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Kargbo-Labour I, Bah MS, Melchers NVSV, Conteh A, Redwood-Sawyerr V, Stolk WA, Paye J, Sonnie M, Veinoglou A, Koroma JB, Hodges MH, Weaver AM, Zhang Y. Impact assessment of onchocerciasis through lymphatic filariasis transmission assessment surveys using Ov-16 rapid diagnostic tests in Sierra Leone. Parasit Vectors 2024; 17:121. [PMID: 38468307 PMCID: PMC10926616 DOI: 10.1186/s13071-024-06198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/15/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Onchocerciasis is endemic in 14 of Sierra Leone's 16 districts with high prevalence (47-88.5%) according to skin snips at baseline. After 11 rounds of mass treatment with ivermectin with good coverage, an impact assessment was conducted in 2017 to assess the progress towards eliminating onchocerciasis in the country. METHODS A cluster survey was conducted, either integrated with lymphatic filariasis (LF) transmission assessment survey (TAS) or standalone with the LF TAS sampling strategy in 12 (now 14) endemic districts. Finger prick blood samples of randomly selected children in Grades 1-4 were tested in the field using SD Bioline Onchocerciasis IgG4 rapid tests. RESULTS In total, 17,402 children aged 4-19 years in 177 schools were tested, and data from 17,364 children aged 4-14 years (14,230 children aged 5-9 years) were analyzed. Three hundred forty-six children were confirmed positive for Ov-16 IgG4 antibodies, a prevalence of 2.0% (95% CI 1.8-2.2%) in children aged 4-14 years with prevalence increasing with age. Prevalence in boys (2.4%; 95% CI 2.1-2.7%) was higher than in girls (1.6%; 95% CI 1.4-1.9%). There was a trend of continued reduction from baseline to 2010. Using data from children aged 5-9 years, overall prevalence was 1.7% (95% CI 1.5-1.9%). The site prevalence ranged from 0 to 33.3% (median prevalence = 0.0%): < 2% in 127 schools, 2 to < 5% in 34 schools and ≥ 5% in 16 schools. There was a significant difference in average prevalence between districts. Using spatial analysis, the Ov-16 IgG4 antibody prevalence was predicted to be < 2% in coastal areas and in large parts of Koinadugu, Bombali and Tonkolili Districts, while high prevalence (> 5%) was predicted in some focal areas, centered in Karene, Kailahun and Moyamba/Tonkolili. CONCLUSIONS Low Ov-16 IgG4 antibody prevalence was shown in most areas across Sierra Leone. In particular, low seroprevalence in children aged 5-9 years suggests that the infection was reduced to a low level after 11 rounds of treatment intervention. Sierra Leone has made major progress towards elimination of onchocerciasis. However, attention must be paid to those high prevalence focal areas.
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Affiliation(s)
- Ibrahim Kargbo-Labour
- National Neglected Tropical Disease Control Programme, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Natalie V S Vinkeles Melchers
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Social Sciences, Health and Society, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Abdulai Conteh
- National Neglected Tropical Disease Control Programme, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jusufu Paye
- Helen Keller International, Freetown, Sierra Leone
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2
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Oyeyemi OT, Ogundahunsi O, Schunk M, Fatem RG, Shollenberger LM. Neglected tropical disease (NTD) diagnostics: current development and operations to advance control. Pathog Glob Health 2024; 118:1-24. [PMID: 37872790 PMCID: PMC10769148 DOI: 10.1080/20477724.2023.2272095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Neglected tropical diseases (NTDs) have become important public health threats that require multi-faceted control interventions. As late treatment and management of NTDs contribute significantly to the associated burdens, early diagnosis becomes an important component for surveillance and planning effective interventions. This review identifies common NTDs and highlights the progress in the development of diagnostics for these NTDs. Leveraging existing technologies to improve NTD diagnosis and improving current operational approaches for deployment of developed diagnostics are crucial to achieving the 2030 NTD elimination target. Point-of-care NTD (POC-NTD) diagnostic tools are recommended preferred diagnostic options in resource-constrained areas for mapping risk zones and monitoring treatment efficacy. However, few are currently available commercially. Technical training of remote health care workers on the use of POC-NTD diagnostics, and training of health workers on the psychosocial consequences of these diagnostics are critical in harnessing POC-NTD diagnostic potential. While the COVID-19 pandemic has challenged the possibility of achieving NTD elimination in 2030 due to the disruption of healthcare services and dwindling financial support for NTDs, the possible contribution of NTDs in exacerbating COVID-19 pandemic should motivate NTD health system strengthening.
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Affiliation(s)
- Oyetunde T. Oyeyemi
- Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo, Nigeria
- Department of Biological Sciences, Old Dominion University, Virginia, USA
| | - Olumide Ogundahunsi
- The Central Office for Research and Development (CORD), University of Medical Sciences, Ondo, Nigeria
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU) institution, Munich, Germany
| | - Ramzy G. Fatem
- Schistosome Biological Supply Center, Theodor Bilharz Research Institute, Giza, Egypt
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Rosa BA, Curtis K, Erdmann Gilmore P, Martin J, Zhang Q, Sprung R, Weil GJ, Townsend RR, Fischer PU, Mitreva M. Direct Proteomic Detection and Prioritization of 19 Onchocerciasis Biomarker Candidates in Humans. Mol Cell Proteomics 2022; 22:100454. [PMID: 36435333 PMCID: PMC9792368 DOI: 10.1016/j.mcpro.2022.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/30/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Onchocerca volvulus, the causative agent of onchocerciasis, infects over 20 million people and can cause severe dermatitis and ocular conditions including blindness. Current treatments employed in mass drug administration programs do not kill adult female worms, and common diagnostic tests cannot reliably assess viability of adult worms. There is an urgent need for better diagnostic tests to facilitate monitoring the efficacy of new treatments and disease elimination efforts. Here, eight plasma samples collected from individuals infected with O. volvulus and seven from uninfected individuals were analyzed by MS/MS spectrometry to directly identify O. volvulus proteins present in infected but absent in uninfected control samples. This direct proteomic approach for biomarker discovery had not been previously employed for onchocerciasis. Among all detected proteins, 19 biomarker candidates were supported by two or more unique peptides, identified in the plasma of at least three O. volvulus-infected human samples and absent in all control samples. Comprehensive analysis and ranking of these candidates included detailed functional annotation and a review of RNA-seq gene expression profiles. Isotope-labeled standard peptides were run in parallel and validated MS/MS peptide identifications for 15 peptides from 11 of the 19 proteins, and two infected urine and one uninfected urine sample was used for additional validation. A major antigen/OVOC11613 was identified as the most promising candidate with eight unique peptides across five plasma samples and one urine sample. Additional strong candidates included OVOC1523/ATP synthase, OVOC247/laminin and OVOC11626/PLK5, and along with OVOC11613, and were also detected in urine samples from onchocerciasis patients. This study has identified a promising novel set of proteins that will be carried forward to develop assays that can be used for diagnosis of O. volvulus infections and for monitoring treatment efficacy.
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Affiliation(s)
- Bruce A. Rosa
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Kurt Curtis
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Petra Erdmann Gilmore
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - John Martin
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Qiang Zhang
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Robert Sprung
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Gary J. Weil
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - R. Reid Townsend
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Peter U. Fischer
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Makedonka Mitreva
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA,Department of Genetics, Washington University School of Medicine, St Louis, Missouri, USA,McDonnell Genome Institute, Washington University School of Medicine, St Louis, Missouri, USA,For correspondence: Makedonka Mitreva
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4
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Coulibaly YI, Sangare M, Dolo H, Soumaoro L, Coulibaly SY, Dicko I, Diabaté AF, Diarra L, Coulibaly ME, Doumbia SS, Diallo AA, Dembele M, Koudou BG, Bockarie MJ, Kelly-Hope LA, Klion AD, Nutman TB. No evidence of lymphatic filariasis transmission in Bamako urban setting after three mass drug administration rounds. Parasitol Res 2022; 121:3243-3248. [PMID: 36066741 PMCID: PMC9556341 DOI: 10.1007/s00436-022-07648-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022]
Abstract
Lymphatic filariasis (LF) elimination activities started in Mali in 2005 in the most endemic areas and reached countrywide coverage in 2009. In 2004, the district of Bamako was endemic for LF with a prevalence of 1.5%. The current study was designed to determine LF endemicity level in the urban area of Bamako after three rounds of ivermectin and albendazole mass drug administration (MDA). A cross-sectional study was conducted in 2011 in Bamako city, consisting of human prevalence and entomological surveys. Volunteers aged 14 years and above were invited to participate and tested for evidence of Wuchereria bancrofti using night time blood thick smear microfilarial count and blood spots for LF antibodies using the SD BIOLINE Oncho/LF IgG4 Biplex rapid test (Ov16/Wb123). Mosquitoes were collected using CDC light and gravid traps and tested using molecular methods. Poolscreen software v2.0 was used to estimate vector transmission potential. Of the 899 volunteers, one (0.11%) was found to be positive for LF using the Oncho/LF IgG4 Biplex rapid test, and none was found to have Wuchereria bancrofti microfilariae. No mosquitoes were found infected among 6174 Culex spp. (85.2%), 16 Anopheles gambiae s.l. (An. gambiae s.l.) (0.2%), 26 Aedes spp. (0.4%), 858 Ceratopogonidae (11.8%) and 170 other insects not identified (2.3%) tested. Our data indicate that there was no active LF transmission in the low prevalence urban district of Bamako after three MDA rounds. These data helped the National LF programme move forward towards the elimination goal.
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Affiliation(s)
- Yaya Ibrahim Coulibaly
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.,Dermatology Hospital of Bamako, Bamako, Mali
| | - Moussa Sangare
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali. .,Interdisciplinary School of Health Sciences
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
| | - Housseini Dolo
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Lamine Soumaoro
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Siaka Yamoussa Coulibaly
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Ilo Dicko
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Abdoul Fatao Diabaté
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Lamine Diarra
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Michel Emmanuel Coulibaly
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Salif Seriba Doumbia
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Abdallah Amadou Diallo
- Mali - International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Massitan Dembele
- National Lymphatic Filariasis Elimination Program, Ministry of Health and Public Hygiene, Bamako, Mali
| | - Benjamin G Koudou
- Centre Suisse de Recherche Scientifiques en Côte d'Ivoire, 01 BP 1303 Abidjan 01, Abidjan, Côte d'Ivoire.,UFR Science de la Nature, Université Nangui Abrogoua, 02 BP 801 Abidjan 01, Abidjan, Côte d'Ivoire
| | | | - Louise A Kelly-Hope
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, 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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Sears WJ, Nutman TB. Strongy Detect: Preliminary Validation of a Prototype Recombinant Ss-NIE/Ss-IR Based ELISA to Detect Strongyloides stercoralis Infection. PLoS Negl Trop Dis 2022; 16:e0010126. [PMID: 35077470 PMCID: PMC8789141 DOI: 10.1371/journal.pntd.0010126] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Strongyloides stercoralis (Ss) is the etiological agent of strongyloidiasis, a neglected tropical disease of global concern. Laboratory diagnosis of strongyloidiasis is most often based on detection of antibodies against antigens in an enzyme linked immunosorbent assay (ELISA). Herein, we report a preliminary validation study of newly developed IgG4- and/or IgG- based ELISAs to detect strongyloidiasis (Strongy Detect, InBios) incorporating a cocktail of 2 previously described recombinant antigens, Ss-NIE and Ss-IR.
Methods
The sensitivity and specificity were determined by using the assay in 150 cryopreserved serum samples from humans known to be Ss infected (n = 74), helminth uninfected (n = 47), or infected with a helminth other than Ss [n = 29). The treatment associated dynamics of antibody detection were then assessed using 35 paired samples obtained before and after definitive therapy.
Results
The IgG and IgG4 assays were 99% and 96% sensitive, respectively, and 99% and 100% specific, respectively. Neither the IgG or IgG4 assay showed cross reactions with sera from those infected with other helminths. Although ELISA values did decline post-treatment few returned to levels below the cutoff for infection.
Conclusion
Strongy Detect is the most sensitive and specific commercialized immunoassay for detection of strongyloidiasis. The assay remains positive for greater than a year post-treatment.
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Affiliation(s)
- William J. Sears
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
- * E-mail:
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
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6
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Lagatie O, Batsa Debrah L, Debrah AY, Stuyver LJ. Whole blood transcriptome analysis in onchocerciasis. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 2:100100. [PMID: 36082138 PMCID: PMC9445278 DOI: 10.1016/j.crpvbd.2022.100100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022]
Abstract
Identifying the molecular mechanisms controlling the host’s response to infection with Onchocerca volvulus is important to understand how the human host controls such parasitic infection. Little is known of the cellular immune response upon infection with O. volvulus. We performed a transcriptomic study using PAXgene-preserved whole blood from 30 nodule-positive individuals and 21 non-endemic controls. It was found that of the 45,042 transcripts that were mapped to the human genome, 544 were found to be upregulated and 447 to be downregulated in nodule-positive individuals (adjusted P-value < 0.05). Pathway analysis was performed on this set of differentially expressed genes, which demonstrated an impact on oxidative phosphorylation and protein translation. Upstream regulator analysis showed that the mTOR associated protein RICTOR appears to play an important role in inducing the transcriptional changes in infected individuals. Functional analysis of the genes affected by infection indicated a suppression of antibody response, Th17 immune response and proliferation of activated T lymphocytes. Multiple regression models were used to select 22 genes that could contribute significantly in the generation of a classifier to predict infection with O. volvulus. For these 22 genes, as well as for 8 reference target genes, validated RT-qPCR assays were developed and used to re-analyze the discovery sample set. These data were used to perform elastic net regularized logistic regression and a panel of 7 genes was found to be the best performing classifier. The resulting algorithm returns a value between 0 and 1, reflecting the predicted probability of being infected. A validation panel of 69 nodule-positive individuals and 5 non-endemic controls was used to validate the performance of this classifier. Based on this validation set only, a sensitivity of 94.2% and a specificity of 60.0% was obtained. When combining the discovery test set and validation set, a sensitivity of 96.0% and a specificity of 92.3% was obtained. Large-scale validation approaches will be necessary to define the intended use for this classifier. Besides the use as marker for infection in MDA efficacy surveys and epidemiological transmission studies, this classifier might also hold potential as pharmacodynamic marker in macrofilaricide clinical trials. Whole blood transcriptome analysis was performed in onchocerciasis patients. Suppression of antibodies, Th17, and proliferation of activated T cells. RICTOR plays an important role in inducing the transcriptional changes. A 7-gene expression classifier was built as a tool for onchocerciasis detection.
