-Simone SG. Electrochemical immunosensor for differential diagnostic of Wuchereria bancrofti using a synthetic peptide. Biosens Bioelectron 2018; 113:9-15. [DOI: 10.1016/j.bios.2018.04.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
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29
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Rao RU, Samarasekera SD, Nagodavithana KC, Goss CW, Punchihewa MW, Dassanayaka TDM, Ranasinghe USB, Mendis D, Weil GJ. Comprehensive Assessment of a Hotspot with Persistent Bancroftian Filariasis in Coastal Sri Lanka. Am J Trop Med Hyg 2018; 99:735-742. [PMID: 30014812 PMCID: PMC6169179 DOI: 10.4269/ajtmh.18-0169] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Sri Lankan Anti-Filariasis campaign distributed five rounds of mass drug administration (MDA with diethylcarbamazine plus albendazole) to some 10 million people in eight districts between 2002 and 2006. Sri Lanka was recognized by the WHO for having eliminated lymphatic filariasis (LF) as a public health problem in 2016. However, recent studies by our group documented pockets with persistent LF in coastal Sri Lanka, especially in Galle district. The present study was performed to reexamine an area previously identified as a potential hotspot for persistent LF (Balapitiya Public Health Inspector area, population 17,500). A community survey documented high rates for circulating filarial antigenemia (3%, confidence interval [CI]: 1.8–4.9) and microfilaremia (1%, CI: 0.5–2.5%). Circulating filarial antigenemia rates were 2.8-fold higher in males than females. High prevalence was also observed for anti-filarial antibodies in young children (5.7%, CI: 3.7–8.4%) and for filarial DNA in vector mosquitoes (5.2%, CI: 4.2–6.3%). Spatial data showed that persistent LF was dispersed across the entire study area. Other studies showed that persistent LF was not limited to Balapitiya and not solved by additional rounds of MDA. Molecular xenomonitoring studies conducted in 2016 in 22 of 168 Public Health Midwife areas in the coastal Galle evaluation unit (approximate population 600,000) found that 179 of 660 (27%) pools of Culex collected from all areas were positive for Wuchereria bancrofti DNA by quantitative polymerase chain reaction; the estimated infection rate in mosquitoes was 1.26%, CI: 1.0–1.5%. Interventions other than routine MDA will be required to remove LF hotspots in Balapitiya and in other areas in coastal Sri Lanka.
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Affiliation(s)
- Ramakrishna U Rao
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Charles W Goss
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | | | | | | | - Devika Mendis
- Ministry of Health, Anti-Filariasis Campaign, Colombo, Sri Lanka
| | - Gary J Weil
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
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Kelly-Hope LA, Blundell HJ, Macfarlane CL, Molyneux DH. Innovative Surveillance Strategies to Support the Elimination of Filariasis in Africa. Trends Parasitol 2018; 34:694-711. [PMID: 29958813 DOI: 10.1016/j.pt.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/18/2018] [Accepted: 05/30/2018] [Indexed: 01/18/2023]
Abstract
Lymphatic filariasis (LF) and onchocerciasis are two neglected tropical diseases (NTDs) of public health significance targeted for global elimination. The World Health Organization (WHO) African Region is a priority region, with the highest collective burden of LF and onchocerciasis globally. Coendemic loiasis further complicates elimination due to the risk of adverse events associated with ivermectin treatment. A public health framework focusing on health-related data, systematic collection of data, and analysis and interpretation of data is used to highlight the range of innovative surveillance strategies required for filariasis elimination. The most recent and significant developments include: rapid point-of-care test (POCT) diagnostics; clinical assessment tools; new WHO guidelines; open-access online data portals; mHealth platforms; large-scale prevalence maps; and the optimisation of mathematical models.
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Affiliation(s)
- Louise A Kelly-Hope
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Harriet J Blundell
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cara L Macfarlane
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David H Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
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31
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de Araújo PSR, de Souza Junior VR, de Souza A, de Barros Correia Fontes L, Brandao E, Rocha A. Chiluria in a lymphatic filariasis endemic area. BMC Res Notes 2018; 11:269. [PMID: 29720217 PMCID: PMC5932810 DOI: 10.1186/s13104-018-3357-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/18/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To establish clinical and laboratory data of individuals presenting chyluria in endemic areas. RESULTS 75 individuals were studied. The majority were females with an average age of 45 years residing in the Metropolitan Region of Recife. The mean time between the beginning of the presentation of chyluria and the first care service in the Serviço de Referencia Nacional em Filarioses was approximately 5 years. The most frequent urinalysis changes were hematuria (27.6%), leukocytes (21.9%) and proteinuria (10.5%). The Addis test showed mean values of 155.43 E/min/mL of cylinders, 52,892 E/min/mL of erythrocytes and 291,660 E/min/mL of leukocytes. Among recorded cases, proteinuria had a mean value of 1372.80 mg/dL in 24 h, and the presence of lymphocytes in the urine was positive in 68.3%. Among lymphatic filariasis tests, immunochromatography was positive in 16.7%, there was circulating filarial antigen determined by detection of OG4C3 antibodies in 7.7% and microfilaremia in only 1/55.
