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Osman E, Amin NA, Noon TPM, Lahat SNH, Rosli MS, Sham SF, Periyasamy PR, Ghazali N, Manap SNAA, Noordin R. Comparison of Two Serological Assays in Detecting Strongyloides Infection in Immunocompromised Patients. Am J Trop Med Hyg 2022; 107:tpmd220076. [PMID: 35895335 PMCID: PMC9490643 DOI: 10.4269/ajtmh.22-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 11/07/2022] Open
Abstract
Strongyloides infection may develop into fatal hyperinfection and dissemination syndrome in immunocompromised hosts. Despite suboptimal specificity issues, the detection of IgG antibodies by ELISA has been central in the serodiagnosis of Strongyloides infection. Recently, an IgG4-based lateral-flow test (SsRapid) using recombinant NIE (rNIE) protein with good diagnostic performance has been reported. This study assessed the result concordance between a commercial IgG-ELISA and the SsRapid. Additionally, we determined the Strongyloides seroprevalence and its association with clinical manifestations. Immunocompromised patients (N = 200) were from Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia, and were diagnosed with HIV/AIDS, hematological malignancy, and solid organ cancers. Their plasma samples were tested using a commercial IgG-ELISA and SsRapid. A fair concordance (κ = 0.27-0.33; P < 0.05) among the tests was demonstrated. The SsRapid exhibited a significantly higher (P < 0.05) seroprevalence (10.5% [21/200]) compared with IgG-ELISA (7.5% [15/200]). After adsorption with rNIE, all SsRapid-positive samples tested negative with the rapid test, thus showing binding specificity. There was no significant association with clinical manifestations. This study revealed that SsRapid is a useful diagnostic tool for Strongyloides infection, and there is a notable seroprevalence among the immunocompromised patients.
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Affiliation(s)
- Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Azma Amin
- Universiti Kuala Lumpur Institute of Medical Science Technology Selangor, Malaysia
| | - Thieeraporn Phraseart Ma Noon
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nuratiqah Hanani Lahat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohamad Syairazi Rosli
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shazia Farhana Sham
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Nuraffini Ghazali
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nor Azreen Abd Manap
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia (USM), Penang, Malaysia
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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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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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Serre-Delcor N, Treviño B, Monge B, Salvador F, Torrus D, Gutiérrez-Gutiérrez B, López-Vélez R, Soriano-Arandes A, Sulleiro E, Goikoetxea J, Pérez-Molina JA. Eosinophilia prevalence and related factors in travel and immigrants of the network +REDIVI. Enferm Infecc Microbiol Clin 2016; 35:617-623. [PMID: 27032297 DOI: 10.1016/j.eimc.2016.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022]
Abstract
The population movements during the last decades have resulted in a progressively increasing interest in certain infectious diseases. Eosinophilia is a common finding in immigrants and travellers. One of the most common causes of eosinophilia is helminth infection, and some intestinal protozoa. The aim of this paper is to describe the epidemiological characteristics of cases with eosinophilia and its association with the presence of parasites in the REDIVI data network. This is a multicentre prospective observational study that includes patients diagnosed with eosinophilia registered in the cooperative network for the study of infectious diseases in travellers and immigrants (+REDIVI) from January 2009 to December 2012. A total of 5,255 episodes were recorded in the network during the study period, and eosinophilia was observed in 8.1-31.3% of cases (depending on the immigration group). There were 60.2% men, with a median age of 31years. There were 72.4% immigrants, and 81.2% were asymptomatic. The most commonly identified parasites were S.stercoralis (34.4%), Schistosoma sp. (11.0%), and hookworm (8.6%). The relationship between eosinophilia and parasite infection was significant for all helminths (except for cutaneous larva migrans). The symptoms and duration of the journey did not significantly determine the presence of eosinophilia. In the case of eosinophilia in a person who has lived in helminth endemic areas, it is advisable to carry out targeted studies to diagnose the infection, regardless of immigration type, length of stay, or the presence of symptoms.