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Affiliation(s)
- Ole Lagatie
- Johnson & Johnson Global Public Health, Janssen R&D, Turnhoutseweg 30, 2340 Beerse, Belgium
- Corresponding author.
| | - Linda Batsa Debrah
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alex Y. Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lieven J. Stuyver
- Johnson & Johnson Global Public Health, Janssen R&D, Turnhoutseweg 30, 2340 Beerse, Belgium
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Lagatie O, Njumbe Ediage E, Van Roosbroeck D, Van Asten S, Verheyen A, Batsa Debrah L, Debrah A, Odiere MR, T’Kindt R, Dumont E, Sandra K, Dillen L, Verhaeghe T, Vreeken R, Cuyckens F, Stuyver LJ. Multimodal biomarker discovery for active Onchocerca volvulus infection. PLoS Negl Trop Dis 2021; 15:e0009999. [PMID: 34843471 PMCID: PMC8659328 DOI: 10.1371/journal.pntd.0009999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/09/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022] Open
Abstract
The neglected tropical disease onchocerciasis, or river blindness, is caused by infection with the filarial nematode Onchocerca volvulus. Current estimates indicate that 17 million people are infected worldwide, the majority of them living in Africa. Today there are no non-invasive tests available that can detect ongoing infection, and that can be used for effective monitoring of elimination programs. In addition, to enable pharmacodynamic studies with novel macrofilaricide drug candidates, surrogate endpoints and efficacy biomarkers are needed but are non-existent. We describe the use of a multimodal untargeted mass spectrometry-based approach (metabolomics and lipidomics) to identify onchocerciasis-associated metabolites in urine and plasma, and of specific lipid features in plasma of infected individuals (O. volvulus infected cases: 68 individuals with palpable nodules; lymphatic filariasis cases: 8 individuals; non-endemic controls: 20 individuals). This work resulted in the identification of elevated concentrations of the plasma metabolites inosine and hypoxanthine as biomarkers for filarial infection, and of the urine metabolite cis-cinnamoylglycine (CCG) as biomarker for O. volvulus. During the targeted validation study, metabolite-specific cutoffs were determined (inosine: 34.2 ng/ml; hypoxanthine: 1380 ng/ml; CCG: 29.7 ng/ml) and sensitivity and specificity profiles were established. Subsequent evaluation of these biomarkers in a non-endemic population from a different geographical region invalidated the urine metabolite CCG as biomarker for O. volvulus. The plasma metabolites inosine and hypoxanthine were confirmed as biomarkers for filarial infection. With the availability of targeted LC-MS procedures, the full potential of these 2 biomarkers in macrofilaricide clinical trials, MDA efficacy surveys, and epidemiological transmission studies can be investigated. Today’s diagnosis of infection with the filarial parasite Onchocerca volvulus mainly depends on the microscopic analysis of skin biopsies and serological testing. The work presented here describes the use of multiple mass spectrometry-based screening methods (metabolomics and lipidomics) to search for biomarkers indicative of infection with Onchocerca volvulus. This resulted in the identification of elevated concentrations of the plasma metabolites inosine and hypoxanthine as biomarkers for filarial infection, and of the urine metabolite cis-cinnamoylglycine as biomarker for O. volvulus. Further evaluation of these biomarkers in a geographically distinct non-endemic population however invalidated the use of urine cis-cinnamoylglycine. These findings are of utmost importance as it not only opens new avenues in the development of non-invasive diagnostic tools for filarial infections, but also emphasizes the need for evaluation and validation of newly discovered biomarkers in different populations from different geographies.
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Affiliation(s)
- Ole Lagatie
- J&J Global Public Health, Janssen R&D, Beerse, Belgium
- * E-mail:
| | | | | | | | - Ann Verheyen
- J&J Global Public Health, Janssen R&D, Beerse, Belgium
| | - Linda Batsa Debrah
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alex Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Maurice R. Odiere
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Ruben T’Kindt
- Research Institute for Chromatography (RIC), Kortrijk, Belgium
| | - Emmie Dumont
- Research Institute for Chromatography (RIC), Kortrijk, Belgium
| | - Koen Sandra
- Research Institute for Chromatography (RIC), Kortrijk, Belgium
| | - Lieve Dillen
- Discovery Sciences, Janssen R&D, Beerse, Belgium
| | | | - Rob Vreeken
- Discovery Sciences, Janssen R&D, Beerse, Belgium
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8
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Pastor AF, Silva MR, Dos Santos WJT, Rego T, Brandão E, de-Melo-Neto OP, Rocha A. Recombinant antigens used as diagnostic tools for lymphatic filariasis. Parasit Vectors 2021; 14:474. [PMID: 34526120 PMCID: PMC8442287 DOI: 10.1186/s13071-021-04980-3] [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] [Received: 06/02/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Lymphatic filariasis (LF) is a parasitic disease caused by the worms Wuchereria bancrofti, Brugia malayi, or Brugia timori. It is a tropical and subtropical illness that affects approximately 67 million people worldwide and that still requires better diagnostic tools to prevent its spread and enhance the effectiveness of control procedures. Traditional parasitological tests and diagnostic methods based on whole protein extracts from different worms are known for problems related to sample time collection, sensitivity, and specificity. More recently, new diagnostic tools based on immunological methods using recombinant antigens have been developed. The current review describes the several recombinant antigens used as tools for lymphatic filariasis diagnosis in antigen and antibody capture assays, highlighting their advantages and limitations as well as the main commercial tests developed based on them. The literature chronology is from 1991 to 2021. First, it describes the historical background related to the identification of relevant antigens and the generation of the recombinant polypeptides used for the LF diagnosis, also detailing features specific to each antigen. The subsequent section then discusses the use of those proteins to develop antigen and antibody capture tests to detect LF. So far, studies focusing on antibody capture assays are based on 13 different antigens with at least six commercially available tests, with five proteins further used for the development of antigen capture tests. Five antigens explored in this paper belong to the SXP/RAL-2 family (BmSXP, Bm14, WbSXP-1, Wb14, WbL), and the others are BmShp-1, Bm33, BmR1, BmVAH, WbVAH, BmALT-1, BmALT-2, and Wb123. It is expected that advances in research with these antigens will allow further development of tests combining both sensitivity and specificity with low costs, assisting the Global Program to Eliminate Lymphatic Filariasis (GPELF). ![]()
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Affiliation(s)
- André Filipe Pastor
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brazil. .,Instituto Federal de Educação, Ciência e Tecnologia do Sertão Pernambucano (IFSertao-PE), Campus Floresta, Floresta, PE, Brazil.
| | | | | | - Tamisa Rego
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brazil
| | - Eduardo Brandão
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brazil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Serviço de Referência Nacional em Filarioses, Recife, PE, Brazil
| | | | - Abraham Rocha
- Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Recife, PE, Brazil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Aggeu Magalhães, Serviço de Referência Nacional em Filarioses, Recife, PE, Brazil.,Laboratório do Hospital Otávio de Freitas, Secretaria de Saúde do Estado de Pernambuco, Recife, PE, Brazil
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9
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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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Niamsi-Emalio Y, Nana-Djeunga HC, Chesnais CB, Pion SDS, Tchatchueng-Mbougua JB, Boussinesq M, Basáñez MG, Kamgno J. Unusual Localization of Blood-Borne Loa loa Microfilariae in the Skin Depends on Microfilarial Density in the Blood: Implications for Onchocerciasis Diagnosis in Coendemic Areas. Clin Infect Dis 2021; 72:S158-S164. [PMID: 33909066 PMCID: PMC8201578 DOI: 10.1093/cid/ciab255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background The diagnostic gold standard for onchocerciasis relies on identification and enumeration of (skin-dwelling) Onchocerca volvulus microfilariae (mf) using the skin snip technique (SST). In a recent study, blood-borne Loa loa mf were found by SST in individuals heavily infected with L. loa, and microscopically misidentified as O. volvulus due to their superficially similar morphology. This study investigates the relationship between L. loa microfilarial density (Loa MFD) and the probability of testing SST positive. Methods A total of 1053 participants from the (onchocerciasis and loiasis coendemic) East Region in Cameroon were tested for (1) Loa MFD in blood samples, (2) O. volvulus presence by SST, and (3) Immunoglobulin (Ig) G4 antibody positivity to Ov16 by rapid diagnostic test (RDT). A Classification and Regression Tree (CART) model was used to perform a supervised classification of SST status and identify a Loa MFD threshold above which it is highly likely to find L. loa mf in skin snips. Results Of 1011 Ov16-negative individuals, 28 (2.8%) tested SST positive and 150 (14.8%) were L. loa positive. The range of Loa MFD was 0–85 200 mf/mL. The CART model subdivided the sample into 2 Loa MFD classes with a discrimination threshold of 4080 (95% CI, 2180–12 240) mf/mL. The probability of being SST positive exceeded 27% when Loa MFD was >4080 mf/mL. Conclusions The probability of finding L. loa mf by SST increases significantly with Loa MFD. Skin-snip polymerase chain reaction would be useful when monitoring onchocerciasis prevalence by SST in onchocerciasis–loiasis coendemic areas.
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Affiliation(s)
- Yannick Niamsi-Emalio
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon
| | - Hugues C Nana-Djeunga
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon
| | - Cédric B Chesnais
- Institut de Recherche pour le Développement (IRD), UMI233/INSERM U1175, Université de Montpellier , Montpellier, France
| | - Sébastien D S Pion
- Institut de Recherche pour le Développement (IRD), UMI233/INSERM U1175, Université de Montpellier , Montpellier, France
| | - Jules B Tchatchueng-Mbougua
- Service d'Epidémiologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun
| | - Michel Boussinesq
- Institut de Recherche pour le Développement (IRD), UMI233/INSERM U1175, Université de Montpellier , Montpellier, France
| | - María-Gloria Basáñez
- MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected Tropical Disease Research, Dep artment of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Joseph Kamgno
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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11
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Wanji S, Deribe K, Minich J, Debrah AY, Kalinga A, Kroidl I, Luguet A, Hoerauf A, Ritter M. Podoconiosis - From known to unknown: Obstacles to tackle. Acta Trop 2021; 219:105918. [PMID: 33839086 DOI: 10.1016/j.actatropica.2021.105918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022]
Abstract
Podoconiosis is a non-filarial and non-communicable disease leading to lymphedema of the lower limbs. Worldwide, 4 million individuals live with podoconiosis, which is accompanied by disability and painful intermittent acute inflammatory episodes that attribute to significant disability adjusted life years (DALYs). Different risk factors like contact with volcanic red clay soil, high altitude (above 1000 m), high seasonal rainfall (above 1000 mm/year) and occupation (e.g., subsistence farmer) are associated with the risk of podoconiosis. Although podoconiosis was described to be endemic in 32 countries in Africa, parts of Latin America and South East Asia, knowledge about related genetics, pathophysiology, immunology and especially the causing molecule(s) in the soil remain uncertain. Thus, podoconiosis can be considered as one of the most neglected diseases. This review provides an overview about this non-filarial related geochemical disease and aim to present perspectives and future directions that might be important for better understanding of the disease, prospect for point-of-care diagnosis, achieving protection and developing novel treatment strategies.
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12
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Deribe K, Florence L, Kelemework A, Getaneh T, Tsegay G, Cano J, Giorgi E, Newport MJ, Davey G. Developing and validating a clinical algorithm for the diagnosis of podoconiosis. Trans R Soc Trop Med Hyg 2021; 114:916-925. [PMID: 33174588 PMCID: PMC7738664 DOI: 10.1093/trstmh/traa074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/06/2020] [Accepted: 08/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Difficulties in reliably diagnosing podoconiosis have severely limited the scale-up and uptake of the World Health Organization-recommended morbidity management and disability prevention interventions for affected people. We aimed to identify a set of clinical features that, combined into an algorithm, allow for diagnosis of podoconiosis. METHODS We identified 372 people with lymphoedema and administered a structured questionnaire on signs and symptoms associated with podoconiosis and other potential causes of lymphoedema in northern Ethiopia. All individuals were tested for Wuchereria bancrofti-specific immunoglobulin G4 in the field using Wb123. RESULTS Based on expert diagnosis, 344 (92.5%) of the 372 participants had podoconiosis. The rest had lymphoedema due to other aetiologies. The best-performing set of symptoms and signs was the presence of moss on the lower legs and a family history of leg swelling, plus the absence of current or previous leprosy, plus the absence of swelling in the groin, plus the absence of chronic illness (such as diabetes mellitus or heart or kidney diseases). The overall sensitivity of the algorithm was 91% (95% confidence interval [CI] 87.6 to 94.4) and specificity was 95% (95% CI 85.45 to 100). CONCLUSIONS We developed a clinical algorithm of clinical history and physical examination that could be used in areas suspected or endemic for podoconiosis. Use of this algorithm should enable earlier identification of podoconiosis cases and scale-up of interventions.