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Affiliation(s)
- Paulo Sérgio Ramos de Araújo
- Federal University of Pernambuco, Av. Prof. Moraes Rego 1235, Recife, Pernambuco 50670-901 Brazil
- Instituto Aggeu Magalhaes, FIOCRUZ, Av. Prof. Moraes Rego 1235, Recife, 50670-901 Brazil
| | | | - Anderson de Souza
- Federal University of Pernambuco, Av. Prof. Moraes Rego 1235, Recife, Pernambuco 50670-901 Brazil
| | | | - Eduardo Brandao
- Instituto Aggeu Magalhaes, FIOCRUZ, Av. Prof. Moraes Rego 1235, Recife, 50670-901 Brazil
| | - Abraham Rocha
- Instituto Aggeu Magalhaes, FIOCRUZ, Av. Prof. Moraes Rego 1235, Recife, 50670-901 Brazil
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Mansonella ozzardi mitogenome and pseudogene characterisation provides new perspectives on filarial parasite systematics and CO-1 barcoding. Sci Rep 2018; 8:6158. [PMID: 29670192 PMCID: PMC5906601 DOI: 10.1038/s41598-018-24382-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/15/2018] [Indexed: 11/26/2022] Open
Abstract
Despite the broad distribution of M. ozzardi in Latin America and the Caribbean, there is still very little DNA sequence data available to study this neglected parasite’s epidemiology. Mitochondrial DNA (mtDNA) sequences, especially the cytochrome oxidase (CO1) gene’s barcoding region, have been targeted successfully for filarial diagnostics and for epidemiological, ecological and evolutionary studies. MtDNA-based studies can, however, be compromised by unrecognised mitochondrial pseudogenes, such as Numts. Here, we have used shot-gun Illumina-HiSeq sequencing to recover the first complete Mansonella genus mitogenome and to identify several mitochondrial-origin pseudogenes. Mitogenome phylogenetic analysis placed M. ozzardi in the Onchocercidae “ONC5” clade and suggested that Mansonella parasites are more closely related to Wuchereria and Brugia genera parasites than they are to Loa genus parasites. DNA sequence alignments, BLAST searches and conceptual translations have been used to compliment phylogenetic analysis showing that M. ozzardi from the Amazon and Caribbean regions are near-identical and that previously reported Peruvian M. ozzardi CO1 reference sequences are probably of pseudogene origin. In addition to adding a much-needed resource to the Mansonella genus’s molecular tool-kit and providing evidence that some M. ozzardi CO1 sequence deposits are pseudogenes, our results suggest that all Neotropical M. ozzardi parasites are closely related.
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Pastor AF, Rocha A, Cassemiro KDM, Tenório M, Melo P, Grilis MR, Rhuama M, Rezende AM, Melo Neto OPD, Marques E, Dhalia R. Evaluation of the recombinant antigens Wb14 and WbT for the capture antibody diagnosis of lymphatic filariasis. Mem Inst Oswaldo Cruz 2018; 113:e170435. [PMID: 29590236 PMCID: PMC5868868 DOI: 10.1590/0074-02760170435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Lymphatic filariasis (LF) is a parasitic disease caused mainly by the Wuchereria bancrofti worm and that affects up to 120 million people worldwide. LF is the second cause of chronic global deformity, responsible for 15 million people with lymphedema (elephantiasis) and 25 million men with scrotal hydrocele. Its diagnosis is still associated with numerous difficulties, such as the sample collection periods (microfilaria nocturnal periodicity) and limited diagnostic kits. OBJECTIVES The aim of this work was to evaluate two recombinant antigens (Wb14 and WbT) as part of an enzyme-linked immunosorbent assay (ELISA) based antibody capture tests for LF. METHODS The recombinant antigens rWb14 and rWbT were expressed in Escherichia coli BL21 and an antibody capture ELISA was performed. For this, sera were used from microfilaremic individuals with W. bancrofti (MF), chronic pathology (CP), individuals infected with Strongyloides (SP) and healthy controls from endemic (EN) and non-endemic (NE) areas. FINDINGS Both tests showed similar results, with 90% sensitivity and 96.6% specificity. In comparison with the BM14 ELISA commercial test, the Wb14 and WbT antigens performed with identical sensitivity but greater specificity. Reduced positivity with the CP suggested a potential to monitor cure. This was not confirmed, however, when sera from individuals up to seven years after treatment were assayed. MAIN CONCLUSIONS The Wb14 and WbT ELISAs were considered efficient and promising diagnostic tests. Due to the importance of antibody capture analysis to evaluate the Global Program to Eliminate Lymphatic Filariasis (GPELF), the tests proposed here appear as great alternatives to the available commercial system.
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Affiliation(s)
- André Filipe Pastor
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Universidade Federal de Pernambuco, Recife, PE, Brasil.,Instituto Federal de Ciência e Tecnologia do Sertão Pernambucano, Campus Floresta, PE, Brasil
| | - Abraham Rocha
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Serviço de Referêcia Nacional em Filarioses, Recife, PE, Brasil.,Hospital Otávio de Freitas, Recife, PE, Brasil
| | | | - Marli Tenório
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil
| | - Paula Melo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Serviço de Referêcia Nacional em Filarioses, Recife, PE, Brasil
| | - Maria Rosângela Grilis
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Serviço de Referêcia Nacional em Filarioses, Recife, PE, Brasil
| | - Maressa Rhuama
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Universidade Federal de Pernambuco, Recife, PE, Brasil
| | | | - Osvaldo Pompilio de Melo Neto
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - Ernesto Marques
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil
| | - Rafael Dhalia
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brasil.,Universidade Federal de Pernambuco, Recife, PE, Brasil
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Aguiar-Santos A, Montenegro S, Medeiros Z, Rocha A, Morais C, Silva A, Bonfim C, Costa T, Sarinho E. Immunomodulation of allergic response in children and adolescents: What we can learn from lymphatic filarial infection. Allergol Immunopathol (Madr) 2018; 46:167-174. [PMID: 29366523 DOI: 10.1016/j.aller.2017.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/17/2017] [Accepted: 09/13/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although it is well known that allergic diseases involve a strong Th2 immune response, with production of high levels of specific IgE allergen, knowledge on the association between filarial infection and allergies, among paediatric patients is scarce. OBJECTIVE To evaluate the allergic response patterns in cases of filarial infection by comparing peripheral eosinophils, total IgE levels, immediate hypersensitivity and cytokine levels in children and adolescents in Brazil. METHODS This was an exploratory study with three groups: (I) with filarial infection and without allergic diseases; (II) without filarial infection and with allergic diseases; and (III) without filarial infection and without allergic diseases. The prick test and specific IgE tests for aeroallergens were performed using five antigens. Peripheral eosinophils and total IgE were also evaluated. IL-4 and IL-5 were determined using whole-blood culture stimulated by three antigens. RESULTS Eosinophilia and elevated levels of total IgE (≥400IU/dl) were observed in all groups. The prick test was positive in 56.6% of the cases. Group I presented hypersensitive responses similar to the allergic disease groups. In the whole-blood culture stimulated by Dermatophagoides pteronyssinus, average IL-4 production did not differ significantly among the groups, but IL5 production resulting from stimulation was greater in the allergic disease groups (p<0.05). CONCLUSIONS The allergic response pattern in group with filarial infection was similar to that of the groups with and without allergic diseases, but the response to IL-5 in the culture stimulated by D. pteronyssinus was an exclusive characteristic of the allergic group.