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Affiliation(s)
- Núria Serre-Delcor
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España.
| | - Begoña Treviño
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Begoña Monge
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Fernando Salvador
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | - Diego Torrus
- Hospital General Universitario de Alicante, Alicante, España
| | | | - Rogelio López-Vélez
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Antoni Soriano-Arandes
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Elena Sulleiro
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | | | - Jose A Pérez-Molina
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
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Pak BJ, Vasquez-Camargo F, Kalinichenko E, Chiodini PL, Nutman TB, Tanowitz HB, McAuliffe I, Wilkins P, Smith PT, Ward BJ, Libman MD, Ndao M. Development of a rapid serological assay for the diagnosis of strongyloidiasis using a novel diffraction-based biosensor technology. PLoS Negl Trop Dis 2014; 8:e3002. [PMID: 25102174 PMCID: PMC4125104 DOI: 10.1371/journal.pntd.0003002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/31/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Strongyloidiasis is a persistent human parasitic infection caused by the intestinal nematode, Strongyloides stercoralis. The parasite has a world-wide distribution, particularly in tropical and subtropical regions with poor sanitary conditions. Since individuals with strongyloidiasis are typically asymptomatic, the infection can persist for decades without detection. Problems arise when individuals with unrecognized S. stercoralis infection are immunosuppressed, which can lead to hyper-infection syndrome and disseminated disease with an associated high mortality if untreated. Therefore a rapid, sensitive and easy to use method of diagnosing Strongyloides infection may improve the clinical management of this disease. METHODOLOGY/PRINCIPAL FINDINGS An immunological assay for diagnosing strongyloidiasis was developed on a novel diffraction-based optical bionsensor technology. The test employs a 31-kDa recombinant antigen called NIE derived from Strongyloides stercoralis L3-stage larvae. Assay performance was tested using retrospectively collected sera from patients with parasitologically confirmed strongyloidiasis and control sera from healthy individuals or those with other parasitoses including schistosomiasis, trichinosis, echinococcosis or amebiasis who were seronegative using the NIE ELISA assay. If we consider the control group as the true negative group, the assay readily differentiated S. stercoralis-infected patients from controls detecting 96.3% of the positive cases, and with no cross reactivity observed in the control group These results were in excellent agreement (κ = 0.98) with results obtained by an NIE-based enzyme-linked immunosorbent assay (ELISA). A further 44 sera from patients with suspected S. stercoralis infection were analyzed and showed 91% agreement with the NIE ELISA. CONCLUSIONS/SIGNIFICANCE In summary, this test provides high sensitivity detection of serum IgG against the NIE Strongyloides antigen. The assay is easy to perform and provides results in less than 30 minutes, making this platform amenable to rapid near-patient screening with minimal technical expertise.
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Affiliation(s)
| | - Fabio Vasquez-Camargo
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Peter L. Chiodini
- Department of Clinical Parasitology, Hospital for Tropical Diseases, University College London Hospitals, London, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Herbert B. Tanowitz
- Department of Pathology Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Isabel McAuliffe
- US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patricia Wilkins
- US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Brian J. Ward
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Michael D. Libman
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
- * E-mail:
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Abstract
The aim of this study was to develop a low-cost antifilarial immunoglobulin (Ig) G4 detection kit for the diagnosis of lymphatic filariasis. The kit was designed to be used by minimally trained personnel without the constraints of expensive laboratory equipment. We provide a description of the development and validation of a single-serum-dilution based enzyme-linked immunosorbent assay (ELISA) kit with ready-to-use reagents for measuring antifilarial IgG4 antibodies. The kit was tested on residents in Brugia malayi-endemic areas in southern Thailand. Detection was performed by naked-eye observation of the resultant colour of the immunological reactivity. The coefficient of variation (CV) was used to assess the reproducibility of the results. Long-term stability was measured over a 6-month period. Sensitivity of the test kit was 97% when compared with microfilariae detection in thick blood smears. Specificity was 98.7% based on the sera of 57 patients living outside the endemic areas who were infected with other parasites and 100 parasite-free subjects. All positive CVs were < 10%. The test kit was remarkably stable over 6 months. Field validation was performed by the detection of antifilarial IgG4 in 4365 serum samples collected from residents of brugian filariasis-endemic areas and compared with outcome colours of the test samples by the naked eye. Subsequent ELISA evaluation of these results using an ELISA reader indicated high agreement by the kappa statistic. These results demonstrate that the test kit is efficient and useful for public health laboratories as an alternative tool for the diagnosis of lymphatic filarial infection.
