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Mnkai J, Ritter M, Maganga L, Maboko L, Olomi W, Clowes P, Minich J, Lelo AE, Kariuki D, Debrah AY, Geldmacher C, Hoelscher M, Saathoff E, Chachage M, Pfarr K, Hoerauf A, Kroidl I. Increased HIV Incidence in Wuchereria bancrofti Microfilaria Positive Individuals in Tanzania. Pathogens 2023; 12:pathogens12030387. [PMID: 36986309 PMCID: PMC10054595 DOI: 10.3390/pathogens12030387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Infections with Wuchereria bancrofti are associated with reduced immunity against concomitant infections. Indeed, our previous study described a 2.3-fold increased HIV incidence among individuals with W. bancrofti infection, as measured by the circulating filarial antigen of the adult worm. This new study aimed to retrospectively determine microfilariae status of the participants to assess if the previously described increased HIV susceptibility was associated with the presence of MF in the same cohort. Methods: CFA positive but HIV negative biobanked human blood samples (n = 350) were analyzed for W. bancrofti MF chitinase using real time PCR. Results: The PCR provided a positive signal in 12/350 (3.4%) samples. During four years of follow-up (1109 person years (PY)), 22 study participants acquired an HIV infection. In 39 PY of W. bancrofti MF chitinase positive individuals, three new HIV infections occurred (7.8 cases per 100 PY), in contrast to 19 seroconversions in 1070 PY of W. bancrofti MF chitinase negative individuals (1.8 cases per 100 PY, p = 0.014). Conclusions: In the subgroup of MF-producing Wb-infected individuals, the HIV incidence exceeded the previously described moderate increased risk for HIV seen in all Wb-infected individuals (regardless of MF status) compared with uninfected persons from the same area.
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Affiliation(s)
- Jonathan Mnkai
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
| | - Lucas Maganga
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Leonard Maboko
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
- Tanzania Commission for AIDS, Dodoma P.O. Box 2904, Tanzania
| | - Willyhelmina Olomi
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Petra Clowes
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
| | - Jessica Minich
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
| | - Agola Eric Lelo
- Kenya Medical Research Institute (KEMRI), KNH, Nairobi, Kenya
| | - Daniel Kariuki
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
| | - Alexander Yaw Debrah
- Kumasi Centre for Collaborative Research (KCCR), Kwame Nkrumah University of Science and Technology, UPO, PMB, Kumasi, Ghana
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Mkunde Chachage
- National Institute of Medical Research (NIMR), Mbeya Medical Research Center (MMRC), Mbeya P.O. Box 2410, Tanzania
- Mbeya College of Health and Allied Sciences (UDSM-MCHAS), University of Dar es Salaam, Mbeya 608, Tanzania
| | - Kenneth Pfarr
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 53127 Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), 53127 Bonn, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 53127 Bonn, Germany
- German-West African Centre for Global Health and Pandemic Prevention (G-WAC), Partner Site Bonn, 53127 Bonn, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), 80802 Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
- Correspondence:
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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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Riches N, Badia-Rius X, Mzilahowa T, Kelly-Hope LA. A systematic review of alternative surveillance approaches for lymphatic filariasis in low prevalence settings: Implications for post-validation settings. PLoS Negl Trop Dis 2020; 14:e0008289. [PMID: 32396575 PMCID: PMC7217451 DOI: 10.1371/journal.pntd.0008289] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 04/13/2020] [Indexed: 01/08/2023] Open
Abstract
Due to the success of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) many countries have either eliminated the disease as a public health problem or are scheduled to achieve this elimination status in the coming years. The World Health Organization (WHO) recommend that the Transmission Assessment Survey (TAS) is used routinely for post-mass drug administration (MDA) surveillance but it is considered to lack sensitivity in low prevalence settings and not be suitable for post-validation surveillance. Currently there is limited evidence to support programme managers on the design of appropriate alternative strategies to TAS that can be used for post-validation surveillance, as recommended by the WHO. We searched for human and mosquito LF surveillance studies conducted between January 2000 and December 2018 in countries which had either completed MDA or had been validated as having eliminated LF. Article screening and selection were independently conducted. 