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Affiliation(s)
- Kebede Deribe
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, PO Box 9086, Ethiopia
| | - Lyndsey Florence
- King's College Hospital NHS Foundation Trust, Denmark Hill SE5 9RS, London, UK
| | - Abebe Kelemework
- International Orthodox Christian Charities, PO Box 495 Bahir Dar, Ethiopia
| | - Tigist Getaneh
- International Orthodox Christian Charities, PO Box 495 Bahir Dar, Ethiopia
| | - Girmay Tsegay
- College of Medicine and Health Sciences, Debre Markos University, PO Box 269, Debre Markos, Ethiopia
| | - Jorge Cano
- Department of Disease Control, London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - Emanuele Giorgi
- CHICAS Research Group, Lancaster Medical School, Lancaster University, Bailrigg, LA1 4YW, Lancaster, UK
| | - Melanie J Newport
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK
| | - Gail Davey
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, PO Box 9086, Ethiopia
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13
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Bharadwaj M, Bengtson M, Golverdingen M, Waling L, Dekker C. Diagnosing point-of-care diagnostics for neglected tropical diseases. PLoS Negl Trop Dis 2021; 15:e0009405. [PMID: 34138846 PMCID: PMC8211285 DOI: 10.1371/journal.pntd.0009405] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inadequate and nonintegrated diagnostics are the Achilles' heel of global efforts to monitor, control, and eradicate neglected tropical diseases (NTDs). While treatment is often available, NTDs are endemic among marginalized populations, due to the unavailability or inadequacy of diagnostic tests that cause empirical misdiagnoses. The need of the hour is early diagnosis at the point-of-care (PoC) of NTD patients. Here, we review the status quo of PoC diagnostic tests and practices for all of the 24 NTDs identified in the World Health Organization's (WHO) 2021-2030 roadmap, based on their different diagnostic requirements. We discuss the capabilities and shortcomings of current diagnostic tests, identify diagnostic needs, and formulate prerequisites of relevant PoC tests. Next to technical requirements, we stress the importance of availability and awareness programs for establishing PoC tests that fit endemic resource-limited settings. Better understanding of NTD diagnostics will pave the path for setting realistic goals for healthcare in areas with minimal resources, thereby alleviating the global healthcare burden.
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Affiliation(s)
- Mitasha Bharadwaj
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Michel Bengtson
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Mirte Golverdingen
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Loulotte Waling
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Cees Dekker
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
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Brattig NW, Cheke RA, Garms R. Onchocerciasis (river blindness) - more than a century of research and control. Acta Trop 2021; 218:105677. [PMID: 32857984 DOI: 10.1016/j.actatropica.2020.105677] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/06/2020] [Accepted: 08/21/2020] [Indexed: 12/14/2022]
Abstract
This review summarises more than a century of research on onchocerciasis, also known as river blindness, and its control. River blindness is an infection caused by the tissue filaria Onchocerca volvulus affecting the skin, subcutaneous tissue and eyes and leading to blindness in a minority of infected persons. The parasite is transmitted by its intermediate hosts Simulium spp. which breed in rivers. Featured are history and milestones in onchocerciasis research and control, state-of-the-art data on the parasite, its endobacteria Wolbachia, on the vectors, previous and current prevalence of the infection, its diagnostics, the interaction between the parasite and its host, immune responses and the pathology of onchocerciasis. Detailed information is documented on the time course of control programmes in the afflicted countries in Africa and the Americas, a long road from previous programmes to current successes in control of the transmission of this infectious disease. By development, adjustment and optimization of the control measures, transmission by the vector has been interrupted in foci of countries in the Americas, in Uganda, in Sudan and elsewhere, followed by onchocerciasis eliminations. The current state and future perspectives for control, elimination and eradication within the next 20-30 years are described and discussed. This review contributes to a deeper comprehension of this disease by a tissue-dwelling filaria and it will be helpful in efforts to control and eliminate other filarial infections.
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15
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Dolo H, Coulibaly YI, Sow M, Dembélé M, Doumbia SS, Coulibaly SY, Sangare MB, Dicko I, Diallo AA, Soumaoro L, Coulibaly ME, Diarra D, Colebunders R, Nutman TB, Walker M, Basáñez MG. Serological Evaluation of Onchocerciasis and Lymphatic Filariasis Elimination in the Bakoye and Falémé Foci, Mali. Clin Infect Dis 2021; 72:1585-1593. [PMID: 32206773 PMCID: PMC8096229 DOI: 10.1093/cid/ciaa318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Indexed: 11/14/2022] Open
Abstract
Background Ivermectin-based onchocerciasis elimination, reported in 2009–2012, for Bakoye and Falémé, Mali, supported policy-shifting from morbidity control to elimination of transmission (EOT). These foci are coendemic with lymphatic filariasis (LF). In 2007–2016 mass ivermectin plus albendazole administration was implemented. We report Ov16 (onchocerciasis) and Wb123 (LF) seroprevalence after 24–25 years of treatment to determine if onchocerciasis EOT and LF elimination as a public health problem (EPHP) have been achieved. Methods The SD Bioline Onchocerciasis/LF Ig[immunoglobulin]G4 biplex rapid diagnostic test (RDT) was used in 2186 children aged 3–10 years in 13 villages (plus 2 hamlets) in Bakoye and in 2270 children in 15 villages (plus 1 hamlet) in Falémé. In Bakoye, all-age serosurveys were conducted in 3 historically hyperendemic villages (1867 individuals aged 3 -78 years). Results In Bakoye, IgG4 seropositivity was 0.27% (95% confidence interval [CI] = .13%–.60%) for both Ov16 and Wb123 antigens. In Falémé, Ov16 and Wb123 seroprevalence was 0.04% (95% CI = .01%–.25%) and 0.09% (95% CI = .02%–.32%), respectively. Ov16-seropositive children were from historically meso/hyperendemic villages. Ov16 positivity was <2% in ≤14 year-olds, and 16% in ≥40 year-olds. Wb123 seropositivity was <2% in ≤39 year-olds, reaching 3% in ≥40 year-olds. Conclusions Notwithstanding uncertainty in the biplex RDT sensitivity, Ov16 and Wb123 seroprevalence among children in Bakoye and Falémé is consistent with EOT (onchocerciasis) and EPHP (LF) since stopping treatment in 2016. The few Ov16-seropositive children should be skin-snip polymerase chain reaction tested and followed up.
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Affiliation(s)
- Housseini Dolo
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali.,Global Health Institute, University of Antwerp, Antwerp, Belgium
| | - Yaya I Coulibaly
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali.,Centre National d'Appui à la lutte contre la Maladie, Bamako, Mali
| | - Moussa Sow
- Programme National de Lutte contre l'Onchocercose, Bamako, Mali
| | - Massitan Dembélé
- Programme National d'Elimination de la Filariose Lymphatique, Bamako, Mali
| | - Salif S Doumbia
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Siaka Y Coulibaly
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Moussa B Sangare
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Ilo Dicko
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Abdallah A Diallo
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Lamine Soumaoro
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Michel E Coulibaly
- Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | | | | | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Martin Walker
- Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research, Royal Veterinary College, Hatfield, United Kingdom
| | - Maria-Gloria Basáñez
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, MRC Centre for Global Infectious Disease Analysis, Imperial College London, United Kingdom
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Drews SJ, Spencer BR, Wendel S, Bloch EM. Filariasis and transfusion-associated risk: a literature review. Vox Sang 2021; 116:741-754. [PMID: 33491765 DOI: 10.1111/vox.13073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/19/2020] [Accepted: 12/28/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Filariae are parasitic worms that include the pathogens Loa loa, Onchocerca volvulus, Wuchereria bancrofti, Brugia spp. and Mansonella spp. which are endemic in parts of Africa, Asia, Asia-Pacific, South and Central America. Filariae have a wide clinical spectrum spanning asymptomatic infection to chronic debilitating disease including blindness and lymphedema. Despite successful eradication programmes, filarial infections remain an important -albeit neglected - source of morbidity. We sought to characterize the risk of transfusion transmission of microfilaria with a view to guide mitigation practices in both endemic and non-endemic countries. MATERIALS AND METHODS A scoping review of scientific publications as well as grey literature was carried out by a group of domain experts in microbiology, transfusion medicine and infectious diseases, representing the parasite subgroup of the International Society of Blood Transfusion. RESULTS Cases of transfusion-transmitted filariasis are rare and confined to case reports of variable quality. Transfusion-associated adverse events related to microfilariae are confined to isolated reports of transfusion reactions. Serious outcomes have not been reported. No known strategies have been implemented, specifically, to mitigate transfusion-transmitted filariasis yet routine blood donor screening for other transfusion-transmissible infections (e.g. hepatitis B, malaria) may indirectly defer donors with microfilaremia in endemic areas. CONCLUSION Rare examples of transfusion-transmitted filariasis, without serious clinical effect, suggest that filariasis poses low transfusion risk. Dedicated mitigation strategies against filarial transfusion transmission are not recommended. Given endemicity in low-resource regions, priority should be on the control of filariasis with public health measures.
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Affiliation(s)
- Steven J Drews
- Canadian Blood Services, Microbiology, Donor and Clinical Services, Edmonton, AB, Canada.,Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | | | - Silvano Wendel
- Banco de Sangue Medical Director, Blood Bank, Hospital Sirio Libanês, São Paulo, Brasil
| | - Evan M Bloch
- Department of Pathology, Transfusion Medicine Division, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Lakwo T, Oguttu D, Ukety T, Post R, Bakajika D. Onchocerciasis Elimination: Progress and Challenges. Res Rep Trop Med 2020; 11:81-95. [PMID: 33117052 PMCID: PMC7548320 DOI: 10.2147/rrtm.s224364] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/16/2020] [Indexed: 01/08/2023] Open
Abstract
Onchocerciasis is a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted through the bites of black flies of the genus Similium that breed in rivers and streams. The impact of mass treatment with ivermectin and supplemented by vector control in some countries has changed the global scene of onchocerciasis. There has been reported progress made in elimination of onchocerciasis in central and southern American countries and in some localities in Africa. The target for elimination in the Americas has been set at 2022 while for 12 countries in Africa this is expected in 2030. This review was conducted to examine the current status of onchocerciasis elimination at the global level and report on progress made. Literature searches were made through PubMed, articles in English or English abstracts, reports and any other relevant articles related to the subject. The global burden of onchocerciasis is progressively reducing and is no longer a public health problem in some regions. However, programs are challenged with a range of issues: cross-border transmission, diagnostic tools, Loa loa co-endemicity, limited workforce in entomology and maintaining enthusiasm among community drug distributors. More concerted effort using appropriate tools is required to overcome the challenges.
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Affiliation(s)
- Thomson Lakwo
- Neglected Tropical Disease Control Program, Vector Control Division, Ministry of Health, Kampala, Uganda
| | - David Oguttu
- Neglected Tropical Disease Control Program, Vector Control Division, Ministry of Health, Kampala, Uganda
| | - Tony Ukety
- Centre de Recherche pour les Maladies Tropicales, Rethy, Ituri Province, The Democratic Republic of the Congo
| | - Rory Post
- Disease Control Department, London School of Hygiene & Tropical Medicine, London, UK.,School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Didier Bakajika
- Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Congo
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Taylor EM. NTD Diagnostics for Disease Elimination: A Review. Diagnostics (Basel) 2020; 10:E375. [PMID: 32517108 PMCID: PMC7344624 DOI: 10.3390/diagnostics10060375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/07/2020] [Accepted: 06/02/2020] [Indexed: 11/16/2022] Open
Abstract
Neglected Tropical Diseases (NTDs) marked out for disease elimination provide a lens through which to explore the changing status of diagnosis in global health. This paper reports on the findings of a scoping review, which set out to explore the main debates around diagnosis for the elimination of NTDs, including the multiple roles diagnostic technologies are being ascribed and the ideal characteristics of tests. It also attempts to summarise the state of diagnosis for three NTDs with elimination goals. The review places special emphasis on point-of-care testing in acknowledgement of the remote and underserved areas where NTDs proliferate. Early NTD campaigns were largely focused on attack phase planning, whereby a similar set of interventions could be transplanted anywhere. Now, with elimination goals in sight, strategies must be tailored to local settings if they are to attain and sustain success. Diagnostic data helps with local adaptation and is increasingly used for programmatic decision-making. The review finds that elimination goals reframe whom diagnosis is for and the myriad roles diagnostics can play. The exigencies of elimination also serve to highlight deficiencies in the current diagnostic arsenal and development pipeline for many NTDs. Moving forward, a guiding framework is needed to drive research and stimulate investment in diagnosis to support NTD goals.
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Affiliation(s)
- Emma Michelle Taylor
- Department of Social Anthropology, University of Edinburgh, Edinburgh EH8 9LD, UK
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Richards FO, Eigege A, Umaru J, Kahansim B, Adelamo S, Kadimbo J, Danboyi J, Mafuyai H, Saka Y, Noland GS, Anyaike C, Igbe M, Rakers L, Griswold E, Unnasch TR, Nwoke BEB, Miri E. The Interruption of Transmission of Human Onchocerciasis by an Annual Mass Drug Administration Program in Plateau and Nasarawa States, Nigeria. Am J Trop Med Hyg 2020; 102:582-592. [PMID: 32043442 PMCID: PMC7056427 DOI: 10.4269/ajtmh.19-0577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Plateau and Nasarawa states in central Nigeria were endemic for onchocerciasis. The rural populations of these two states received annual ivermectin mass drug administration (MDA) for a period of 8–26 years (1992–2017). Ivermectin combined with albendazole was given for 8–13 of these years for lymphatic filariasis (LF); the LF MDA program successfully concluded in 2012, but ivermectin MDA continued in areas known to have a baseline meso-/hyperendemic onchocerciasis. In 2017, serological and entomological assessments were undertaken to determine if MDA for onchocerciasis could be stopped in accordance with the current WHO guidelines. Surveys were conducted in 39 sites that included testing 5- to < 10-year-old resident children by using ELISA for OV16 IgG4 antibodies, and Onchocerca volvulus O150 pooled polymerase chain reaction (PCR) testing of Simulium damnosum s.l. vector heads. Only two of 6,262 children were OV16 positive, and none of 19,056 vector heads were positive for parasite DNA. Therefore, both states were able to meet WHO stop-MDA thresholds of an infection rate in children of < 0.1% and a rate of infective blackflies of <1/2,000, with 95% statistical confidence. Transmission of onchocerciasis was declared interrupted in Plateau and Nasarawa states by the Federal Ministry of Health, and 2.2 million ivermectin treatments/year were stopped in 2018. Post-treatment Surveillance was launched focusing on entomological monitoring on borders with neighboring onchocerciasis-endemic states. An apparent positive impact of the LF MDA program on eliminating hypo-endemic onchocerciasis was observed. This is the first stop-MDA decision for onchocerciasis in Nigeria and the largest single stop-MDA decision for onchocerciasis yet reported. This achievement, along with the process used in adapting and implementing the 2016 WHO stop-MDA guidelines, will be important as a potential model for decision makers and national onchocerciasis elimination committees in other African countries that are charged with advancing their programs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yisa Saka
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | | | - Chukwuma Anyaike
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Michael Igbe
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
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Lagatie O, Granjon E, Odiere MR, Zrein M, Stuyver LJ. Assessment of multiplex Onchocerca volvulus peptide ELISA in non-endemic tropical regions. Parasit Vectors 2019; 12:570. [PMID: 31783767 PMCID: PMC6884800 DOI: 10.1186/s13071-019-3824-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Currently, serodiagnosis of infection with the helminth parasite Onchocerca volvulus is limited to the Ov-16 IgG4 test, a test that has limited sensitivity and suboptimal specificity. In previous studies, we identified several linear epitopes that have the potential to supplement the diagnostic toolbox for onchocerciasis. METHODS In this study three peptides, bearing in total six linear epitopes were transferred to a multiplex ELISA platform. This multiplex ELISA was used to assess the clinical utility of the peptide serology markers by analyzing sample sets from both O. volvulus endemic and non-endemic regions. RESULTS The multiplex platform was shown to be reproducible and data obtained on the multiplex platform were comparable to the singleplex ELISA data. The clinical utility assessment showed that in a population of school-aged children from western Kenya, a virtually O. volvulus-free area, significant cross-reactivity with an as-yet to be determined immunogen was detected. CONCLUSIONS The observations made in this study invalidate the usefulness of the peptide serology markers for onchocerciasis detection. We discuss what could be the origin of this unexpected serological response, but also highlight the need for better characterized biobanks for biomarker discovery activities.