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Norsyahida A, Riazi M, Sadjjadi SM, Muhammad Hafiznur Y, Low HC, Zeehaida M, Noordin R. Laboratory detection of strongyloidiasis: IgG-, IgG4- and IgE-ELISAs and cross-reactivity with lymphatic filariasis. Parasite Immunol 2013; 35:174-9. [DOI: 10.1111/pim.12029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 02/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- A. Norsyahida
- Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Minden; Penang; Malaysia
| | - M. Riazi
- School of Pharmaceutical Sciences; Universiti Sains Malaysia; Minden; Penang; Malaysia
| | | | - Y. Muhammad Hafiznur
- Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Minden; Penang; Malaysia
| | - H. C. Low
- School of Mathematical Sciences; Universiti Sains Malaysia; Minden; Penang; Malaysia
| | - M. Zeehaida
- Department of Medical Microbiology & Parasitology; School of Medical Sciences; Universiti Sains Malaysia; Kota Bharu; Kelantan; Malaysia
| | - R. Noordin
- Institute for Research in Molecular Medicine; Universiti Sains Malaysia; Minden; Penang; Malaysia
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Moss DM, Priest JW, Boyd A, Weinkopff T, Kucerova Z, Beach MJ, Lammie PJ. Multiplex bead assay for serum samples from children in Haiti enrolled in a drug study for the treatment of lymphatic filariasis. Am J Trop Med Hyg 2011; 85:229-37. [PMID: 21813840 DOI: 10.4269/ajtmh.2011.11-0029] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A multiplex bead assay (MBA) was used to analyze serum samples collected longitudinally from children enrolled in a drug trial for treatment of filariasis in Leogane, Haiti. Recombinant antigens Bm14 and Bm33 from Brugia malayi, third polar tube protein (PTP3) from Encephalitozoon cuniculi, and merozoite surface protein-1(19) (MSP-1(19)) from Plasmodium falciparum were coupled to carboxylated polystyrene microspheres. IgG responses to PTP3 and MSP-1(19) were not affected by albendazole (ALB), diethylcarbamazine (DEC), or combination of diethylcarbamazine and albendazole (DEC/ALB). However, IgG and IgG4 responses to Bm14 and Bm33 were significantly decreased (P < 0.001) by DEC and DEC/ALB treatment. Antibody responses to Bm14 and Bm33 decreased after DEC treatment (but not placebo) among children who were negative for microfilaremia and antigenemia at baseline, suggesting that these children harbored early stages of infection. The MBA is an excellent serologic technique for multiple antigens that offers substantial advantages over single-antigen based enzyme-linked immunosorbent assay in mass drug administration studies for monitoring changes in antibody levels.
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Affiliation(s)
- Delynn M Moss
- National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Joseph HM, Melrose W. Applicability of the Filter Paper Technique for Detection of Antifilarial IgG(4) Antibodies Using the Bm14 Filariasis CELISA. J Parasitol Res 2010; 2010:594687. [PMID: 20700424 PMCID: PMC2911587 DOI: 10.1155/2010/594687] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 12/16/2009] [Accepted: 01/05/2010] [Indexed: 11/21/2022] Open
Abstract
Demonstration of successful elimination of lymphatic filariasis (LF) in endemic countries requires sensitive diagnostics for accurate definitions of endpoints and future surveillance. There has been interest in complementing available diagnostics with antibody serology testing in children, since negative serology would correspond with cessation of LF transmission. The Filariasis CELISA detects antifilarial IgG(4) and has favourable results with serum samples but field application requires an easier sampling method. Ninety-four paired plasma and filter paper samples were assayed with promising results. The filter paper method resulted in a sensitivity of 92% and a specificity of 77% when compared to the paired plasma. One hundred and one filter paper samples were assessed for storage effects. Following 10-month storage at -20( degrees )C there was a significant reduction in reactivity (P < .001). Overall the results indicated that filter paper sampling would be a favourable sensitive and specific alternative for blood collection in surveys.