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Brant TA, Okorie PN, Ogunmola O, Ojeyode NB, Fatunade S, Davies E, Saka Y, Stanton MC, Molyneux DH, Russell Stothard J, Kelly-Hope LA. Integrated risk mapping and landscape characterisation of lymphatic filariasis and loiasis in South West Nigeria. Parasite Epidemiol Control 2018; 3:21-35. [PMID: 29774296 PMCID: PMC5952684 DOI: 10.1016/j.parepi.2017.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/20/2017] [Accepted: 12/26/2017] [Indexed: 11/26/2022] Open
Abstract
Nigeria has the heaviest burden of lymphatic filariasis (LF) in sub-Saharan Africa, which is caused by the parasite Wuchereria bancrofti and transmitted by Anopheles mosquitoes. LF is targeted for elimination and the national programme is scaling up mass drug administration (MDA) across the country to interrupt transmission. However, in some regions the co-endemicity of the filarial parasite Loa loa (loiasis) is an impediment due to the risk of severe adverse events (SAEs) associated with the drug ivermectin. To better understand factors influencing LF elimination in loiasis areas, this study conducted a cross-sectional survey on the prevalence and co-distribution of the two infections, and the potential demographic, landscape, human movement, and intervention-related risk factors at a micro-level in the South West zone of Nigeria. In total, 870 participants from 10 communities on the fringe of a meso-endemic loiasis area of Osun State were selected. LF prevalence was measured by clinical assessment and using the rapid immunochromatographic test (ICT) to detect W. bancrofti antigen. Overall LF prevalence was low with ICT positivity ranging from 0 to 4.7%, with only 1 hydrocoele case identified. Males had significantly higher ICT positivity than females (3.2% vs 0.8%). Participants who did not sleep under a bed net had higher ICT positivity (4.0%) than those who did (1.3%). ICT positivity was also higher in communities with less tree coverage/canopy height (2.5-2.8%) than more forested areas with greater tree coverage/canopy height (0.9-1.0%). In comparison, loiasis was determined using the rapid assessment procedure for loiasis (RAPLOA), and found in all 10 communities with prevalence ranging from 1.4% to 11.2%. No significant difference was found by participants' age or sex. However, communities with predominately shrub land (10.4%) or forested land cover (6.2%) had higher prevalence than those with mosaic vegetation/croplands (2.5%). Satellite imagery showed denser forested areas in higher loiasis prevalence communities, and where low or no ICT positivity was found. Only one individual was found to be co-infected. GPS tracking of loiasis positive cases and controls also highlighted denser forested areas within higher loiasis risk communities and the sparser land cover in lower-risk communities. Mapping LF-loiasis distributions against landscape characteristics helped to highlight the micro-heterogeneity, identify potential SAE hotspots, and determine the safest and most appropriate treatment strategy.
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Affiliation(s)
- Tara A. Brant
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Patricia N. Okorie
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olushola Ogunmola
- Federal Ministry of Health, Department of Public Health, Neglected Tropical Diseases Division, South West Zone, Nigeria
| | - Nureni Bolaji Ojeyode
- State Ministry of Health, Department of Primary Health Care and Disease Control, Division of Neglected Tropical Diseases, Osogbo, Osun State, Nigeria
| | - S.B. Fatunade
- State Ministry of Health, Department of Primary Health Care and Disease Control, Division of Neglected Tropical Diseases, Osogbo, Osun State, Nigeria
| | - Emmanuel Davies
- Federal Ministry of Health, Department of Public Health, Neglected Tropical Diseases Division, Abuja, Nigeria
| | - Yisa Saka
- Federal Ministry of Health, Department of Public Health, Neglected Tropical Diseases Division, Abuja, Nigeria
| | - Michelle C. Stanton
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David H. Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - J. Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Louise A. Kelly-Hope
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
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Won KY, Sambou S, Barry A, Robinson K, Jaye M, Sanneh B, Sanyang A, Gass K, Lammie PJ, Rebollo M. Use of Antibody Tools to Provide Serologic Evidence of Elimination of Lymphatic Filariasis in The Gambia. Am J Trop Med Hyg 2018; 98:15-20. [PMID: 29165213 PMCID: PMC5928708 DOI: 10.4269/ajtmh.17-0371] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A current need in the global effort to eliminate lymphatic filariasis (LF) is the availability of reliable diagnostic tools that can be used to guide programmatic decisions, especially decisions made in the final stages of the program. This study conducted in The Gambia aimed to assess antifilarial antibody levels among populations living in historically highly LF-endemic areas and to evaluate the use of serologic tools to confirm the interruption of LF transmission. A total of 2,612 dried blood spots (DBSs) collected from individuals aged 1 year and above from 15 villages were tested for antibodies to Wb123 by enzyme-linked immunosorbent assay (ELISA). A subset of DBS (N = 599) was also tested for antibodies to Bm14 by ELISA. Overall, the prevalence of Wb123 was low (1.5%, 95% confidence interval [CI] 1.1-2.1%). In 7 of 15 villages (46.7%), there were no Wb123-positive individuals identified. Individuals with positive responses to Wb123 ranged in age from 3 to 100 years. Overall, Bm14 prevalence was also low (1.5%, 95% CI 0.7-2.8%). Bm14 positivity was significantly associated with older age (P < 0.001). The low levels of antibody responses to Wb123 observed in our study strongly suggest that sustainable LF transmission has likely ceased in The Gambia. In addition, our results support the conclusion that serologic tools can have a role in guiding programmatic decision making and supporting surveillance.