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Affiliation(s)
- Ole Lagatie
- Janssen Global Public Health, Turnhoutseweg 30, 2340, Beerse, Belgium.
| | - Elodie Granjon
- InfYnity Biomarkers, 78 rue du Bourbonnais, 69009, Lyon, France
| | - Maurice R Odiere
- Kenya Medical Research Institute, Centre for Global Health Research, P. O. Box 1578, 40100, Kisumu, Kenya
| | - Maan Zrein
- InfYnity Biomarkers, 78 rue du Bourbonnais, 69009, Lyon, France
| | - Lieven J Stuyver
- Janssen Global Public Health, Turnhoutseweg 30, 2340, Beerse, Belgium
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Coffeng LE, Stolk WA, Golden A, de los Santos T, Domingo GJ, de Vlas SJ. Predictive Value of Ov16 Antibody Prevalence in Different Subpopulations for Elimination of African Onchocerciasis. Am J Epidemiol 2019; 188:1723-1732. [PMID: 31062838 PMCID: PMC6735885 DOI: 10.1093/aje/kwz109] [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: 07/23/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 12/02/2022] Open
Abstract
The World Health Organization currently recommends assessing elimination of onchocerciasis by testing whether Ov16 antibody prevalence in children aged 0–9 years is below 0.1%. However, the certainty of evidence for this recommendation is considered to be low. We used the established ONCHOSIM model to investigate the predictive value of different Ov16-antibody prevalence thresholds in various age groups for elimination of onchocerciasis in a variety of endemic settings and for various mass drug administration scenarios. According to our simulations, the predictive value of Ov16 antibody prevalence for elimination depends highly on the precontrol epidemiologic situation, history of mass drug administration, the age group that is sampled, and the chosen Ov16-antibody prevalence threshold. The Ov16 antibody prevalence in children aged 5–14 years performs best in predicting elimination. Appropriate threshold values for this age group start at 2.0% for very highly endemic areas; for lower-endemic areas, even higher threshold values are safe to use. Guidelines can be improved by sampling school-aged children, which also is operationally more feasible than targeting children under age 10 years. The use of higher threshold values allows sampling of substantially fewer children. Further improvement can be achieved by taking a differentiated sampling approach based on precontrol endemicity.
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Affiliation(s)
- Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | | | | | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Gebrezgabiher G, Mekonnen Z, Yewhalaw D, Hailu A. Reaching the last mile: main challenges relating to and recommendations to accelerate onchocerciasis elimination in Africa. Infect Dis Poverty 2019; 8:60. [PMID: 31269966 PMCID: PMC6609392 DOI: 10.1186/s40249-019-0567-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 06/10/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Onchocerciasis (river blindness), caused by the filarial worm species Onchocerca volvulus, is a serious vector-borne neglected tropical disease (NTD) of public health and socioeconomic concern. It is transmitted through the bite of black flies of the genus Simulium, and manifested in dermal and ocular lesions. Ninety-nine percent of the total global risk and burden of onchocerciasis is in Africa. This scoping review examines the key challenges related to the elimination of onchocerciasis by 2020-2025 in Africa, and proposes recommendations to overcome the challenges and accelerate disease elimination. To find relevant articles published in peer-reviewed journals, a search of PubMed and Google Scholar databases was carried out. MAIN TEXT Rigorous regional interventions carried out to control and eliminate onchocerciasis in the past four decades in Africa have been effective in bringing the disease burden under control; it is currently not a public health problem in most endemic areas. Notably, transmission of the parasite is interrupted in some hyperendemic localities. Recently, there has been a policy shift from control to complete disease elimination by 2020 in selected countries and by 2025 in the majority of endemic African countries. The WHO has published guidelines for stopping mass drug administration (MDA) and verifying the interruption of transmission and elimination of human onchocerciasis. Therefore, countries have revised their plans, established a goal of disease elimination in line with an evidence based decision to stop MDA and verify elimination, and incorporated it into their NTDs national master plans. Nevertheless, challenges remain pertaining to the elimination of onchocerciasis in Africa. The challenge we review in this paper are: incomplete elimination mapping of all transmission zones, co-endemicity of onchocerciasis and loiasis, possible emergence of ivermectin resistance, uncoordinated cross-border elimination efforts, conflict and civil unrest, suboptimal program implementation, and technical and financial challenges. This paper also proposes recommendations to overcome the challenges and accelerate disease elimination. These are: a need for complete disease elimination mapping, a need for collaborative elimination activities between national programs, a need for a different drug distribution approach in conflict-affected areas, a need for routine monitoring and evaluation of MDA programs, a need for implementing alternative treatment strategies (ATSs) in areas with elimination anticipated beyond 2025, and a need for strong partnerships and continued funding. CONCLUSIONS National programs need to regularly monitor and evaluate the performance and progress of their interventions, while envisaging the complete elimination of onchocerciasis from their territory. Factors hindering the targeted goal of interruption of parasite transmission need to be identified and remedial actions should be taken. If possible and appropriate, ATSs need to be implemented to accelerate disease elimination by 2025.
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Affiliation(s)
- Gebremedhin Gebrezgabiher
- School of Medical Laboratory Sciences, Institute of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
- College of Veterinary Medicine, Samara University, Samara, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Institute of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Rebollo MP, Zoure H, Ogoussan K, Sodahlon Y, Ottesen EA, Cantey PT. Onchocerciasis: shifting the target from control to elimination requires a new first-step-elimination mapping. Int Health 2019; 10:i14-i19. [PMID: 29471341 PMCID: PMC5881272 DOI: 10.1093/inthealth/ihx052] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/11/2017] [Indexed: 11/13/2022] Open
Abstract
The meaning of 'mapping' in relation to onchocerciasis has changed at least three times over the past 50 years as the programmatic goals and the assessment tools have changed. With the current goal being global elimination of Onchocerca volvulus (OV), all areas where OV might currently be transmitted and where mass drug administration (MDA) with ivermectin treatment has not been delivered previously must now be identified by careful, detailed 'elimination mapping' as either OV endemic or not, so that appropriate programmatic targets can be established. New tools and strategies for such elimination mapping have become available, though ongoing studies must still be completed to define agreed upon optimal diagnostic evaluation units, sampling strategies and serologic tools. With detailed guidance and technical support from the World Health Organization and with implementation and financial support from their global partners, the OV-endemic countries of Africa can soon complete their elimination mapping and then continue with MDA programmes to progressively achieve the same success in OV elimination as that already achieved by the growing list of formerly OV-endemic countries in the Americas.
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Affiliation(s)
- Maria P Rebollo
- Expanded Special Project for Elimination of NTDs, Decatur, GA, USA
| | - Honorat Zoure
- Expanded Special Project for Elimination of NTDs, Decatur, GA, USA
| | - Kisito Ogoussan
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, USA
| | - Yao Sodahlon
- Mectizan Donation Program, Task Force for Global Health, Decatur, Georgia, USA
| | - Eric A Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, Georgia, USA
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Wanji S, Esum ME, Njouendou AJ, Mbeng AA, Chounna Ndongmo PW, Abong RA, Fru J, Fombad FF, Nchanji GT, Ngongeh G, Ngandjui NV, Enyong PI, Storey H, Curtis KC, Fischer K, Fauver JR, Lew D, Goss CW, Fischer PU. Mapping of lymphatic filariasis in loiasis areas: A new strategy shows no evidence for Wuchereria bancrofti endemicity in Cameroon. PLoS Negl Trop Dis 2019; 13:e0007192. [PMID: 30849120 PMCID: PMC6436748 DOI: 10.1371/journal.pntd.0007192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 03/27/2019] [Accepted: 01/28/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mapping of lymphatic filariasis (LF) caused by Wuchereria bancrofti largely relies on the detection of circulating antigen using ICT cards. Several studies have recently shown that this test can be cross-reactive with sera of subjects heavily infected with Loa loa and thus mapping results in loiasis endemic areas may be inaccurate. METHODOLOGY/PRINCIPAL FINDINGS In order to develop an LF mapping strategy for areas with high loiasis prevalence, we collected day blood samples from 5,001 subjects residing in 50 villages that make up 6 health districts throughout Cameroon. Antigen testing using Filarial Test Strip (FTS, a novel platform that uses the same reagents as ICT) revealed an overall positivity rate of 1.1% and L. loa microfilaria (Mf) rates of up to 46%. Among the subjects with 0 to 8,000 Mf/ml in day blood, only 0.4% were FTS positive, while 22.2% of subjects with >8,000 Mf/ml were FTS positive. A Mf density of >8,200 Mf/ml was determined as the cut point at which positive FTS results should be excluded from the analysis. No FTS positive samples were also positive for W. bancrofti antibodies as measured by two different point of care tests that use the Wb123 antigen not found in L. loa. Night blood examination of the FTS positive subjects showed a high prevalence of L. loa Mf with densities up to 12,710 Mf/ml. No W. bancrofti Mf were identified, as confirmed by qPCR. Our results show that high loads of L. loa Mf in day blood are a reliable indicator of FTS positivity, and Wb123 rapid test proved to be relatively specific. CONCLUSIONS/SIGNIFICANCE Our study provides a simple day blood-based algorithm for LF mapping in loiasis areas. The results indicate that many districts that were formerly classified as endemic for LF in Cameroon are non-endemic and do not require mass drug administration for elimination of LF.
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Affiliation(s)
- Samuel Wanji
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
- * E-mail:
| | - Mathias Eyong Esum
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Abdel Jelil Njouendou
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Amuam Andrew Mbeng
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Patrick W. Chounna Ndongmo
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Raphael Awah Abong
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Jerome Fru
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Fanny F. Fombad
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Gordon Takop Nchanji
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Glory Ngongeh
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Narcisse V. Ngandjui
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Peter Ivo Enyong
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Helen Storey
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Kurt C. Curtis
- Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Kerstin Fischer
- Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Joseph R. Fauver
- Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Daphne Lew
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Charles W. Goss
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Peter U. Fischer
- Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
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Vlaminck J, Lagatie O, Verheyen A, Dana D, Van Dorst B, Mekonnen Z, Levecke B, Stuyver LJ. Patent infections with soil-transmitted helminths and Schistosoma mansoni are not associated with increased prevalence of antibodies to the Onchocerca volvulus peptide epitopes OvMP-1 and OvMP-23. Parasit Vectors 2019; 12:63. [PMID: 30691520 PMCID: PMC6350367 DOI: 10.1186/s13071-019-3308-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 01/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ov16 serology is considered a reference method for Onchocerca volvulus epidemiological mapping. Given the suboptimal sensitivity of this test and the fact that seroconversion takes more than a year after infection, additional serological tests might be needed to guide onchocerciasis elimination programmes. Recently, two linear epitopes encoded in OvMP-1 and OvMP-23 peptides were introduced as serological markers, but the observed antibody cross-reactivity in samples originating from Onchocerca volvulus non-endemic areas required further investigation. METHODS We evaluated both peptide markers in an O. volvulus hypo-endemic setting in Jimma Town, Ethiopia using peptide ELISA. For all individuals (n = 303), the infection status with soil-transmitted helminths and Schistosoma mansoni was known. RESULTS We found that 11 (3.6%) individuals were positive for anti-Ov16 IgG4 antibodies, while 34 (11.2%) and 15 (5.0%) individuals were positive for OvMP-1 and OvMP-23, respectively. Out of the 34 OvMP-1 positive samples, 33 were negative on the Ov16 IgG4 ELISA. Similarly, out of the 15 OvMP-23 positive samples, 14 scored negative on this reference method. No difference in seroprevalence for all three markers could be observed between uninfected individuals and individuals infected with different soil-transmitted helminths or S. mansoni. Moreover, the intensity of the response to OvMP-1, OvMP-23 or Ov16 was not significantly stronger in individuals carrying patent STH or S. mansoni infections, nor was there any correlation between the intensities of the responses to the three different antigens. CONCLUSIONS This study demonstrates that a patent infection with either soil-transmitted helminths or S. mansoni does not lead to increased antibody recognition of both OvMP-1 and OvMP23.