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Affiliation(s)
- Hayley M. Joseph
- Lymphatic Filariasis Support Centre, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Wayne Melrose
- Lymphatic Filariasis Support Centre, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia
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A cohort study on anti-filarial IgG4 and its assessment in good and uncertain MDA-compliant subjects in brugian filariasis endemic areas in southern Thailand. J Helminthol 2009; 83:351-60. [PMID: 19422729 DOI: 10.1017/s0022149x09352669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The prevalence of Brugia malayi was surveyed in three highly endemic provinces in southern Thailand as part of an ongoing evaluation of the effectiveness of two rounds of mass drug administration (MDA). Prior to MDA IV, and thereafter every 6 months up to 18 months, including MDA V at 12 months, nocturnal blood sampling was assayed for microfilaria (mf) and IgG4 antibodies in 200 subjects from Nakorn Srithammarat and Surathani provinces. From an additional 300 subjects from Narathiwatt province, daytime blood was also examined for IgG4 antibodies for 1 year. Subjects who tested positive, with reciprocal IgG4 titres above 100, were dichotomized in the 'good compliant' or 'uncertain compliant' groups. Stool samples were examined for intestinal parasites from all 500 subjects simultaneously. Only two subjects (1%) tested positive for mf, while 98 subjects (19.6% of 500) tested positive for IgG4. In general, the good drug-compliant subjects were less likely to exhibit the IgG4 response than subjects in the uncertain compliant group. Only six subjects (1.2%) exhibited lymphoedema while 68 subjects (13.6%) had a total of 105 parasitic infections, with female instances of protozoan infections exceeding male instances of helminth infections. It was concluded that the two MDA rounds were highly successful in not only in reducing mf to negligible levels but also in lowering antifilarial IgG4 titres in the good compliant subjects. The IgG4 assay is a sensitive and cost-effective surveillance tool for the early detection of brugian infections that is not contingent on nocturnal blood collections.
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Ramanathan R, Burbelo PD, Groot S, Iadarola MJ, Neva FA, Nutman TB. A luciferase immunoprecipitation systems assay enhances the sensitivity and specificity of diagnosis of Strongyloides stercoralis infection. J Infect Dis 2008; 198:444-51. [PMID: 18558872 DOI: 10.1086/589718] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND We investigated whether luciferase immunoprecipitation systems (LIPS) can be the basis for a more rapid, specific, and standardized assay for the diagnosis of Strongyloides stercoralis infection. METHODS A LIPS assay was developed based on immunoglobulin (Ig) G or IgG4 antibody to a recombinant Strongyloides antigen (NIE) and was compared with an NIE enzyme-linked immunosorbent assay (ELISA). A second antigen, S. stercoralis immunoreactive antigen (SsIR), was tested alone and in combination with NIE. The assays were tested using serum samples from patients with parasitologically proven S. stercoralis or filarial infections and from healthy, uninfected control subjects. RESULTS The NIE LIPS assay based on IgG antibody easily differentiated between S. stercoralis-infected and uninfected patients (P< .0001) and demonstrated improved specificity compared with the NIE ELISA (100% vs. 95%). Serum from filaria-infected patients did not cross-react when tested with the NIE LIPS assay. When SsIR was used in combination with NIE in the LIPS format, sensitivity and specificity improved to 100%, with a 7-fold difference between positive and negative values. No advantage was found in using a LIPS assay based on IgG4. At posttreatment follow-up, a significant decline in antibody titers was detected using the NIE ELISA (P< .0017) and the NIE LIPS assay (P< .0001). CONCLUSIONS LIPS addresses several limitations of current ELISAs and represents a major advance in the diagnosis of S. stercoralis infection.