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Affiliation(s)
- Kimberly Y Won
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sana Sambou
- Ministry of Health and Social Welfare, Banjul, The Gambia
| | - Amanda Barry
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Keri Robinson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Momodou Jaye
- Ministry of Health and Social Welfare, Banjul, The Gambia
| | - Bakary Sanneh
- Ministry of Health and Social Welfare, Banjul, The Gambia
| | | | | | - Patrick J Lammie
- Task Force for Global Health, Decatur, Georgia.,Centers for Disease Control and Prevention, Atlanta, Georgia
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Rao RU, Samarasekera SD, Nagodavithana KC, Dassanayaka TDM, Punchihewa MW, Ranasinghe USB, Weil GJ. Reassessment of areas with persistent Lymphatic Filariasis nine years after cessation of mass drug administration in Sri Lanka. PLoS Negl Trop Dis 2017; 11:e0006066. [PMID: 29084213 PMCID: PMC5679644 DOI: 10.1371/journal.pntd.0006066] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 11/09/2017] [Accepted: 10/24/2017] [Indexed: 12/02/2022] Open
Abstract
Background Sri Lanka was one of the first countries to initiate a lymphatic filariasis (LF) elimination program based on WHO guidelines. The Anti-Filariasis Campaign provided 5 annual rounds of mass drug administration (MDA) with diethylcarbamazine plus albendazole in all 8 endemic districts from 2002–2006. Microfilaremia (Mf) prevalences have been consistently <1% in all sentinel and spot-check sites since 2006, and all evaluation units passed school-based transmission assessment surveys (TAS) in 2013. We previously reported results from comprehensive surveillance studies conducted in 2011–2013 that documented low-level persistence of Wuchereria bancrofti in 19 high risk areas in 8 endemic districts. We now present results from repeat surveys conducted 3 to 4 years later in 6 areas that had the strongest LF signals in the prior study. Methodology and principal findings The surveys assessed prevalence of filarial antigenemia (CFA) and Mf in communities, CFA and anti-filarial antibody in school children (ages 6–8), and filarial DNA in Culex mosquitoes (molecular xenomonitoring, MX). Three study areas had significantly improved infection parameters compared to the prior study, but three other areas had little change. MX was more sensitive for detecting W. bancrofti persistence, and it was a better predictor than other parameters. Adult males accounted for more than 80% of infections detected in the study. Conclusions These results suggest that W. bancrofti transmission was near the break point in some of the areas studied in 2011–13. LF is likely to decline to zero without further intervention in these areas, while other areas may require further intervention. Long term surveillance may be needed to verify W. bancrofti elimination in areas like Sri Lanka with efficient transmission by Culex. Test and treat or other programs targeting adult males plus bed net promotion may be more effective than MDA for clearing remaining hotspots of transmission in Sri Lanka. Lymphatic Filariasis (LF, also known as “elephantiasis”) is a disabling and deforming tropical disease caused by parasitic worms that are transmitted by mosquitoes. The Sri Lankan Anti-Filariasis Campaign provided 5 annual rounds of mass drug administration (MDA) with diethylcarbamazine and albendazole between 2002 and 2006 in all endemic areas, and this reduced infection prevalence to very low levels. Post-MDA surveillance conducted by our group in 19 sentinel sites in 8 endemic districts in 2011–2013 revealed evidence of persistent LF infection in all study sites. The present paper reports results of repeat assessments conducted 3–4 years later in 6 areas with high signals in the prior study. LF parameters were significantly improved in 3 areas where LF appears to be on a glide path to elimination. However, LF infection parameters remained high in 3 areas, and further work will probably be required to interrupt transmission in these areas. Molecular xenomonitoring (to detect filarial DNA in mosquito vectors) was especially sensitive for detecting persistent LF in Sri Lanka, and this may also be true in other areas with Culex transmission. Our results suggest that test and treat or other programs targeting adult males plus expanded bed net use may be helpful for clearing up remaining LF hotspots.
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Affiliation(s)
- Ramakrishna U. Rao
- Washington University School of Medicine, St. Louis, MO, United States of America
- * E-mail:
| | | | | | | | | | | | - Gary J. Weil
- Washington University School of Medicine, St. Louis, MO, United States of America
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A multi-center field study of two point-of-care tests for circulating Wuchereria bancrofti antigenemia in Africa. PLoS Negl Trop Dis 2017; 11:e0005703. [PMID: 28892473 PMCID: PMC5608416 DOI: 10.1371/journal.pntd.0005703] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/21/2017] [Accepted: 06/11/2017] [Indexed: 11/19/2022] Open
Abstract
Background The Global Programme to Eliminate Lymphatic Filariasis uses point-of-care tests for circulating filarial antigenemia (CFA) to map endemic areas and for monitoring and evaluating the success of mass drug administration (MDA) programs. We compared the performance of the reference BinaxNOW Filariasis card test (ICT, introduced in 1997) with the Alere Filariasis Test Strip (FTS, introduced in 2013) in 5 endemic study sites in Africa. Methodology The tests were compared prior to MDA in two study sites (Congo and Côte d'Ivoire) and in three sites that had received MDA (DRC and 2 sites in Liberia). Data were analyzed with regard to % positivity, % agreement, and heterogeneity. Models evaluated potential effects of age, gender, and blood microfilaria (Mf) counts in individuals and effects of endemicity and history of MDA at the village level as potential factors linked to higher sensitivity of the FTS. Lastly, we assessed relationships between CFA scores and Mf in pre- and post-MDA settings. Principal findings Paired test results were available for 3,682 individuals. Antigenemia rates were 8% and 22% higher by FTS than by ICT in pre-MDA and in post-MDA sites, respectively. FTS/ICT ratios were higher in areas with low infection rates. The probability of having microfilaremia was much higher in persons with CFA scores >1 in untreated areas. However, this was not true in post-MDA settings. Conclusions/Significance This study has provided extensive new information on the performance of the FTS compared to ICT in Africa and it has confirmed the increased sensitivity of FTS reported in prior studies. Variability in FTS/ICT was related in part to endemicity level, history of MDA, and perhaps to the medications used for MDA. These results suggest that FTS should be superior to ICT for mapping, for transmission assessment surveys, and for post-MDA surveillance. The Global Programme to Eliminate Lymphatic Filariasis (LF) uses point-of-care tests for circulating filarial antigenemia to map endemic areas and for monitoring and evaluating the success of mass drug administration (MDA) programs. We compared the performance of the reference BinaxNOW Filariasis card test (ICT) with the Alere Filariasis Test Strip (FTS, introduced in 2013) in 3,682 people in 5 endemic study sites in Africa. Our study confirmed the increased sensitivity of FTS reported in prior studies. FTS/ICT ratios tended to be higher in areas with low residual endemicity after MDA. However, FTS rates were only slightly higher than ICT rates in young children. These results suggest that FTS should be superior to ICT as a tool for mapping and for monitoring and evaluating LF elimination programmes.