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Affiliation(s)
- Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, University of Ghent, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Ole Lagatie
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium.
| | - Ann Verheyen
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Daniel Dana
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Bieke Van Dorst
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, University of Ghent, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Lieven J Stuyver
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
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Dolo H, Coulibaly YI, Dembele B, Guindo B, Coulibaly SY, Dicko I, Doumbia SS, Dembele M, Traore MO, Goita S, Dolo M, Soumaoro L, Coulibaly ME, Diallo AA, Diarra D, Zhang Y, Colebunders R, Nutman TB. Integrated seroprevalence-based assessment of Wuchereria bancrofti and Onchocerca volvulus in two lymphatic filariasis evaluation units of Mali with the SD Bioline Onchocerciasis/LF IgG4 Rapid Test. PLoS Negl Trop Dis 2019; 13:e0007064. [PMID: 30699120 PMCID: PMC6370230 DOI: 10.1371/journal.pntd.0007064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/11/2019] [Accepted: 12/08/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mali has become increasingly interested in the evaluation of transmission of both Wuchereria bancrofti and Onchocerca volvulus as prevalences of both infections move toward their respective elimination targets. The SD Bioline Onchocerciasis/LF IgG4 Rapid Test was used in 2 evaluation units (EU) to assess its performance as an integrated surveillance tool for elimination of lymphatic filariasis (LF) and onchocerciasis. METHODOLOGY/PRINCIPAL FINDINGS A cross sectional survey with SD Bioline Onchocerciasis/LF IgG4 Rapid Test was piggy-backed onto a transmission assessment survey (TAS) (using the immunochromatographic card test (ICT) Binax Filariasis Now test for filarial adult circulating antigen (CFA) detection) for LF in Mali among 6-7 year old children in 2016 as part of the TAS in two EUs namely Kadiolo-Kolondieba in the region of Sikasso and Bafoulabe -Kita-Oussoubidiagna-Yelimane in the region of Kayes. In the EU of Kadiolo- Kolondieba, of the 1,625 children tested, the overall prevalence of W. bancrofti CFA was 0.62% (10/1,625) [CI = 0.31-1.09]; while that of IgG4 to Wb123 was 0.19% (3/1,600) [CI = 0.04-0.50]. The number of positives tested with the two tests were statistically comparable (p = 0.09). In the EU of Bafoulabe-Kita-Oussoubidiagna-Yelimane, an overall prevalence of W. bancrofti CFA was 0% (0/1,700) and that of Wb123 IgG4 antibody was 0.06% (1/1,700), with no statistically significant difference between the two rates (p = 0.99). In the EU of Kadiolo- Kolondieba, the prevalence of Ov16-specific IgG4 was 0.19% (3/1,600) [CI = 0.04-0.50]. All 3 positives were in the previously O. volvulus-hyperendemic district of Kolondieba. In the EU of Bafoulabe-Kita-Oussoubidiagna-Yelimane, an overall prevalence of Ov16-specific IgG4 was 0.18% (3/1,700) [CI = 0.04-0.47]. These 3 Ov16 IgG4 positives were from previously O.volvulus-mesoendemic district of Kita. CONCLUSIONS/SIGNIFICANCE The SD Bioline Onchocerciasis/LF IgG4 Rapid test appears to be a good tool for integrated exposure measures of LF and onchocerciasis in co-endemic areas.
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Affiliation(s)
- Housseini Dolo
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
- Global Health Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Yaya Ibrahim Coulibaly
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
- Centre National d’Appui à la Lutte contre la Maladie, Bamako, Mali
| | - Benoit Dembele
- Neglected Tropical Diseases Control Programme, Helen Keller Iinternational Bamako, Mali
| | - Boubacar Guindo
- Neglected Tropical Diseases Control Programme, Helen Keller Iinternational Bamako, Mali
| | - Siaka Yamoussa 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
| | - Salif Seriba Doumbia
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Massitan Dembele
- Programme National d’Elimination de la Filariose Lymphatique, Bamako, Mali
| | | | - Seydou Goita
- Neglected Tropical Diseases Control Programme, Helen Keller Iinternational Bamako, Mali
| | - Mamadou Dolo
- Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Lamine Soumaoro
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Michel Emmanuel Coulibaly
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Abdallah Amadou Diallo
- Filariasis Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | | | - Yaobi Zhang
- Helen Keller International, Regional Office for Africa, Dakar, Senegal
| | - Robert Colebunders
- Global Health Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, United States of America
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de Souza DK, Otchere J, Ahorlu CS, Adu-Amankwah S, Larbi IA, Dumashie E, McCarthy FA, King SA, Otoo S, Osabutey D, Osei JHN, Sedzro KM, Asiedu O, Dadzie SK, Ayi I, Marfo B, Biritwum NK, Boakye DA. Low Microfilaremia Levels in Three Districts in Coastal Ghana with at Least 16 Years of Mass Drug Administration and Persistent Transmission of Lymphatic Filariasis. Trop Med Infect Dis 2018; 3:tropicalmed3040105. [PMID: 30274501 PMCID: PMC6306872 DOI: 10.3390/tropicalmed3040105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 11/16/2022] Open
Abstract
Ghana has been implementing mass drug administration (MDA) of ivermectin and albendazole for the elimination of lymphatic filariasis (LF) since the year 2000, as part of the Global Programme to Eliminate Lymphatic Filariasis (GPELF). It was estimated that 5⁻6 years of treatment would be sufficient to eliminate the disease. Tremendous progress has been made over the years, and treatment has stopped in many disease endemic districts. However, despite the successful implementation of MDA, there are districts with persistent transmission. In this study we assessed the epidemiology of LF in three adjoining districts that have received at least 16 years of MDA. The assessments were undertaken one year after the last MDA. 1234 adults and 182 children below the age of 10 years were assessed. The overall prevalence of circulating filarial antigen in the study participants was 8.3% (95% CI: 6.9⁻9.9), with an estimated microfilaria prevalence of 1.2%. The microfilarial intensity in positive individuals ranged from 1 to 57 microfilariae/mL of blood. Higher antigen prevalence was detected in males (13.0%; 95% CI: 10.3⁻16.2) compared to females (5.5%; 95% CI: 4.1⁻7.2). The presence of infection was also highest in individuals involved in outdoor commercial activities, with the risks of infection being four- to five-fold higher among farmers, fishermen, drivers and artisans, compared to all other occupations. Using bednets or participating in MDA did not significantly influence the risk of infection. No children below the age of 10 years were found with infection. Detection of Wb123 antibodies for current infections indicated a prevalence of 14.4% (95% CI: 8.1⁻23.0) in antigen-positive individuals above 10 years of age. No antibodies were detected in children 10 years or below. Assessment of infection within the An. gambiae vectors of LF indicated an infection rate of 0.9% (95% CI: 0.3⁻2.1) and infectivity rate of 0.5% (95% CI: 0.1⁻1.6). These results indicate low-level transmission within the districts, and suggest that it will require targeted interventions in order to eliminate the infection.
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Affiliation(s)
- Dziedzom K de Souza
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Joseph Otchere
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Collins S Ahorlu
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Susan Adu-Amankwah
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Irene A Larbi
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Edward Dumashie
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Frances A McCarthy
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Sandra A King
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Samson Otoo
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Dickson Osabutey
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Joseph H N Osei
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Kojo M Sedzro
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Odame Asiedu
- Neglected Tropical Diseases Programme, Ghana Health Service, Accra, Ghana.
| | - Samuel K Dadzie
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Irene Ayi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
| | - Benjamin Marfo
- Neglected Tropical Diseases Programme, Ghana Health Service, Accra, Ghana.
| | | | - Daniel A Boakye
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon-Accra, Ghana.
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Murdoch ME. Onchodermatitis: Where Are We Now? Trop Med Infect Dis 2018; 3:E94. [PMID: 30274490 PMCID: PMC6160948 DOI: 10.3390/tropicalmed3030094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 02/07/2023] Open
Abstract
Onchocerciasis causes debilitating pruritus and rashes as well as visual impairment and blindness. Prior to control measures, eye disease was particularly prominent in savanna areas of sub-Saharan Africa whilst skin disease was more common across rainforest regions of tropical Africa. Mass drug distribution with ivermectin is changing the global scene of onchocerciasis. There has been successful progressive elimination in Central and Southern American countries and the World Health Organization has set a target for elimination in Africa of 2025. This literature review was conducted to examine progress regarding onchocercal skin disease. PubMed searches were performed using keywords 'onchocerciasis', 'onchodermatitis' and 'onchocercal skin disease' over the past eight years. Articles in English, or with an English abstract, were assessed for relevance, including any pertinent references within the articles. Recent progress in awareness of, understanding and treatment of onchocercal skin disease is reviewed with particular emphasis on publications within the past five years. The global burden of onchodermatitis is progressively reducing and is no longer seen in children in many formerly endemic foci.
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Affiliation(s)
- Michele E Murdoch
- Department of Dermatology, West Herts Hospitals NHS Trust, Vicarage Road, Watford, Hertfordshire WD18 0HB, UK.
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29
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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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30
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Prince-Guerra JL, Cama VA, Wilson N, Thiele EA, Likwela J, Ndakala N, Muzinga Wa Muzinga J, Ayebazibwe N, Ndjakani YD, Pitchouna NA, Mumba D, Tshefu AK, Ogawa G, Cantey PT. Comparison of PCR Methods for Onchocerca volvulus Detection in Skin Snip Biopsies from the Tshopo Province, Democratic Republic of the Congo. Am J Trop Med Hyg 2018; 98:1427-1434. [PMID: 29611501 DOI: 10.4269/ajtmh.17-0809] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Defining the optimal diagnostic tools for evaluating onchocerciasis elimination efforts in areas co-endemic for other filarial nematodes is imperative. This study compared three published polymerase chain reaction (PCR) methods: the Onchocerca volvulus-specific qPCR-O150, the pan-filarial qPCR melt curve analysis (MCA), and the O150-PCR enzyme-linked immunosorbent assay (ELISA) currently used for vector surveillance in skin snip biopsies (skin snips) collected from the Democratic Republic of the Congo. The pan-filarial qPCR-MCA was compared with species-specific qPCRs for Loa loa and Mansonella perstans. Among the 471 skin snips, 47.5%, 43.5%, and 27.0% were O. volvulus positive by qPCR-O150, qPCR-MCA, and O150-PCR ELISA, respectively. Using qPCR-O150 as the comparator, the sensitivity and specificity of qPCR-MCA were 89.3% and 98.0%, respectively, whereas for O150-PCR ELISA, they were 56.7% and 100%, respectively. Although qPCR-MCA identified the presence of L. loa and Mansonella spp. in skin snips, species-specific qPCRs had greater sensitivity and were needed to identify M. perstans. Most of the qPCR-MCA misclassifications occurred in mixed infections. The reduced sensitivity of O150-PCR ELISA was associated with lower microfilaria burden and with lower amounts of O. volvulus DNA. Although qPCR-MCA identified most of the O. volvulus-positive skin snips, it is not sufficiently robust to be used for stop-mass drug administration (MDA) evaluations in areas co-endemic for other filariae. Because O150-PCR ELISA missed 43.3% of qPCR-O150-positive skin snips, the qPCR-O150 assay is more appropriate for evaluating skin snips of OV-16 + children in stop-MDA assessments. Although improving the sensitivity of the O150-PCR ELISA as an alternative to qPCR might be possible, qPCR-O150 offers distinct advantages aside from increased sensitivity.
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Affiliation(s)
- Jessica L Prince-Guerra
- American Society for Microbiology/Centers for Disease Control and Prevention Postdoctoral Research Fellowship, Atlanta, Georgia
| | - Vitaliano A Cama
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nana Wilson
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth A Thiele
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Josias Likwela
- Programme National de la Lutte contre l'Onchocercose, Kisangani, Congo, Democratic Republic of the Congo
| | - Nestor Ndakala
- Field Epidemiology and Laboratory Training Program, Kinshasa, Democratic Republic of the Congo
| | | | | | - Yassa D Ndjakani
- Division of Global Health Protection, Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Naomi A Pitchouna
- Programme Nationale de la Lutte contre l'Onchocercose, Kinshasa, Democratic Republic of the Congo
| | - Dieudonne Mumba
- Institut National de Recherche Biomédicale, Kinshasa, Congo, Democratic Republic of the Congo
| | | | - Guilherme Ogawa
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul T Cantey
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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31
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Affiliation(s)
- Katherine M. Gass
- Neglected Tropical Disease Support Center, The Task Force for Global Health, Decatur, Georgia, United States of America
- * E-mail:
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32
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Mahdy MAK, Abdul-Ghani R, Abdulrahman TAA, Al-Eryani SMA, Al-Mekhlafi AM, Alhaidari SAA, Azazy AA. Onchocerca volvulus infection in Tihama region - west of Yemen: Continuing transmission in ivermectin-targeted endemic foci and unveiled endemicity in districts with previously unknown status. PLoS Negl Trop Dis 2018; 12:e0006329. [PMID: 29505580 PMCID: PMC5854432 DOI: 10.1371/journal.pntd.0006329] [Citation(s) in RCA: 6] [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: 12/03/2017] [Revised: 03/15/2018] [Accepted: 02/20/2018] [Indexed: 11/29/2022] Open
Abstract
Background Onchocerciasis in Yemen is one of the most neglected diseases, where baseline estimates of onchocerciasis and monitoring of the impact of ivermectin regularly administered to the affected individuals on its transmission are lacking. Therefore, this study aimed to determine the anti-Ov16 IgG4 seroprevalence among local communities of Hodeidah and Al-Mahwit governorates of Tihama region. The factors possibly associated with previous exposure to infection were also studied. Methodology/Principal findings This cross-sectional study was conducted in two ivermectin-targeted districts endemic for onchocerciasis in Hodeidah and Al-Mahwit and two untargeted districts with unknown previous endemicity in Hodeidah between February and July 2017. For 508 residents sampled by a multi-stage random approach, data were collected and blood specimens were screened for anti-Ov16 IgG4 using the SD BIOLINE Onchocerciasis IgG4 rapid tests. The study revealed an overall anti-Ov16 IgG4 rate of 18.5% (94/508) in all surveyed districts, with 10.2% (12/118) of children aged ≤10 years being seropositive. Moreover, rates of 8.0% (4/50) and 6.1% (4/66) were found in districts not officially listed as endemic for the disease. Multivariable analysis confirmed the age of more than ten years and residing within a large family as the independent predictors of exposure to infection. Conclusions/Significance Onchocerciasis transmission is still ongoing as supported by the higher anti-Ov16 IgG4 seroprevalence rate among children aged ≤10 years compared to that (<0.1%) previously set by the World Health Organization as a serologic criterion for transmission interruption. Further large-scale studies combining serologic and entomologic criteria are recommended for the mapping of O. volvulus in human and blackfly populations in endemic foci and their neighboring areas of uncertain endemicity. In addition, ivermectin distribution, coverage and impact on disease transmission need to be continually assessed. Onchocerciasis is endemic in certain foci in the western governorates of Yemen. Monitoring the impact of the regular ivermectin administration to affected individuals on the transmission status and providing baseline onchocerciasis estimates in endemic areas are crucial for planning effective elimination strategies. We found that the disease transmission is still ongoing in Hodeidah and Al-Mahwit governorates of Tihama region as indicated by the anti-Ov16 IgG4 seropositivity among children aged ≤10 years. In Bani Sa'ad, where affected individuals had been regularly targeted with ivermectin over the last 15 years, we found that the anti-Ov16 IgG4 seroprevalence rate was significantly lower among children aged ≤10 years (9.1%; 5/55) compared to those >10 years (24.5%; 37/151), reflecting a possible decline in disease transmission. We also revealed onchocerciasis transmission in districts with unknown previous endemicity for the first time, with rates of 8.0% and 6.1% being found in Al Marawi'ah and As Sukhnah districts of Hodeidah. Large-scale surveys are recommended for mapping of O. volvulus in human and blackfly populations in endemic foci and neighboring untargeted areas of uncertain endemicity as a forward step towards the elimination of the disease from the country.