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Affiliation(s)
- Roshan Ramanathan
- Clinical Parasitology Unit and Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
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12
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Abstract
PURPOSE OF REVIEW Tropical pulmonary eosinophilia is predominantly seen in the tropical and subtropical regions of the world. It is being increasingly reported from other parts of world, however, due to increases in global travel and migration. This review focuses attention on recent developments. RECENT FINDINGS Tropical pulmonary eosinophilia is an occult form of human filariasis. The gamma-glutaryl transpeptidase found in the infective L3 stage larvae of Brugia malayi has been found to have similarities with the gamma-glutaryl transpeptidase present on the surface of human pulmonary epithelium. It has, therefore, been proposed that filarial gamma-glutaryl transpeptidase may play an important role in the pathogenesis of tropical eosinophilia. Airway hyperresponsiveness, manifesting as asthma-like syndrome, has been reported in tropical pulmonary eosinophilia and it has been suggested that interleukin-4 induces and interferon-gamma suppresses filarial-induced airway hyperresponsiveness. The intense eosinophilic alveolitis seen in acute tropical pulmonary eosinophilia is suppressed by 3 weeks of treatment with diethylcarbamazine citrate. A mild eosinophilic alveolitis along with radiological, physiological and hematological abnormalities, though with reduced intensity, persists in some patients however. SUMMARY A chronic mild interstitial lung disease has been found to persist in tropical pulmonary eosinophilia despite treatment.
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Yong MK, Marshall CL, Eisen DP. Tropical pulmonary eosinophilia: a rare cause of cough in immigrants to Australia. Med J Aust 2007; 187:416-8. [PMID: 17908009 DOI: 10.5694/j.1326-5377.2007.tb01316.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 06/21/2007] [Indexed: 11/17/2022]
Affiliation(s)
- Michelle K Yong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, VIC, Australia.
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Hales BJ, Laing IA, Pearce LJ, Hazell LA, Mills KL, Chua KY, Thornton RB, Richmond P, Musk AW, James AL, Lesouëf PN, Thomas WR. Distinctive immunoglobulin E anti-house dust allergen-binding specificities in a tropical Australian Aboriginal community. Clin Exp Allergy 2007; 37:1357-63. [PMID: 17845417 DOI: 10.1111/j.1365-2222.2007.02786.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is evidence that the specificity of the IgE binding in allergy tests can vary for different populations. OBJECTIVE We aimed to examine the allergenic specificity of IgE binding in sera from house dust mite (HDM)-atopic subjects in a tropical Australian Aboriginal community. METHODS Sera shown to contain IgE antibodies to an HDM extract of Dermatophagoides pteronyssinus were examined for IgE binding to a panel of nine purified HDM allergens from this mite species by quantitative microtitre assays. IgG antibody binding (IgG1 and IgG4) was also measured. RESULTS The IgE-binding activity in the sera from the Aboriginal community was not directed to the expected major groups 1 and 2 HDM allergens but instead to the group 4 amylase allergen. There was also little IgE binding to the potentially cross-reactive tropomyosin (Der p 10) or arginine kinase (Der p 20) allergens. The IgG4 antibody was rarely detected and limited to the Der p 4 allergen. IgG1 antibody binding was frequently measured to all the allergens regardless of an individual's atopic status, whereas in urban communities it is restricted to the major allergens and to atopic subjects. CONCLUSION The high IgE anti-HDM response of Australian Aboriginals predominantly bound Der p 4 and not the Der p 1 and 2 allergens, showing a distinctive allergy that could affect the disease outcome and diagnosis.