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Brito M, Paulo R, Van-Dunem P, Martins A, Unnasch TR, Novak RJ, Jacob B, Stanton MC, Molyneux DH, Kelly-Hope LA. Rapid integrated clinical survey to determine prevalence and co-distribution patterns of lymphatic filariasis and onchocerciasis in a Loa loa co-endemic area: The Angolan experience. Parasite Epidemiol Control 2017; 2:71-84. [PMID: 29774284 PMCID: PMC5952692 DOI: 10.1016/j.parepi.2017.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 01/03/2023] Open
Abstract
The Republic of Angola is a priority country for onchocerciasis and lymphatic filariasis (LF) elimination, however, the co-distribution of the filarial parasite Loa loa (loiasis) is a significant impediment, due to the risk of severe adverse events (SAEs) associated with ivermectin used in mass drug administration (MDA) campaigns. Angola has a high risk loiasis zone identified in Bengo Province where alternative interventions may need to be implemented; however, the presence and geographical overlap of the three filarial infections/diseases are not well defined. Therefore, this study conducted a rapid integrated filarial mapping survey based on readily identifiable clinical conditions of each disease in this risk zone to help determine prevalence and co-distribution patterns in a timely manner with limited resources. In total, 2007 individuals from 29 communities in five provincial municipalities were surveyed. Community prevalence estimates were determined by the rapid assessment procedure for loiasis (RAPLOA) and rapid epidemiological mapping of onchocerciasis (REMO) together with two questions on LF clinical manifestations (presence of lymphoedema, hydrocoele). Overall low levels of endemicity, with different overlapping distributions were found. Loiasis was found in 18 communities with a prevalence of 2.0% (31/1571), which contrasted to previous results defining the area as a high risk zone. Onchocerciasis prevalence was 5.3% (49/922) in eight communities, and LF prevalence was 0.4% for lymphoedema (8/2007) and 2.6% for hydrocoeles (20/761 males) in seven and 12 communities respectively. The clinical mapping survey method helped to highlight that all three filarial infections are present in this zone of Bengo Province. However, the significant difference in loiasis prevalence found between the past and this current survey suggests that further studies including serological and parasitological confirmation are required. This will help determine levels of infection and risk, understand the associations between clinical, serological and parasitological prevalence patterns, and better determine the most appropriate treatment strategies to reach onchocerciasis and LF elimination targets in the loiasis co-endemic areas. Our results also suggest that the utility of the earlier RAPLOA derived maps, based on surveys undertaken over a decade ago, are likely to be invalid given the extent of population movement and environmental change, particularly deforestation, and that fine scale micro-mapping is required to more precisely delineate the interventions required defined by these complex co-endemicities.
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Affiliation(s)
- Miguel Brito
- Centro de Investigacao em Saude de Angola/Health Research Centre of Angola, Caxito, Angola
- Lisbon School of Health Technology, Lisbon, Portugal
| | - Rossely Paulo
- Centro de Investigacao em Saude de Angola/Health Research Centre of Angola, Caxito, Angola
- Centre for Neglected Tropical Diseases, and Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Pedro Van-Dunem
- National Directorate of Public Health, Ministry of Health, Angola
| | - António Martins
- Centro de Investigacao em Saude de Angola/Health Research Centre of Angola, Caxito, Angola
| | - Thomas R Unnasch
- College of Public Health, Department of Global Health, University of South Florida, Florida, USA
| | - Robert J Novak
- College of Public Health, Department of Global Health, University of South Florida, Florida, USA
| | - Benjamin Jacob
- College of Public Health, Department of Global Health, University of South Florida, Florida, USA
| | - Michelle C Stanton
- Centre for Neglected Tropical Diseases, and Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David H Molyneux
- Centre for Neglected Tropical Diseases, and Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Louise A Kelly-Hope
- Centre for Neglected Tropical Diseases, and Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
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Nana-Djeunga HC, Tchouakui M, Njitchouang GR, Tchatchueng-Mbougua JB, Nwane P, Domche A, Bopda J, Mbickmen-Tchana S, Akame J, Tarini A, Epée E, Biholong BD, Zhang Y, Tougoue JJ, Kabore A, Njiokou F, Kamgno J. First evidence of lymphatic filariasis transmission interruption in Cameroon: Progress towards elimination. PLoS Negl Trop Dis 2017; 11:e0005633. [PMID: 28662054 PMCID: PMC5490934 DOI: 10.1371/journal.pntd.0005633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 05/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lymphatic filariasis (LF) is among the 10 neglected tropical diseases targeted for control or elimination by 2020. For LF elimination, the World Health Organization (WHO) has proposed a comprehensive strategy including (i) interruption of LF transmission through large-scale annual treatment (or mass drug administration (MDA)) of all eligible individuals in endemic areas, and (ii) alleviation of LF-associated suffering through morbidity management and disability prevention. In Cameroon, once-yearly mass administration of ivermectin and albendazole has been implemented since 2008. The aim of this study was to assess progress towards the elimination goal, looking specifically at the impact of six rounds of MDA on LF transmission in northern Cameroon. METHODOLOGY The study was conducted in the North and Far North Regions of Cameroon. Five health districts that successfully completed six rounds of MDA (defined as achieving a treatment coverage ≥ 65% each year) and reported no positive results for Wuchereria bancrofti microfilariaemia during routine surveys following the fifth MDA were grouped into three evaluation units (EU) according to WHO criteria. LF transmission was assessed through a community-based transmission assessment survey (TAS) using an immunochromatographic test (ICT) for the detection of circulating filarial antigen (CFA) in children aged 5-8 years old. PRINCIPAL FINDINGS A total of 5292 children (male/female ratio 1.04) aged 5-8 years old were examined in 97 communities. Positive CFA results were observed in 2, 8 and 11 cases, with a CFA prevalence of 0.13% (95% CI: 0.04-0.46) in EU#1, 0.57% (95% CI: 0.32-1.02) in EU#2, and 0.45% (95% CI: 0.23-0.89) in EU#3. CONCLUSION/SIGNIFICANCE The positive CFA cases were below WHO defined critical cut-off thresholds for stopping treatment and suggest that transmission can no longer be sustained. Post-MDA surveillance activities should be organized to evaluate whether recrudescence can occur.