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Affiliation(s)
- Mohammed A. K. Mahdy
- Tropical Disease Research Center, University of Science and Technology, Sana’a, Yemen
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
- * E-mail:
| | - Rashad Abdul-Ghani
- Tropical Disease Research Center, University of Science and Technology, Sana’a, Yemen
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | | | - Samira M. A. Al-Eryani
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Abdulsalam M. Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Sami A. A. Alhaidari
- National Schistosomiasis and Parasites Control Program, Ministry of Public Health and Population, Sana’a, Yemen
| | - Ahmed A. Azazy
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, KSA
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Kamgno J, Nana-Djeunga HC, Pion SD, Chesnais CB, Klion AD, Mackenzie CD, Nutman TB, Boussinesq M. Operationalization of the test and not treat strategy to accelerate the elimination of onchocerciasis and lymphatic filariasis in Central Africa. Int Health 2018; 10:i49-i53. [PMID: 29471340 PMCID: PMC6282645 DOI: 10.1093/inthealth/ihx051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/20/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022] Open
Abstract
After 30 years of treatment with Mectizan (ivermectin), cutaneous and ocular complications of Onchocerca volvulus infection are now scarce in endemic communities. Indeed, transmission has been interrupted and the O. volvulus- associated disease has disappeared in some African foci. Despite this success, onchocerciasis elimination in Loa loa co-endemic areas is still constrained by severe adverse events (SAEs) occurring after ivermectin treatment in some individuals harbouring very high L. loa microfilaremia. One approach towards the prevention of these SAEs is to identify individuals with high L. loa microfilaremia and exclude them from ivermectin treatment. The development of the LoaScope has provided the tool that underlies this test and not treat (TaNT) strategy. The first successful TaNT campaign was conducted in a L. loa highly endemic focus in Cameroon in 2015 without any SAEs. To accomplish this within a research setting, 60 people were deployed for this campaign, making this 'research' strategy not sustainable from a cost perspective. We describe here a way of reducing the cost of the TaNT strategy with a smaller team (three people) selected within affected communities. We also suggest the organization of a TaNT campaign in affected countries.
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Affiliation(s)
- Joseph Kamgno
- Centre for Research on Filariasis and Other Tropical Diseases, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | - Sébastien D Pion
- IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France
| | - Cédric B Chesnais
- IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France
| | - Amy D Klion
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | | | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Michel Boussinesq
- IRD UMI 233-INSERM U1175-Montpellier University, Montpellier, France
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34
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Unnasch TR, Golden A, Cama V, Cantey PT. Diagnostics for onchocerciasis in the era of elimination. Int Health 2018; 10:i20-i26. [PMID: 29471336 PMCID: PMC5881263 DOI: 10.1093/inthealth/ihx047] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 10/19/2017] [Accepted: 11/06/2017] [Indexed: 12/31/2022] Open
Abstract
In the past few years, efforts to eliminate onchocerciasis from Africa have intensified. These efforts are primarily based on the mass distribution of the anti-helminthic drug Mectizan™ (ivermectin). This program has led to the development of new guidelines by the World Health Organization for the verification that transmission has been suppressed and eventually eliminated. The requirements of diagnostic tools for this purpose differ in many ways from tests used to diagnose infection in individuals. In this review, we summarize the progress that has been made to identify diagnostics that meet the specialized requirements needed to verify onchocerciasis elimination, discuss why these tests were selected and summarize the needs that still exist to complete the arsenal of diagnostic tools that will be useful as the goal of elimination is achieved.
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Affiliation(s)
- Thomas R Unnasch
- Center for Global Health Infectious Disease Research, College of Public Health, University of South Florida, 3720 Spectrum Blvd., Suite 304, Tampa, FL 33612, USA
| | | | - Vitaliano Cama
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GAUSA
| | - Paul T Cantey
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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35
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Deribe K, Beng AA, Cano J, Njouendo AJ, Fru-Cho J, Awah AR, Eyong ME, Chounna Ndongmo PW, Giorgi E, Pigott DM, Golding N, Pullan RL, Noor AM, Enquselassie F, Murray CJL, Brooker SJ, Hay SI, Enyong P, Newport MJ, Wanji S, Davey G. Mapping the geographical distribution of podoconiosis in Cameroon using parasitological, serological, and clinical evidence to exclude other causes of lymphedema. PLoS Negl Trop Dis 2018; 12:e0006126. [PMID: 29324858 PMCID: PMC5764238 DOI: 10.1371/journal.pntd.0006126] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/21/2017] [Indexed: 11/20/2022] Open
Abstract
Background Podoconiosis is a non-filarial elephantiasis, which causes massive swelling of the lower legs. It was identified as a neglected tropical disease by WHO in 2011. Understanding of the geographical distribution of the disease is incomplete. As part of a global mapping of podoconiosis, this study was conducted in Cameroon to map the distribution of the disease. This mapping work will help to generate data on the geographical distribution of podoconiosis in Cameroon and contribute to the global atlas of podoconiosis. Methods We used a multi‐stage sampling design with stratification of the country by environmental risk of podoconiosis. We sampled 76 villages from 40 health districts from the ten Regions of Cameroon. All individuals of 15-years old or older in the village were surveyed house-to-house and screened for lymphedema. A clinical algorithm was used to reliably diagnose podoconiosis, excluding filarial-associated lymphedema. Individuals with lymphoedema were tested for circulating Wuchereria bancrofti antigen and specific IgG4 using the Alere Filariasis Test Strips (FTS) test and the Standard Diagnostics (SD) BIOLINE lymphatic filariasis IgG4 test (Wb123) respectively, in addition to thick blood films. Presence of DNA specific to W. bancrofti was checked on night blood using a qPCR technique. Principal findings Overall, 10,178 individuals from 4,603 households participated in the study. In total, 83 individuals with lymphedema were identified. Of the 83 individuals with lymphedema, two were found to be FTS positive and all were negative using the Wb123 test. No microfilaria of W. bancrofti were found in the night blood of any individual with clinical lymphedema. None were found to be positive for W. bancrofti using qPCR. Of the two FTS positive cases, one was positive for Mansonella perstans DNA, while the other harbored Loa loa microfilaria. Overall, 52 people with podoconiosis were identified after applying the clinical algorithm. The overall prevalence of podoconiosis was found to be 0.5% (95% [confidence interval] CI; 0.4–0.7). At least one case of podoconiosis was found in every region of Cameroon except the two surveyed villages in Adamawa. Of the 40 health districts surveyed, 17 districts had no cases of podoconiosis; in 15 districts, mean prevalence was between 0.2% and 1.0%; and in the remaining eight, mean prevalence was between 1.2% and 2.7%. Conclusions Our investigation has demonstrated low prevalence but almost nationwide distribution of podoconiosis in Cameroon. Designing a podoconiosis control program is a vital next step. A health system response to the burden of podoconiosis is important, through case surveillance and morbidity management services. Podoconiosis is a geochemical neglected tropical disease, which causes massive swelling of the lower legs and feet. Although podoconiosis is one of the major causes of lower leg swelling worldwide, understanding of the geographical distribution of the disease is incomplete. In Cameroon, few studies have been conducted, and these have indicated varied and localized distribution of the disease. We conducted this countrywide mapping survey to determine the prevalence and spatial distribution of podoconiosis in Cameroon. We undertook nationwide mapping of podoconiosis in Cameroon by surveying 10,178 individuals from 4,603 households, in 76 communities. During the survey, individuals with lymphedema underwent a rapid-format antigen antibody test, and a thick blood film (TBF) for microscopic examination, as a confirmatory tool for detecting W. bancrofti micro filarial. Peripheral night blood and parasite DNA detection was used to exclude lymphatic filariasis, and a clinical history and physical examination was conducted to diagnosis podoconiosis. The overall prevalence of podoconiosis was found to be 0.5%. At least one case of podoconiosis was found in every region of Cameroon except Adamawa, where in the two surveyed villages no cases of podoconiosis were identified. Our investigation has demonstrated low prevalence but almost nationwide distribution of podoconiosis in Cameroon. Designing a podoconiosis control program is a vital next step. A health system response to the burden of podoconiosis is important, through case surveillance and morbidity management services.
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Affiliation(s)
- Kebede Deribe
- Wellcome Trust Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, United Kingdom
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Amuam Andrew Beng
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Jorge Cano
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Abdel Jelil Njouendo
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Jerome Fru-Cho
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Abong Raphael Awah
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Mathias Esum Eyong
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Patrick W. Chounna Ndongmo
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Emanuele Giorgi
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Lancaster Medical School, Faculty of Health and Medicine Lancaster University, Lancaster, United Kingdom
| | - David M. Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States of America
| | - Nick Golding
- School of BioSciences, University of Melbourne, Parkville, Australia
- Spatial Ecology and Epidemiology Group, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Rachel L. Pullan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Abdisalan M. Noor
- Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States of America
| | - Simon J. Brooker
- Bill and Melinda Gates Foundation, Seattle, WA, United States of America
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States of America
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Peter Enyong
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Melanie J. Newport
- Wellcome Trust Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Samuel Wanji
- Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Gail Davey
- Wellcome Trust Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, United Kingdom
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Lagatie O, Verheyen A, Nijs E, Van Dorst B, Batsa Debrah L, Debrah A, Supali T, Sartono E, Stuyver LJ. Evaluation of the Diagnostic Performance of Onchocerca volvulus Linear Epitopes in a Peptide Enzyme-Linked Immunosorbent Assay. Am J Trop Med Hyg 2018; 98:779-785. [PMID: 29313477 PMCID: PMC5930915 DOI: 10.4269/ajtmh.17-0756] [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] [Indexed: 11/16/2022] Open
Abstract
Diagnostic tools for the detection of infection with Onchocerca volvulus are presently limited to microfilaria detection in skin biopsies and serological assessment using the Ov16 immunoglobulin G4 (IgG4) rapid test, both of which have limited sensitivity. We have investigated the diagnostic performance of a peptide enzyme-linked immunosorbent assay (ELISA) based on immunodominant linear epitopes previously discovered. Peptides that were used in these assays were designated O. volvulus motif peptides (OvMP): OvMP-1 (VSV-EPVTTQET-VSV), OvMP-2 (VSV-KDGEDK-VSV), OvMP-3 (VSV-QTSNLD-VSV), and the combination of the latter two, OvMP-23 (VSV-KDGEDK-VSV-QTSNLD-VSV). Sensitivity (O. volvulus infection), specificity (non-helminth infections), and cross-reactivity (helminth infections) were determined using several panels of clinical plasma isolates. OvMP-1 was found to be very sensitive (100%) and specific (98.7%), but showed substantial cross-reactivity with other helminths. Of the other peptides, OvMP-23 was the most promising peptide with a sensitivity of 92.7%, a specificity of 100%, and a cross-reactivity of 6%. It was also demonstrated that these peptides were immunoreactive to IgG but not IgG4, and there is no correlation with the Ov16 IgG4 status, making them promising candidates to complement this already available test. Combination of the Ov16 IgG4 rapid test and OvMP-23 peptide ELISA led to a sensitivity of 97.3% for the detection of O. volvulus infection, without compromising specificity and with minimal impact on cross-reactivity. The available results open the opportunity for a “clinical utility use case” discussion for improved O. volvulus epidemiological mapping.
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Affiliation(s)
- Ole Lagatie
- Janssen Diagnostics, Janssen R&D, Beerse, Belgium
| | - Ann Verheyen
- Janssen Diagnostics, Janssen R&D, Beerse, Belgium
| | - Erik Nijs
- Janssen Diagnostics, Janssen R&D, Beerse, Belgium
| | | | - Linda Batsa Debrah
- Kumasi Centre for Collaborative Research into Tropical medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alex Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Taniawati Supali
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Erliyani Sartono
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
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37
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Ritter M, Ndongmo WPC, Njouendou AJ, Nghochuzie NN, Nchang LC, Tayong DB, Arndts K, Nausch N, Jacobsen M, Wanji S, Layland LE, Hoerauf A. Mansonella perstans microfilaremic individuals are characterized by enhanced type 2 helper T and regulatory T and B cell subsets and dampened systemic innate and adaptive immune responses. PLoS Negl Trop Dis 2018; 12:e0006184. [PMID: 29324739 PMCID: PMC5783424 DOI: 10.1371/journal.pntd.0006184] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/24/2018] [Accepted: 12/20/2017] [Indexed: 11/19/2022] Open
Abstract
The filarial nematode Mansonella perstans is endemic throughout Africa, northern South America and the Caribbean. Interestingly, M. perstans-infected individuals present no distinct clinical picture associated with certain pathology. Due to its relatively silent nature, research on this tropical disease has been neglected, especially M. perstans-driven immune responses. A hindrance in obtaining data on M. perstans-specific responses has been the inability to obtain adult worms since their habitats in serous cavities are difficult to access. Thus, in this study, for the first time, we used Mansonella perstans worm antigen extract as stimulant to obtain filarial-specific recall and immunoglobulin responses from M. perstans microfilaremic individuals (Mp MF+) from Cameroon. Moreover, systemic immune profiles in sera and immune cell composition in peripheral blood from Mp MF+ and amicrofilaremic individuals (Mp MF-) were obtained. Our data reveal that Mp MF+ individuals showed significantly reduced cytokine (IL-4, IL-6 and IL-12p70) and chemokine levels (IL-8 and RANTES), but significantly higher MIP-1β as well as increased M. perstans-specific IgG4 levels compared to Mp MF- individuals. In contrast, upon re-stimulation with worm antigen extract, IFN-γ, IL-13, IL-10 and IL-17A secretion was enhanced in cell cultures from Mp MF+ individuals when compared to those from cultures of healthy European individuals. Moreover, analysis of immune cell composition in peripheral blood from Mp MF+ individuals revealed increased type 2 helper T (Th2), natural killer (NK), regulatory B and T cell (Breg and Treg) subsets but decreased type 1 regulatory T (Tr1) cells. In summary, this study deciphers for the first time, M. perstans-specific immune responses using worm antigen extract and shows that patent M. perstans infections have distinct Th2, Breg and Treg subsets accompanied with reduced systemic innate and adaptive immune responses and dominant filarial-specific IgG4 levels.