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Affiliation(s)
- B J Hales
- Division of Molecular Biotechnology, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia.
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Wongkamchai S, Rochjanawatsiriroj C, Monkong N, Nochot H, Loymek S, Jiraamornnimit C, Hunnangkul S, Choochote W. Diagnostic value of IgG isotype responses against Brugia malayi antifilarial antibodies in the clinical spectrum of brugian filariasis. J Helminthol 2007; 80:363-7. [PMID: 17125545 DOI: 10.1017/joh2006365] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To study the diagnostic significance of antifilarial IgG subclasses in the clinical spectrum of brugian filariasis, IgG1, IgG3 and IgG4 antifilarial antibodies were determined in an exposed population comprising 74 asymptomatic amicrofilaraemics, 30 microfilaraemics, 20 lymphangitis and 16 elephantiasis patients resident in Narathiwart province, an area endemic for Brugia malayi lymphatic filariasis in southern Thailand. The dominant isotype of antifilarial antibody was IgG4. A significantly higher percentage of individuals were positive for IgG1 in the microfilaraemic and lymphangitis groups compared with the elephantiasis and endemic normal patients, while a significantly higher positive rate of IgG3 was found in those with lymphangitis. The possible role of these isotypes for diagnostic purposes and the pattern of antibody response in various clinically manifesting groups are discussed.
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Affiliation(s)
- S Wongkamchai
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok-Noi, Bangkok, Thailand.
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16
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de Gruijter JM, Blotkamp J, Gasser RB, Amponsah S, Polderman AM. Morphological variability withinOesophagostomum bifurcumamong different primate species from Ghana. J Helminthol 2007; 80:357-61. [PMID: 17125544 DOI: 10.1017/joh2006363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAdultOesophagostomum bifurcum(Nematoda: Strongylida) from human and non-human primates from Ghana were compared in order to investigate the extent of morphological variability within the species. Using analysis of variance and principal component analysis, significant differences in morphological characters (such as parasite length, width, length of the oesophagus and length of spicules) were demonstrated betweenO. bifurcumworms from humans, the Mona, Patas or Green monkey and/or Olive baboons. These findings suggest thatO. bifurcumfrom different species of primate host represent distinct population variants, also supported by recent epidemiological and genetic studies ofO. bifurcumfrom such hosts.
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Affiliation(s)
- J M de Gruijter
- Department of Parasitology, Leiden University Medical Centre, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands.
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17
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van Doorn HR, Koelewijn R, Hofwegen H, Gilis H, Wetsteyn JCFM, Wismans PJ, Sarfati C, Vervoort T, van Gool T. Use of enzyme-linked immunosorbent assay and dipstick assay for detection of Strongyloides stercoralis infection in humans. J Clin Microbiol 2007; 45:438-42. [PMID: 17151215 PMCID: PMC1829047 DOI: 10.1128/jcm.01735-06] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Revised: 10/10/2006] [Accepted: 11/21/2006] [Indexed: 02/06/2023] Open
Abstract
A homemade enzyme-linked immunosorbent assay (ELISA) (Academic Medical Center ELISA [AMC-ELISA]) and a dipstick assay for the detection of anti-Strongyloides stercoralis antibodies in serum were developed and evaluated together with two commercially available ELISAs (IVD-ELISA [IVD Research, Inc.] and Bordier-ELISA [Bordier Affinity Products SA]) for their use in the serodiagnosis of imported strongyloidiasis. Both commercially available ELISAs have not been evaluated previously. The sensitivities of the assays were evaluated using sera from 90 patients with parasitologically proven intestinal strongyloidiasis and from 9 patients with clinical larva currens. The sensitivities of the AMC-ELISA, dipstick assay, IVD-ELISA, and Bordier-ELISA were 93, 91, 89, and 83%, respectively, for intestinal strongyloidiasis. In all tests, eight of nine sera from patients with larva currens were positive. The specificity was assessed using a large serum bank of 220 sera from patients with various parasitic, bacterial, viral, and fungal infectious diseases; sera containing autoimmune antibodies; and sera from healthy blood donors. The specificities of AMC-ELISA, dipstick assay, IVD-ELISA, and Bordier-ELISA were 95.0, 97.7, 97.2, and 97.2%, respectively. Our data suggest that all four assays are sensitive and specific tests for the diagnosis of both intestinal and cutaneous strongyloidiasis.