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Affiliation(s)
- Hugues C. Nana-Djeunga
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Magellan Tchouakui
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Guy R. Njitchouang
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
| | | | - Philippe Nwane
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
| | - André Domche
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jean Bopda
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
| | | | - Julie Akame
- Helen Keller International, Yaoundé, Cameroon
| | - Ann Tarini
- Helen Keller International, Yaoundé, Cameroon
| | | | | | - Yaobi Zhang
- Helen Keller International, Regional Office for Africa, Dakar, Senegal
| | - Jean J. Tougoue
- RTI International, Washington, D.C., United States of America
| | - Achille Kabore
- RTI International, Washington, D.C., United States of America
| | - Flobert Njiokou
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé, Cameroon
| | - Joseph Kamgno
- Centre for Research on Filariasis and other Tropical Diseases, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- * E-mail:
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Abeygunasekera AM, Sutharshan K, Balagobi B. New developments in chyluria after global programs to eliminate lymphatic filariasis. Int J Urol 2017; 24:582-588. [PMID: 28556416 DOI: 10.1111/iju.13378] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/05/2017] [Indexed: 11/28/2022]
Abstract
Chyluria, commonly seen in south Asian countries, is mainly a manifestation of lymphatic filariasis as a result of infestation with Wuchereria bancrofti, although many other causes can contribute. Many patients can be effectively treated with dietary modifications and drug therapy. The most widely used drug is diethyl carbamazine. The recurrences are common after such treatment. Such patients would benefit from sclerotherapy to obliterate the lympatico-renal fistulae located mainly in the renal pelvicalyceal system. The commonly used sclerosing agent is a combination of 5% povidone-iodine and 50% dextrose instilled through a ureteric catheter. A small percentage of patients who recur after sclerotherapy and those with systemic complications, such as hypoproteinemia and edema, might require surgery in the form of renal hilar lymphatic disconnection. Although it is a major operation, the success rates are >90%. Laparoscopic and robotic techniques have minimized the morbidity related to such surgery. With the advent of the global program for eradication of filariasis initiated by the World Health Organization, the incidence of the disease is decreasing. Mass chemotherapy with diethyl carbamazine is the mainstay of this global program. Many years after eliminating filariasis, chyluria continue to occur in such populations, though in dwindling numbers. Future research should aim at finding more efficacious sclerosing agents with minimal recurrences.
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Affiliation(s)
| | - Kugadas Sutharshan
- Department of Urology, Colombo South Teaching Hospital, Colombo, Sri Lanka
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Subramanian S, Jambulingam P, Chu BK, Sadanandane C, Vasuki V, Srividya A, Mohideen AbdulKader MS, Krishnamoorthy K, Raju HK, Laney SJ, Williams SA, Henderson RH. Application of a household-based molecular xenomonitoring strategy to evaluate the lymphatic filariasis elimination program in Tamil Nadu, India. PLoS Negl Trop Dis 2017; 11:e0005519. [PMID: 28406927 PMCID: PMC5404881 DOI: 10.1371/journal.pntd.0005519] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 04/25/2017] [Accepted: 03/21/2017] [Indexed: 11/24/2022] Open
Abstract
Background The monitoring and evaluation of lymphatic filariasis (LF) has largely relied on the detection of antigenemia and antibodies in human populations. Molecular xenomonitoring (MX), the detection of parasite DNA/RNA in mosquitoes, may be an effective complementary method, particularly for detecting signals in low-level prevalence areas where Culex is the primary mosquito vector. This paper investigated the application of a household-based sampling method for MX in Tamil Nadu, India. Methods MX surveys were conducted in 2010 in two evaluation units (EUs): 1) a hotspot area, defined as sites with community microfilaria prevalence ≥1%, and 2) a larger area that also encompassed the hotspots. Households were systematically selected using a sampling interval proportional to the number of households in the EU. Mosquito pools were collected and analyzed by real-time polymerase chain reaction (qPCR). Two independent samples were taken in each EU to assess reproducibility of results. Follow-up surveys were conducted in 2012. Results In 2010, the proportion of positive pools in the hotspot EU was 49.3% compared to 23.4% in the overall EU. In 2012, pool positivity was significantly reduced to 24.3% and 6.5%, respectively (p<0.0001). Pool positivity based on independent samples taken from each EU in 2010 and 2012 were not significantly different except for the hotspot EU in 2012 (p = 0.009). The estimated prevalence of infection in mosquitoes, measured by PoolScreen, declined from 2.2–2.7% in 2010 to 0.6–1.2% in 2012 in the hotspot area and from 0.9–1.1% to 0.2–0.3% in the larger area. Conclusions The household-based sampling strategy for MX led to mostly reproducible results and supported the observed LF infection trends found in humans. MX has the potential to be a cost-effective, non-invasive monitoring and evaluation tool with sensitive detection of infection signals in low prevalence settings. Further investigation and application of this sampling strategy for MX are recommended to support its adoption as a standardized method for global LF elimination programs. Lymphatic filariasis (LF) is one of the world’s foremost debilitating infectious diseases with nearly 800 million people at risk of infection. Given that LF is a mosquito-borne disease, the use of molecular xenomonitoring (MX) to detect parasite DNA/RNA in mosquitoes can serve as a valuable tool for LF monitoring and evaluation, particularly in Culex vector areas. We investigated using MX in a low-level prevalence district of Tamil Nadu, India by applying a household-based sampling strategy to determine trap location sites. Two independent mosquito samples were collected in each of a higher human infection hotspot area (sites with community microfilaria prevalence ≥1%) and across a larger evaluation area that also encompassed the hotspots. Pooled results showed mostly reproducible outcomes in both settings and a significant higher pool positivity in the hotspot area. A follow-up survey conducted two years later reconfirmed these findings while also showing a reduction in pool positivity and estimated prevalence of infection in mosquitoes in both settings. The utilization of a household-based sampling strategy for MX proved effective and should be further validated in wider epidemiological settings.