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Affiliation(s)
- Manuel Ritter
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
| | - Winston Patrick Chounna Ndongmo
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Abdel Jelil Njouendou
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Nora Nganyewo Nghochuzie
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Lucy Cho Nchang
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Dizzle Bita Tayong
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Kathrin Arndts
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
| | - Norman Nausch
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children’s Hospital, Medical Faculty, Duesseldorf, Germany
| | - Marc Jacobsen
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children’s Hospital, Medical Faculty, Duesseldorf, Germany
| | - Samuel Wanji
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Laura E. Layland
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
- German Centre for Infection Research (DZIF), partner site, Bonn-Cologne, Bonn, Germany
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
- German Centre for Infection Research (DZIF), partner site, Bonn-Cologne, Bonn, Germany
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Bennuru S, O'Connell EM, Drame PM, Nutman TB. Mining Filarial Genomes for Diagnostic and Therapeutic Targets. Trends Parasitol 2017; 34:80-90. [PMID: 29031509 DOI: 10.1016/j.pt.2017.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/12/2017] [Accepted: 09/20/2017] [Indexed: 02/04/2023]
Abstract
Filarial infections of humans cause some of the most important neglected tropical diseases. The global efforts for eliminating filarial infections by mass drug administration programs may require additional tools (safe macrofilaricidal drugs, vaccines, and diagnostic biomarkers). The accurate and sensitive detection of viable parasites is essential for diagnosis and for surveillance programs. Current community-wide treatment modalities do not kill the adult filarial worms effectively; hence, there is a need to identify and develop safe macrofilaricidal drugs. High-throughput sequencing, mass spectroscopy methods and advances in computational biology have greatly accelerated the discovery process. Here, we describe post-genomic developments toward the identification of diagnostic biomarkers and drug targets for the filarial infection of humans.
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Affiliation(s)
- Sasisekhar Bennuru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Elise M O'Connell
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Papa M Drame
- 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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Dieye Y, Storey HL, Barrett KL, Gerth-Guyette E, Di Giorgio L, Golden A, Faulx D, Kalnoky M, Ndiaye MKN, Sy N, Mané M, Faye B, Sarr M, Dioukhane EM, Peck RB, Guinot P, de los Santos T. Feasibility of utilizing the SD BIOLINE Onchocerciasis IgG4 rapid test in onchocerciasis surveillance in Senegal. PLoS Negl Trop Dis 2017; 11:e0005884. [PMID: 28972982 PMCID: PMC5640270 DOI: 10.1371/journal.pntd.0005884] [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: 04/06/2017] [Revised: 10/13/2017] [Accepted: 08/18/2017] [Indexed: 11/25/2022] Open
Abstract
As effective onchocerciasis control efforts in Africa transition to elimination efforts, different diagnostic tools are required to support country programs. Senegal, with its long standing, successful control program, is transitioning to using the SD BIOLINE Onchocerciasis IgG4 (Ov16) rapid test over traditional skin snip microscopy. The aim of this study is to demonstrate the feasibility of integrating the Ov16 rapid test into onchocerciasis surveillance activities in Senegal, based on the following attributes of acceptability, usability, and cost. A cross-sectional study was conducted in 13 villages in southeastern Senegal in May 2016. Individuals 5 years and older were invited to participate in a demographic questionnaire, an Ov16 rapid test, a skin snip biopsy, and an acceptability interview. Rapid test technicians were interviewed and a costing analysis was conducted. Of 1,173 participants, 1,169 (99.7%) agreed to the rapid test while 383 (32.7%) agreed to skin snip microscopy. The sero-positivity rate of the rapid test among those tested was 2.6% with zero positives 10 years and younger. None of the 383 skin snips were positive for Ov microfilaria. Community members appreciated that the rapid test was performed quickly, was not painful, and provided reliable results. The total costs for this surveillance activity was $22,272.83, with a cost per test conducted at $3.14 for rapid test, $7.58 for skin snip microscopy, and $13.43 for shared costs. If no participants had refused skin snip microscopy, the total cost per method with shared costs would have been around $16 per person tested. In this area with low onchocerciasis sero-positivity, there was high acceptability and perceived value of the rapid test by community members and technicians. This study provides evidence of the feasibility of implementing the Ov16 rapid test in Senegal and may be informative to other country programs transitioning to Ov16 serologic tools. As onchocerciasis control programs succeed and transition to elimination efforts, different diagnostic tools are needed. The goal of this study was to determine if integrating the Ov16 rapid test is feasible based on acceptability, usability, and cost. A study was conducted in 13 villages in southeastern Senegal in May 2016. Community members were invited to participate in a demographic questionnaire, a rapid test, a skin snip biopsy, and an acceptability interview. Technicians were also interviewed and a costing analysis was conducted. Out of 1,173 participants, 1,169 (99.7%) agreed to the rapid test while 383 (32.7%) agreed to skin snip microscopy. The rapid test result was reactive in 2.6% of those tested, while none of the skin snips were positive. Community members thought the rapid test was performed quickly, was not painful, and provided reliable results. If no one had refused skin snip microscopy, the total cost would have been around $16 per person tested for either method. In this area with little if any remaining onchocerciasis, there was high acceptability and perceived value of the rapid test. This study suggests that implementing the Ov16 rapid test in Senegal is feasible and these findings may be informative to other country programs.
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Affiliation(s)
- Yakou Dieye
- PATH, Seattle, Washington, United States of America
| | - Helen L Storey
- PATH, Seattle, Washington, United States of America
- * E-mail:
| | | | | | | | | | - Dunia Faulx
- PATH, Seattle, Washington, United States of America
| | | | | | - Ngayo Sy
- Senegal Ministry of Health and Social Action, Dakar, Senegal
| | - Malang Mané
- Senegal Ministry of Health and Social Action, Dakar, Senegal
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Pedram B, Pasquetto V, Drame PM, Ji Y, Gonzalez-Moa MJ, Baldwin RK, Nutman TB, Biamonte MA. A novel rapid test for detecting antibody responses to Loa loa infections. PLoS Negl Trop Dis 2017; 11:e0005741. [PMID: 28749939 PMCID: PMC5531435 DOI: 10.1371/journal.pntd.0005741] [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: 02/28/2017] [Accepted: 06/23/2017] [Indexed: 01/06/2023] Open
Abstract
Ivermectin-based mass drug administration (MDA) programs have achieved remarkable success towards the elimination of onchocerciasis and lymphatic filariasis. However, their full implementation has been hindered in Central Africa by the occurrence of ivermectin-related severe adverse events (SAEs) in a subset of individuals with high circulating levels of Loa loa microfilariae. Extending MDA to areas with coincident L. loa infection is problematic, and inexpensive point-of-care tests for L. loa are acutely needed. Herein, we present a lateral flow assay (LFA) to identify subjects with a serological response to Ll-SXP-1, a specific and validated marker of L. loa. The test was evaluated on serum samples from patients infected with L. loa (n = 109) and other helminths (n = 204), as well as on uninfected controls (n = 77). When read with the naked eye, the test was 94% sensitive for L. loa infection and was 100% specific when sera from healthy endemic and non-endemic controls or from those with S. stercoralis infections were used as the comparators. When sera of patients with O. volvulus, W. bancrofti, or M. perstans were used as the comparators, the specificity of the LFA was 82%, 87%, and 88%, respectively. A companion smartphone reader allowed measurement of the test line intensities and establishment of cutoff values. With a cutoff of 600 Units, the assay sensitivity decreased to 71%, but the specificity increased to 96% for O. volvulus, 100% for W. bancrofti, and 100% for M. perstans-infected individuals. The LFA may find applications in refining the current maps of L. loa prevalence, which are needed to eliminate onchocerciasis and lymphatic filariasis from the African continent.
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Affiliation(s)
- Bijan Pedram
- Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States of America
| | - Valérie Pasquetto
- Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States of America
| | - Papa M. Drame
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Yongchang Ji
- Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States of America
| | - Maria J. Gonzalez-Moa
- Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States of America
| | | | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Marco A. Biamonte
- Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States of America
- * E-mail:
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41
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Feeser KR, Cama V, Priest JW, Thiele EA, Wiegand RE, Lakwo T, Feleke SM, Cantey PT. Characterizing Reactivity to Onchocerca volvulus Antigens in Multiplex Bead Assays. Am J Trop Med Hyg 2017; 97:666-672. [PMID: 28722605 DOI: 10.4269/ajtmh.16-0519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Multiplex bead assays (MBAs) may provide a powerful integrated tool for monitoring, evaluation, and post-elimination surveillance of onchocerciasis and co-endemic diseases; however, the specificity and sensitivity of Onchocerca volvulus antigens have not been characterized within this context. An MBA was developed to evaluate three antigens (OV-16, OV-17, and OV-33) for onchocerciasis. Receiver operating characteristics (ROC) analyses were used to characterize antigen performance using a panel of 610 specimens: 109 O. volvulus-positive specimens, 426 non-onchocerciasis controls with filarial and other confirmed parasitic infection, and 75 sera from patients with no other parasitic infection. The IgG and IgG4 assays for OV-16 demonstrated sensitivities of 95.4% and 96.3%, and specificities of 99.4% and 99.8%, respectively. The OV-17 IgG and IgG4 assays had sensitivities of 86.2% and 76.1% and specificities of 79.2% and 82.8%. For OV-33, the IgG and IgG4 assays had sensitivities of 90.8% and 96.3%, and specificities of 96.8% and 98.6%. The OV-16 IgG4-based MBA had the best assay characteristics, followed by OV-33 IgG4. The OV-16 IgG4 assay would be useful for monitoring and evaluation using the MBA platform. Further evaluations are needed to review the potential use of OV-33 as a confirmatory test in the context of program evaluations.
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Affiliation(s)
- Karla R Feeser
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vitaliano Cama
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeffrey W Priest
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth A Thiele
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan E Wiegand
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomson Lakwo
- Vector Control Division, Uganda Ministry of Health, Kampala, Uganda
| | | | - Paul T Cantey
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Paulin HN, Nshala A, Kalinga A, Mwingira U, Wiegand R, Cama V, Cantey PT. Evaluation of Onchocerciasis Transmission in Tanzania: Preliminary Rapid Field Results in the Tukuyu Focus, 2015. Am J Trop Med Hyg 2017; 97:673-676. [PMID: 28722619 DOI: 10.4269/ajtmh.16-0988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
To compare diagnostic tests for onchocerciasis in a setting that has suppressed transmission, a randomized, age-stratified study was implemented in an area in Tanzania that had received 15 rounds of annual mass drug administration (MDA) with ivermectin. Study participants (N = 948) from 11 villages underwent a questionnaire, skin examination, skin snips, and blood draw. The burden of symptomatic disease was low. Ov-16 antibody rapid diagnostic test (RDT) results were positive in 38 (5.5%) participants, with 1 (0.5%), 1 (0.4%), and 2 (0.8%) in children aged 0-5, 6-10, and 11-15 years, respectively. Despite significant impact of MDA on transmission, the area would have failed to meet World Health Organization serologic criteria for stopping MDA if a full evaluation had been conducted. The specificity of the RDT, which is 97-98%, may result in the identification of a number of false positives that would exceed the current stop MDA threshold.
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Affiliation(s)
| | - Andreas Nshala
- Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania
| | - Akili Kalinga
- National Institute of Medical Research, Tukuyu Medical Research Centre, Tukuyu, Tanzania
| | - Upendo Mwingira
- National Institute of Medical Research, Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania.,Neglected Tropical Diseases Control Program, Dar es Salaam, Tanzania
| | - Ryan Wiegand
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vitaliano Cama
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul T Cantey
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Bennuru S, Lustigman S, Abraham D, Nutman TB. Metabolite profiling of infection-associated metabolic markers of onchocerciasis. Mol Biochem Parasitol 2017; 215:58-69. [PMID: 28188804 PMCID: PMC5474354 DOI: 10.1016/j.molbiopara.2017.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 01/25/2017] [Accepted: 01/28/2017] [Indexed: 11/30/2022]
Abstract
The global efforts for onchocerciasis elimination may require additional tools (safe micro and macrofilaricidal drugs, vaccines and biomarkers) as elimination efforts move toward the "end game". Efforts toward the identification of suitable biomarkers have focused on specific protein(s) and/or nucleic acids, but metabolites present an alternative option as they have limited half-lives and are the result of combinatorial effects. In comparison to previously used methodology of LC-MS for metabolomic approaches, we used a non-targeted capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS) to analyze the serum metabolic profiles of Ov-infected and -uninfected individuals (n=20). We identified 286 known metabolites (167 in the cation mode and 119 in the anion mode). In addition, putative metabolites were identified based on KEGG (51), HMDB (37) and HMT (6) databases. One hundred ten of these putative metabolites were quantified based on peak areas of internal standards and their ability to be mapped to known pathways (primary-, carbon-, lipid-, amino acid-, nucleotide and coenzyme-metabolism). Multivariate analysis demonstrated clustering and segregation of some of these metabolites to either the infected or control groups. The levels of serotonin, hypoxanthine, pipecolic acid and inosine were significantly elevated in those with onchocerciasis, whereas the levels of glycerophosphocholine, choline and adenine were significantly lower. This non-targeted metabolomic approach provides a global view of the metabolic variations that occur during Ov infection and thus allow the discovery of key metabolites (and associated pathways) that may serve as useful biomarkers in human onchocerciasis.