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Affiliation(s)
- H Rogier van Doorn
- Department of Medical Microbiology, Academic Medical Center, Room L1-245, P.O. Box 22660, 1100DD Amsterdam, The Netherlands.
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18
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Weil GJ, Ramzy RMR. Diagnostic tools for filariasis elimination programs. Trends Parasitol 2007; 23:78-82. [PMID: 17174604 DOI: 10.1016/j.pt.2006.12.001] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Revised: 10/27/2006] [Accepted: 12/06/2006] [Indexed: 11/26/2022]
Abstract
The ambitious and exciting Global Programme to Eliminate Lymphatic Filariasis (GPELF) is largely based on a strategy of mass drug administration (MDA) of repeated rounds of antifilarial medications to endemic populations around the world. Diagnostic tools are important to GPELF because they affect decisions regarding where to distribute MDA, how to measure its effects, how to define targets and endpoints for stopping MDA, and how to monitor populations for possible resurgence of filariasis transmission following suspension of MDA. This article reviews available diagnostic tests for filariasis and their potential use as tools for different phases of filariasis elimination programs.
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Affiliation(s)
- Gary J Weil
- Infectious Diseases Division, Washington University School of Medicine, Campus Box 8051, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
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20
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Noordin R, Wahyuni S, Mangali A, Huat LB, Yazdanbakhsh M, Sartono E. Comparison of IgG4 assays using whole parasite extract and BmR1 recombinant antigen in determining antibody prevalence in brugian filariasis. FILARIA JOURNAL 2004; 3:8. [PMID: 15307892 PMCID: PMC517507 DOI: 10.1186/1475-2883-3-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2004] [Accepted: 08/12/2004] [Indexed: 11/10/2022]
Abstract
Background Brugia malayi is endemic in several Asian countries with the highest prevalence in Indonesia. Determination of prevalence of lymphatic filariasis by serology has been performed by various investigators using different kinds of antigen (either soluble worm antigen preparations or recombinant antigens). This investigation compared the data obtained from IgG4 assays using two different kinds of antigen in a study on prevalence of antibodies to B. malayi. Methods Serum samples from a transmigrant population and life long residents previously tested with IgG4 assay using soluble worm antigen (SWA-ELISA), were retested with an IgG4 assay that employs BmR1 recombinant antigen (BmR1 dipstick [Brugia Rapid™]). The results obtained with the two antigens were compared, using Pearson chi-square and McNemar test. Results There were similarities and differences in the results obtained using the two kinds of antigen (SWA and BmR1). Similarities included the observation that assays using both antigens demonstrated an increasing prevalence of IgG4 antibodies in the transmigrant population with increasing exposure to the infection, and by six years living in the area, antibody prevalence was similar to that of life-long residents. With regards to differences, of significance is the demonstration of similar antibody prevalence in adults and children by BmR1 dipstick whereas by SWA-ELISA the antibody prevalence in adults was higher than in children. Conclusions Results and conclusions made from investigations of prevalence of anti-filarial IgG4 antibody in a population would be affected by the assay employed in the study.