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Affiliation(s)
- Swaminathan Subramanian
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Puducherry, India
- * E-mail:
| | - Purushothaman Jambulingam
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Puducherry, India
| | - Brian K. Chu
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Candasamy Sadanandane
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Puducherry, India
| | - Venkatesan Vasuki
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Puducherry, India
| | - Adinarayanan Srividya
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Puducherry, India
| | | | | | - Harikishan K. Raju
- Vector Control Research Centre (Indian Council of Medical Research), Indira Nagar, Puducherry, India
| | - Sandra J. Laney
- SJL Global Consulting, Seattle, Washington, United States of America
| | - Steven A. Williams
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, United States of America
| | - Ralph H. Henderson
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, United States of America
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Poole CB, Li Z, Alhassan A, Guelig D, Diesburg S, Tanner NA, Zhang Y, Evans TC, LaBarre P, Wanji S, Burton RA, Carlow CKS. Colorimetric tests for diagnosis of filarial infection and vector surveillance using non-instrumented nucleic acid loop-mediated isothermal amplification (NINA-LAMP). PLoS One 2017; 12:e0169011. [PMID: 28199317 PMCID: PMC5310896 DOI: 10.1371/journal.pone.0169011] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 11/19/2016] [Indexed: 11/26/2022] Open
Abstract
Accurate detection of filarial parasites in humans is essential for the implementation and evaluation of mass drug administration programs to control onchocerciasis and lymphatic filariasis. Determining the infection levels in vector populations is also important for assessing transmission, deciding when drug treatments may be terminated and for monitoring recrudescence. Immunological methods to detect infection in humans are available, however, cross-reactivity issues have been reported. Nucleic acid-based molecular assays offer high levels of specificity and sensitivity, and can be used to detect infection in both humans and vectors. In this study we developed loop-mediated isothermal amplification (LAMP) tests to detect three different filarial DNAs in human and insect samples using pH sensitive dyes for enhanced visual detection of amplification. Furthermore, reactions were performed in a portable, non-instrumented nucleic acid amplification (NINA) device that provides a stable heat source for LAMP. The efficacy of several strand displacing DNA polymerases were evaluated in combination with neutral red or phenol red dyes. Colorimetric NINA-LAMP assays targeting Brugia Hha I repeat, Onchocerca volvulus GST1a and Wuchereria bancrofti LDR each exhibit species-specificity and are also highly sensitive, detecting DNA equivalent to 1/10-1/5000th of one microfilaria. Reaction times varied depending on whether a single copy gene (70 minutes, O. volvulus) or repetitive DNA (40 min, B. malayi and W. bancrofti) was employed as a biomarker. The NINA heater can be used to detect multiple infections simultaneously. The accuracy, simplicity and versatility of the technology suggests that colorimetric NINA-LAMP assays are ideally suited for monitoring the success of filariasis control programs.
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Affiliation(s)
| | - Zhiru Li
- New England Biolabs, Ipswich, MA United States of America
| | - Andy Alhassan
- New England Biolabs, Ipswich, MA United States of America
| | - Dylan Guelig
- PATH, Seattle, Washington, United States of America
| | | | | | - Yinhua Zhang
- New England Biolabs, Ipswich, MA United States of America
| | | | - Paul LaBarre
- PATH, Seattle, Washington, United States of America
| | - Samuel Wanji
- Research Foundation in Tropical Diseases and Environment, Buea, Cameroon
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Maji B, Akhtar S, Poddar S, Sinha R. A child with white urine: Answers. Pediatr Nephrol 2017; 32:267-269. [PMID: 26604086 DOI: 10.1007/s00467-015-3256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 10/15/2015] [Accepted: 10/16/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Biplab Maji
- Division of Paediatric Nephrology, Institute of Child Health, Biren Guha Street, Kolkata, 700019, India
| | - Shakil Akhtar
- Division of Paediatric Nephrology, Institute of Child Health, Biren Guha Street, Kolkata, 700019, India
| | - Sumon Poddar
- Department of Microbiology, Institute of Child Health, Kolkata, India
| | - Rajiv Sinha
- Division of Paediatric Nephrology, Institute of Child Health, Biren Guha Street, Kolkata, 700019, India.
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Abdel-Shafi IR, Shoieb EY, Attia SS, Rubio JM, Ta-Tang TH, El-Badry AA. Molecular identification and phylogenetic analysis of Wuchereria bancrofti from human blood samples in Egypt. Parasitol Res 2017; 116:963-970. [DOI: 10.1007/s00436-017-5372-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
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Coulibaly YI, Coulibaly SY, Dolo H, Konate S, Diallo AA, Doumbia SS, Soumaoro L, Coulibaly ME, Dicko I, Sangare MB, Dembele B, Sangare M, Dembele M, Touré YT, Kelly-Hope L, Polman K, Kyelem D, Traore SF, Bockarie M, Klion AD, Nutman TB. Dynamics of antigenemia and transmission intensity of Wuchereria bancrofti following cessation of mass drug administration in a formerly highly endemic region of Mali. Parasit Vectors 2016; 9:628. [PMID: 27912789 PMCID: PMC5135747 DOI: 10.1186/s13071-016-1911-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/24/2016] [Indexed: 11/16/2022] Open
Abstract
Background After seven annual rounds of mass drug administration (MDA) in six Malian villages highly endemic for Wuchereria bancrofti (overall prevalence rate of 42.7%), treatment was discontinued in 2008. Surveillance was performed over the ensuing 5 years to detect recrudescence. Methods Circulating filarial antigen (CFA) was measured using immunochromatographic card tests (ICT) and Og4C3 ELISA in 6–7 year-olds. Antibody to the W. bancrofti infective larval stage (L3) antigen, Wb123, was tested in the same population in 2012. Microfilaraemia was assessed in ICT-positive subjects. Anopheles gambiae complex specimens were collected monthly using human landing catch (HLC) and pyrethrum spray catch (PSC). Anopheles gambiae complex infection with W. bancrofti was determined by dissection and reverse transcriptase polymerase chain reaction (RT-PCR) of mosquito pools. Results Annual CFA prevalence rates using ICT in children increased over time from 0% (0/289) in 2009 to 2.7% (8/301) in 2011, 3.9% (11/285) in 2012 and 4.5% (14/309) in 2013 (trend χ2
= 11.85, df =3, P = 0.0006). Wb123 antibody positivity rates in 2013 were similar to the CFA prevalence by ELISA (5/285). Although two W. bancrofti-infected Anopheles were observed by dissection among 12,951 mosquitoes collected by HLC, none had L3 larvae when tested by L3-specific RT-PCR. No positive pools were detected among the mosquitoes collected by pyrethrum spray catch. Whereas ICT in 6–7 year-olds was the major surveillance tool, ICT positivity was also assessed in older children and adults (8–65 years old). CFA prevalence decreased in this group from 4.9% (39/800) to 3.5% (28/795) and 2.8% (50/1,812) in 2009, 2011 and 2012, respectively (trend χ2
= 7.361, df =2, P = 0.0067). Some ICT-positive individuals were microfilaraemic in 2009 [2.6% (1/39)] and 2011 [8.3% (3/36)], but none were positive in 2012 or 2013. Conclusion Although ICT rates in children increased over the 5-year surveillance period, the decrease in ICT prevalence in the older group suggests a reduction in transmission intensity. This was consistent with the failure to detect infective mosquitoes or microfilaraemia. The threshold of ICT positivity in children may need to be re-assessed and other adjunct surveillance tools considered.