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Affiliation(s)
| | | | | | - Thomas B Nutman
- Laboratory of Parasitic Diseases, NIAID, NIH, Bethesda, MD, USA
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44
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Lagatie O, Batsa Debrah L, Debrah A, Stuyver LJ. Plasma-derived parasitic microRNAs have insufficient concentrations to be used as diagnostic biomarker for detection of Onchocerca volvulus infection or treatment monitoring using LNA-based RT-qPCR. Parasitol Res 2017; 116:1013-1022. [PMID: 28111713 PMCID: PMC5313568 DOI: 10.1007/s00436-017-5382-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/16/2017] [Indexed: 01/30/2023]
Abstract
River blindness, caused by infection with the filarial nematode Onchocerca volvulus, is a neglected tropical disease affecting millions of people. There is a clear need for diagnostic tools capable of identifying infected patients, but that can also be used for monitoring disease progression and treatment efficacy. Plasma-derived parasitic microRNAs have been suggested as potential candidates for such diagnostic tools. We have investigated whether these parasitic microRNAs are present in sufficient quantity in plasma of Onchocerca-infected patients to be used as a diagnostic biomarker for detection of O. volvulus infection or treatment monitoring. Plasma samples were collected from different sources (23 nodule-positive individuals and 20 microfilaridermic individuals), microRNAs (miRNAs) were extracted using Qiagen miRNeasy kit, and a set of 17 parasitic miRNAs was evaluated on these miRNA extracts using miRCURY Locked Nucleic Acid (LNA) Universal RT microRNA PCR system. Of the 17 miRNAs evaluated, only 7 miRNAs were found to show detectable signal in a number of samples: bma-miR-236-1, bma-miR-71, ov-miR71-22nt, ov-miR-71-23nt, ov-miR-100d, ov-bantam-a, and ov-miR-87-3p. Subsequent melting curve analysis, however, indicated that the signals observed for ov-miR-71 variants and ov-miR-87-3p are non-specific. The other miRNAs only showed positive signal in one or few samples with Cq values just below the cutoff. Our data indicate that parasitic miRNAs are not present in circulation at a sufficiently high level to be used as biomarker for O. volvulus infection or treatment monitoring using LNA-based RT-qPCR analysis.
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Affiliation(s)
- Ole Lagatie
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium.
| | - Linda Batsa Debrah
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alex Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lieven J Stuyver
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
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Lagatie O, Van Dorst B, Stuyver LJ. Identification of three immunodominant motifs with atypical isotype profile scattered over the Onchocerca volvulus proteome. PLoS Negl Trop Dis 2017; 11:e0005330. [PMID: 28125577 PMCID: PMC5295699 DOI: 10.1371/journal.pntd.0005330] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/07/2017] [Accepted: 01/14/2017] [Indexed: 01/30/2023] Open
Abstract
Understanding the immune response upon infection with the filarial nematode Onchocerca volvulus and the mechanisms that evolved in this parasite to evade immune mediated elimination is essential to expand the toolbox available for diagnostics, therapeutics and vaccines development. Using high-density peptide microarrays we scanned the proteome-wide linear epitope repertoire in Cameroonian onchocerciasis patients and healthy controls from Southern Africa which led to the identification of 249 immunodominant antigenic peptides. Motif analysis learned that 3 immunodominant motifs, encompassing 3 linear epitopes, are present in 70, 43, and 31 of these peptides, respectively and appear to be scattered over the entire proteome in seemingly non-related proteins. These linear epitopes are shown to have an atypical isotype profile dominated by IgG1, IgG3, IgE and IgM, in contrast to the commonly observed IgG4 response in chronic active helminth infections. The identification of these linear epitope motifs may lead to novel diagnostic development but further evaluation of cross-reactivity against common co-infecting human nematode infections will be needed. Infection with the filarial parasite Onchocerca volvulus is the cause of river blindness. We analyzed the immune response against this parasite in infected individuals in order to identify linear epitopes. Using high-density peptide microarrays we discovered three immunodominant motifs in the Onchocerca volvulus proteome that induce a broad IgG response, but the typical IgG4 immune response against parasites was absent. Our study led to the identification of novel potential epitope sequences that can potentially be used for detection of infection with Onchocerca volvulus.
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Affiliation(s)
- Ole Lagatie
- Janssen Diagnostics, Janssen Pharmaceutica NV, Beerse, Belgium
- * E-mail:
| | - Bieke Van Dorst
- Janssen Diagnostics, Janssen Pharmaceutica NV, Beerse, Belgium
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Lagatie O, Merino M, Batsa Debrah L, Debrah AY, Stuyver LJ. An isothermal DNA amplification method for detection of Onchocerca volvulus infection in skin biopsies. Parasit Vectors 2016; 9:624. [PMID: 27906100 PMCID: PMC5134125 DOI: 10.1186/s13071-016-1913-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/24/2016] [Indexed: 12/20/2022] Open
Abstract
Background Diagnostic procedures for the diagnosis of infection with the nematode parasite Onchocerca volvulus are currently based on the microscopic detection of microfilariae in skin biopsies. Alternative approaches based on amplification of parasitic DNA in these skin biopsies are currently being explored. Mostly this is based on the detection of the O-150 repeat sequence using PCR based techniques. Methods An isothermal, loop-mediated amplification method has been designed using the mitochondrial O. volvulus cox1 gene as a target. Results Analysis of dilution series of synthetic DNA containing the targeted sequence show a non-linear dose-response curve, as is usually the case for isothermal amplification methods. Evaluation of cross-reactivity with the heterologous sequence from the closely related parasites Wuchereria bancrofti, Loa loa and Brugia malayi demonstrated strong specificity, as none of these sequences was amplified. The assay however amplified both O. volvulus and O. ochengi DNA, but with a different melting point that can be used to discriminate between the species. Evaluation of this assay in a set of skin snip biopsies collected in an endemic area in Ghana showed a high correlation with O-150 qPCR and also demonstrated a similar sensitivity. Compared to qPCR, LAMP had a sensitivity of 88.2% and a specificity of 99.2%. Conclusions We have developed a sensitive and specific loop-mediated amplification method for detection of O. volvulus DNA in skin biopsies that is capable of providing results within 30 min. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1913-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ole Lagatie
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium.
| | - Michelle Merino
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Linda Batsa Debrah
- Kumasi Centre for Collaborative Research into Tropical medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Y Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lieven J Stuyver
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
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Pion SD, Montavon C, Chesnais CB, Kamgno J, Wanji S, Klion AD, Nutman TB, Boussinesq M. Positivity of Antigen Tests Used for Diagnosis of Lymphatic Filariasis in Individuals Without Wuchereria bancrofti Infection But with High Loa loa Microfilaremia. Am J Trop Med Hyg 2016; 95:1417-1423. [PMID: 27729568 PMCID: PMC5154460 DOI: 10.4269/ajtmh.16-0547] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 08/25/2016] [Indexed: 01/25/2023] Open
Abstract
Since the mid-2000s, the immunochromatographic card test (ICT), a point-of-care test for detecting Wuchereria bancrofti circulating filarial antigens (CFAs), has been the backbone for mapping and monitoring lymphatic filariasis (LF) worldwide. Recently, there have been instances in which CFA positivity has been associated with Loa loa microfilaremia. Here, we examined the association, at both the community and individual levels, between L. loa and CFA using additional diagnostic tools (quantitative polymerase chain reaction [qPCR], Og4C3 enzyme-linked immunosorbent assay, and IgG4 antibodies to Wb123 assays) to demonstrate the relationship between L. loa microfilaremia and ICT positivity. In May 2013, peripheral blood was collected during the day from 1,812 individuals living in southern Cameroon. ICT tests were done on the spot, and positive individuals were resampled at night. Results of qPCR and Wb123 assays concurred proving the absence of W. bancrofti infection. Og4C3 assays indicate a quantitative relationship between the level of L. loa microfilaremia and that of CFA. This was confirmed by epidemiological analyses, which reveal a strong association between L. loa microfilaremia and ICT positivity, with 50% of ICT reacting to L. loa when its microfilarial density exceeds 30,000 microfilariae/mL. At the community level, the proportion of positive ICT would exceed 2% when the prevalence of L. loa microfilaremia in the total population is above 20%. This has significant implications in terms of mapping and control of LF caused by W. bancrofti in Loa-endemic areas. Cross-reactivity of ICT with L. loa has to be considered in the context of both individual and community diagnostics.
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Affiliation(s)
- Sébastien D Pion
- Centre de Recherche sur les Filarioses et autres Maladies Tropicales, Yaoundé, Cameroon.,Unité Mixte Internationale 233, Institut de Recherche pour le Développement, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Céline Montavon
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Cédric B Chesnais
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Joseph Kamgno
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.,Centre de Recherche sur les Filarioses et autres Maladies Tropicales, Yaoundé, Cameroon
| | - Samuel Wanji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and Environment, Buea, Cameroon
| | - Amy D Klion
- National Institutes of Health, Bethesda, Maryland
| | | | - Michel Boussinesq
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
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Barry MA, Murray KO, Hotez PJ, Jones KM. Impact of vectorborne parasitic neglected tropical diseases on child health. Arch Dis Child 2016; 101:640-7. [PMID: 26921274 DOI: 10.1136/archdischild-2015-308266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/29/2016] [Indexed: 11/03/2022]
Abstract
Chagas disease, leishmaniasis, onchocerciasis and lymphatic filariasis are all vectorborne neglected tropical diseases (NTDs) that are responsible for significant disease burden in impoverished children and adults worldwide. As vectorborne parasitic diseases, they can all be targeted for elimination through vector control strategies. Examples of successful vector control programmes for these diseases over the past two decades have included the Southern Cone Initiative against Chagas disease, the Kala-azar Control Scheme against leishmaniasis, the Onchocerciasis Control Programme and the lymphatic filariasis control programme in The Gambia. A common vector control component in all of these programmes is the use of adulticides including dichlorodiphenyltrichloroethane and newer synthetic pyrethroid insecticides against the insect vectors of disease. Household spraying has been used against Chagas disease and leishmaniasis, and insecticide-treated bed nets have helped prevent leishmaniasis and lymphatic filariasis. Recent trends in vector control focus on collaborations between programmes and sectors to achieve integrated vector management that addresses the holistic vector control needs of a community rather than approaching it on a disease-by-disease basis, with the goals of increased efficacy, sustainability and cost-effectiveness. As evidence of vector resistance to currently used insecticide regimens emerges, research to develop new and improved insecticides and novel control strategies will be critical in reducing disease burden. In the quest to eliminate these vectorborne NTDs, efforts need to be made to continue existing control programmes, further implement integrated vector control strategies and stimulate research into new insecticides and control methods.
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Affiliation(s)
- Meagan A Barry
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA Department of Pediatrics, Section of Pediatric Tropical Medicine, Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA
| | - Kristy O Murray
- Department of Pediatrics, Section of Pediatric Tropical Medicine, Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Peter J Hotez
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas, USA Department of Pediatrics, Section of Pediatric Tropical Medicine, Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Kathryn M Jones
- Department of Pediatrics, Section of Pediatric Tropical Medicine, Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA Department of Pediatrics, Section of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
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Lagatie O, Njumbe Ediage E, Batsa Debrah L, Diels L, Nolten C, Vinken P, Debrah A, Dillen L, Silber S, Stuyver LJ. Evaluation of the diagnostic potential of urinary N-Acetyltyramine-O,β-glucuronide (NATOG) as diagnostic biomarker for Onchocerca volvulus infection. Parasit Vectors 2016; 9:302. [PMID: 27216752 PMCID: PMC4877973 DOI: 10.1186/s13071-016-1582-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/10/2016] [Indexed: 12/14/2022] Open
Abstract
Background Onchocerciasis, also known as river blindness is one of the neglected tropical diseases affecting millions of people, mainly in sub-Saharan Africa and is caused by the filarial nematode Onchocerca volvulus. Efforts to eliminate this disease are ongoing and are based on mass drug administration programs with the microfilaricide ivermectin. In order to monitor the efficacy of these programs, there is an unmet need for diagnostic tools capable of identifying infected patients. We have investigated the diagnostic potential of urinary N-acetyltyramine-O,β-glucuronide (NATOG), which is a promising O. volvulus specific biomarker previously identified by urine metabolome analysis. Methods A liquid chromatography tandem mass spectrometry (LC-MS/MS) method was used to assess the stability characteristics of NATOG and to evaluate the levels of NATOG in study samples. An LC-fluorescence method was also developed. Results Stability characteristics of NATOG were investigated and shown to be ideally suited for use in tropical settings. Also, an easy and more accessible method based on liquid chromatography coupled to fluorescence detection was developed and shown to have the necessary sensitivity (limit of quantification 1 μM). Furthermore, we have evaluated the levels of NATOG in a population of 98 nodule-positive individuals from Ghana with no or low levels of microfilaria in the skin and compared them with the levels observed in different control groups (endemic controls (n = 50), non-endemic controls (n = 18) and lymphatic filariasis (n = 51). Only a few (5 %) of nodule-positive individuals showed an increased level (> 10 μM) of NATOG and there was no statistical difference between the nodule-positive individuals and the control groups (P > 0.05). Conclusions Results of the present study indicate the limited potential of NATOG as a diagnostic biomarker for O. volvulus infection in amicrofilaridermic individuals. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1582-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ole Lagatie
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium.
| | | | - Linda Batsa Debrah
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Luc Diels
- Bioanalysis, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Christ Nolten
- Neuroscience, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Petra Vinken
- Toxicology, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Alex Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lieve Dillen
- Bioanalysis, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Steven Silber
- Janssen Global Public Health, Janssen R&D, 12 W Sunset Ave, Philadelphia, PA, 19118, USA
| | - Lieven J Stuyver
- Janssen Diagnostics, Janssen R&D, Turnhoutseweg 30, 2340, Beerse, Belgium
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