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Affiliation(s)
- Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Sitti Wahyuni
- Dept. of Parasitology, Hasanuddin University, Jalan Perintis Kemerdekaan KM 10 Tamalanrea 90245, Makassar, Indonesia
- Department of Parasitology, Leiden University Medical Centre, P.O Box 9600, 2300 RC, Leiden, The Netherlands
| | - Andarias Mangali
- Dept. of Parasitology, Hasanuddin University, Jalan Perintis Kemerdekaan KM 10 Tamalanrea 90245, Makassar, Indonesia
| | - Lim Boon Huat
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Centre, P.O Box 9600, 2300 RC, Leiden, The Netherlands
| | - Erliyani Sartono
- Department of Parasitology, Leiden University Medical Centre, P.O Box 9600, 2300 RC, Leiden, The Netherlands
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Melrose WD, Durrheim DD, Burgess GW. Update on immunological tests for lymphatic filariasis. Trends Parasitol 2004; 20:255-7. [PMID: 15147670 DOI: 10.1016/j.pt.2004.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Wayne D Melrose
- Lymphatic Filariasis Support Center, School of Public Health and Tropical Medicine, James Cook University, Townsville 4811, Australia.
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Washington CH, Radday J, Streit TG, Boyd HA, Beach MJ, Addiss DG, Lovince R, Lovegrove MC, Lafontant JG, Lammie PJ, Hightower AW. Spatial clustering of filarial transmission before and after a Mass Drug Administration in a setting of low infection prevalence. FILARIA JOURNAL 2004; 3:3. [PMID: 15128461 PMCID: PMC420477 DOI: 10.1186/1475-2883-3-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2003] [Accepted: 05/05/2004] [Indexed: 12/04/2022]
Abstract
BACKGROUND: In the global program for the elimination of lymphatic filariasis (LF) longitudinal assessment of the prevalence of microfilaremia and antigenemia is recommended to monitor the effect of mass treatment on transmission. Additional monitoring tools such as entomologic and antibody methods may be useful in identifying residual foci of infection. In this study, we characterized serologic markers of infection and exposure spatially both before and after mass treatment, in an area of initial low Wuchereria bancrofti infection prevalence. METHODS: Consenting persons in the sentinel community were tested for circulating microfilaria and antigen (by immunochromatographic test) before and after the 1st annual mass drug administration of diethylcarbamazine and albendazole. A cohort of 161 persons provided serum specimens both years that were tested for antifilarial IgG (1 and 4) antibody. Every house was mapped using a differential Global Positioning System; this information was linked to the serologic data. W. bancrofti infection in the mosquito vector was assessed with year-round collection. Multiple linear regression was used to investigate the influence of antigen-positive persons on the antifilarial antibody responses of antigen-negative neighbors. RESULTS: After mass treatment, decreases were observed in the sentinel site in the overall prevalence of antigen (10.4% to 6.3%) and microfilaremia (0.9 to 0.4%). Of the persons in the cohort that provided serum specimens both years, 79% received treatment. Antigen prevalence decreased from 15.0% to 8.7%. Among 126 persons who received treatment, antigen and antifilarial IgG1 prevalence decreased significantly (p = 0.002 and 0.001, respectively). Among 34 persons who did not receive treatment, antifilarial IgG1 prevalence increased significantly (p = 0.003). Average antifilarial IgG1 levels decreased in households with high treatment coverage and increased in households that refused treatment. Each 10-meter increase in distance from the residence of a person who was antigen-positive in 2000 was associated a 4.68 unit decrease in antifilarial IgG1 level in 2001, controlling for other factors (p = 0.04). DISCUSSION: Antifilarial antibody assays can be used as a measure of filarial exposure. Our results suggest that micro-scale spatial heterogeneity exists in LF exposure and infection. Treatment appeared to be associated with reduced exposure at the sub-community level, suggesting the need to achieve high and homogeneous coverage. Public health messages should note the benefits of having one's neighbors receive treatment with antifilarial drugs.
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Affiliation(s)
- Charles H Washington
- Center for Tropical Disease Research and Training, University of Notre Dame, IN, USA
| | - Jeanne Radday
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Thomas G Streit
- Center for Tropical Disease Research and Training, University of Notre Dame, IN, USA
| | - Heather A Boyd
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Michael J Beach
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - David G Addiss
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Maribeth C Lovegrove
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Patrick J Lammie
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Allen W Hightower
- Division of Parasitic Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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