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Affiliation(s)
- Yaya I Coulibaly
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali. .,Filarial Program Support Unit, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Siaka Y Coulibaly
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Housseini Dolo
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Siaka Konate
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Abdallah A Diallo
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Salif S Doumbia
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Lamine Soumaoro
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Michel E Coulibaly
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Ilo Dicko
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Moussa B Sangare
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Benoit Dembele
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Modibo Sangare
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | | | - Yeya T Touré
- Faculty of Medicine and Odontostomatology of Bamako, Bamako, Mali
| | - Louise Kelly-Hope
- Filarial Program Support Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dominique Kyelem
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA, USA
| | - Sekou F Traore
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Moses Bockarie
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Amy D Klion
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Thornton JH, Batengana BM, Eiras AE, Irish SR. Evaluation of collection methods for Culex quinquefasciatus, Aedes aegypti, and Aedes simpsoni in northeastern Tanzania. JOURNAL OF VECTOR ECOLOGY : JOURNAL OF THE SOCIETY FOR VECTOR ECOLOGY 2016; 41:265-270. [PMID: 27860009 DOI: 10.1111/jvec.12221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 07/24/2016] [Indexed: 06/06/2023]
Abstract
In East Africa, significant morbidity and mortality are caused by infections spread by Culex quinquefasciatus and Aedes aegypti. Sticky traps have been shown to be effective tools for sampling populations of Aedes mosquitoes and have been found to catch Cx. quinquefasciatus. Thus, they could potentially be used to sample populations of this species. This study compared Sticky ovitraps (SO) and MosquiTraps (MQT) with the CDC Gravid trap (CDC-GT) for collection of Culex and Aedes mosquito populations in Tanzania. A follow-up experiment was carried out using traps set for a 24-h period to accommodate the oviposition habits of Aedes aegypti and Ae. simpsoni s.l. mosquitoes. The results showed that the CDC-GT caught significantly more Cx. quinquefasciatus and Ae. aegypti than the SO or MQT, but there was no significant difference in the number of mosquitoes caught between the two sticky traps or of Ae. simpsoni s.l. caught among the three trap types. The results suggest that CDC-GTs are the most appropriate in sampling of Cx. quinquefasciatus. Although CDC-GTs collected more Ae. aegypti than the sticky traps, the simplicity and cost benefit of sticky traps facilitates large scale studies. All three trap types should be considered for monitoring Aedes mosquitoes.
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Affiliation(s)
| | | | - Alvaro Eduardo Eiras
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Seth Robert Irish
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, U.K
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Okorie PN, de Souza DK. Prospects, drawbacks and future needs of xenomonitoring for the endpoint evaluation of lymphatic filariasis elimination programs in Africa. Trans R Soc Trop Med Hyg 2016; 110:90-7. [PMID: 26822601 DOI: 10.1093/trstmh/trv104] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Lymphatic filariasis (LF) is a debilitating disease caused by Wuchereria bancrofti, Brugia malayi and B. timori parasitic worms and transmitted by Culex, Anopheles, Aedes and Mansonia mosquitoes. Mass drug administration (MDA) to reduce the infection levels in the human population is the key component of LF elimination programs. However, the potential of the use of vector control is gaining recognition as a tool that can complement MDA. The method of monitoring the parasites in mosquito vectors is known as xenomonitoring. Monitoring of vectors for filarial larvae is an important assessment tool for LF elimination programs. Xenomonitoring has the advantage of giving a real-time estimate of disease, because the pre-patent period may take months after infection in humans. It is a non-invasive sensitive tool for assessing the presence of LF in endemic areas. The aim of this review is to discuss the prospects, challenges and needs of xenomonitoring as a public health tool, in the post-MDA evaluation activities of national LF elimination programs.
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Affiliation(s)
- Patricia N Okorie
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Dziedzom K de Souza
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Irvine MA, Njenga SM, Gunawardena S, Njeri Wamae C, Cano J, Brooker SJ, Hollingsworth TD. Understanding the relationship between prevalence of microfilariae and antigenaemia using a model of lymphatic filariasis infection. Trans R Soc Trop Med Hyg 2016; 110:118-24. [PMID: 26822604 PMCID: PMC4731003 DOI: 10.1093/trstmh/trv096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Lymphatic filariasis is a debilitating neglected tropical disease that affects impoverished communities. Rapid diagnostic tests of antigenaemia are a practical alternative to parasitological tests of microfilaraemia for mapping and surveillance. However the relationship between these two methods of measuring burden has previously been difficult to interpret. Methods A statistical model of the distribution of worm burden and microfilariae (mf) and resulting antigenaemic and mf prevalence was developed and fitted to surveys of two contrasting sentinel sites undergoing interventions. The fitted model was then used to explore the relationship in various pre- and post-intervention scenarios. Results The model had good quantitative agreement with the data and provided estimates of the reduction in mf output due to treatment. When extrapolating the results to a range of prevalences there was good qualitative agreement with published data. Conclusions The observed relationship between antigenamic and mf prevalence is a natural consequence of the relationship between prevalence and intensity of adult worms and mf production. The method described here allows the estimation of key epidemiological parameters and consequently gives insight into the efficacy of an intervention programme.
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Affiliation(s)
- Michael A Irvine
- School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK
| | - Sammy M Njenga
- Kenya Medical Research Institute (KEMRI), P.O. Box 54840, Post Code 00200, Nairobi, Kenya
| | - Shamini Gunawardena
- School of Health Sciences, Mount Kenya University, P.O. Box 342-01000, Thika, Kenya
| | - Claire Njeri Wamae
- School of Health Sciences, Mount Kenya University, P.O. Box 342-01000, Thika, Kenya
| | - Jorge Cano
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Simon J Brooker
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - T Deirdre Hollingsworth
- School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
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