Post-Mass Drug Administration Serological Assessment of Lymphatic Filariasis and Onchocerciasis in Plateau State, Nigeria Público
Castor, Rebecca (Spring 2020)
Abstract
Nigeria bears the highest burden in Africa for lymphatic filariasis (LF) and onchocerciasis, two vector-transmitted filarial diseases caused by Wuchereria bancrofti and Onchocerca volvulus, respectively. This study compared results of a novel Ov16/Wb123 biplex rapid antibody test with laboratory‐based ELISA for anti-Ov16 and anti-Wb123 antibodies and LF circulating filarial antigen (CFA) by immunochromatographic card test (ICT) during post-treatment surveillance for LF in 3 local government areas (LGAs) of Plateau State, Nigeria. From April to May 2016, finger-prick blood samples were collected from consenting individuals in school-based Transmission Assessment Surveys (TAS) of first and second year primary school children (approximately 6-7 years old) and community-wide household surveys of individuals >2 years of age in each LGA. Rapid tests (Ov16/Wb123 biplex and ICT) were conducted in the field; dried blood spots (DBS) were prepared for laboratory-based ELISA testing. A total of 6,854 individuals (median age: 7 range: 2-95) had matched demographic data and valid results from all laboratory tests. Overall prevalence estimates for LF CFA, and Wb123 by ELISA and biplex test were 0.13% (95% upper confidence limit [uCL]: 0.23), 1.75% (95% uCL: 2.03), and 0.13% (95% uCL: 0.23), respectively. CFA prevalence generally increased with age, whereas Wb123 prevalence by both ELISA and Biplex tended to be highest in children 5-9 and in the oldest age groups. Of the 9 samples positive for CFA by ICT, only one was positive for Wb123 antibody biplex positive and none were Wb123 ELISA positive. None of the 120 individuals positive by Wb123 ELISA were positive by Wb123 biplex or for CFA by ICT. Overall prevalence estimates for Ov16 by ELISA and biplex were 0.01% (95% uCL: 0.07) and 0.03% (95% uCL: 0.09), respectively. All Ov16-positive individuals were at least 50 years old. Compared to ELISA, the biplex rapid antibody test demonstrated good performance for Ov16, but poorer performance for Wb123. This study strongly suggests that transmission interruption of both diseases has been achieved in the study areas and provides important data on the age distribution of Wb123 and Ov16 in low transmission settings.
Table of Contents
Chapter I: Background 1
Lymphatic filariasis 2
History 3
Biology and Pathology 4
Diagnostic Tests 5
Global Elimination Program 9
Post Treatment Surveillance 12
Onchocerciasis 14
History 15
Biology and Pathology 15
Diagnostic Tests 17
Onchocerciasis Control Programs 18
Post-Treatment Surveillance 19
Chapter II: Manuscript 21
Introduction 22
Methods 25
Survey Design 25
Data Collection 26
Ethical Approval 28
Data Analysis 28
Results 29
Survey Demographics 29
Coverage of Lymphatic Filariasis Control Measures 30
Lymphatic filariasis and Onchocerciasis Descriptive Analysis 30
Household Risk Factor Analysis 33
Discussion 35
Tables and Figures 39
Chapter III: Summary, Public Health Implications, and Future Directions 54
Summary 55
Future Public Health Implications 56
Future Directions 56
References 57
About this Master's Thesis
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