44 papers met the eligibility criteria, summarising evidence from 22 countries and comprising 83 methodologically distinct surveillance studies. No standardised approach was reported. The most common study type was community-based human testing (n = 42, 47.2%), followed by mosquito xenomonitoring (n = 23, 25.8%) and alternative (non-TAS) forms of school-based human testing (n = 19, 21.3%). Most studies were cross-sectional (n = 61, 73.5%) and used non-random sampling methods. 11 different human diagnostic tests were described. Results suggest that sensitivity of LF surveillance can be increased by incorporating newer human diagnostic tests (including antibody tests) and the use of mosquito xenomonitoring may be able to help identify and target areas of active transmission. Alternative sampling methods including the addition of adults to routine surveillance methods and consideration of community-based sampling could also increase sensitivity. The evidence base to support post-validation surveillance remains limited. Further research is needed on the diagnostic performance and cost-effectiveness of new diagnostic tests and methodologies to guide policy decisions and must be conducted in a range of countries. Evidence on how to integrate surveillance within other routine healthcare processes is also important to support the ongoing sustainability of LF surveillance. Lymphatic filariasis (LF) is a mosquito-borne disease, which can result in complications including swelling affecting the limbs (lymphoedema) or scrotum (hydrocele). LF can be eliminated by mass drug administration (MDA) which involves whole communities taking drug treatment at regular intervals. After MDA programmes, country programmes conduct the Transmission Assessment Survey (TAS), which tests school children for LF. It is important to continue testing for LF after elimination because there can be a 10-year period between becoming infected and developing symptoms, but it is thought that the use of TAS in such settings is likely to be too expensive and also not sensitive enough to detect low-level infections. Our study assesses the results from 44 studies in areas of low LF prevalence that have investigated methods of surveillance for LF which differ from the standardised TAS approach. These include both human and mosquito studies. Results show that there is currently no standardised approach to testing, but that surveillance can be made more sensitive through the use of new diagnostic tests, such as antibody testing, and also by targeting higher risk populations. However, further research is needed to understand whether these approaches work in a range of settings and whether they are affordable on the ground.
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Affiliation(s)
- Nicholas Riches
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Xavier Badia-Rius
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Louise A Kelly-Hope
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Silva E, Xavier A, Silva E, Barbosa Júnior W, Rocha A, Freitas V, Oliveira P, Aguiar-Santos AM, Bonfim C, Medeiros Z. Evaluation of lymphatic filariasis in endemic area of Brazil where mass drug administration is not required. Pathog Glob Health 2019; 113:143-148. [PMID: 31138026 DOI: 10.1080/20477724.2019.1623546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Mass drug administration (MDA) is the main counter-transmission strategy of the Global Programme to Eliminate Lymphatic Filariasis. In endemic countries, there are areas where MDA is not required. However, there is no standard approach in these areas, and studies are important to evaluate the epidemiological status. This study aimed to investigate lymphatic filariasis and strategies developed for its control in an area where MDA is not required. Together with the 2018 morbidity evaluation, a survey was conducted using point-of-care immunochromatographic test-AD12 tests for diagnostic screening in an area where MDA is not required. The methodology also included desk research based on Health Department reports of the control activities for lymphatic filariasis during 2003-2016. Among the 934 cases investigated in 2018, there was a 0.64% prevalence of circulating filarial antigen positive, comprising five adults and one 2-year-old child. Six patients aged 39-63 years had filarial disease. Fourteen surveys have already been conducted as control activities, and since 2009, there have been no positive cases. This study showed that the prevalence of antigenemia decreased from 2.97% in 2003 to 0.64% in 2018. Moreover, the transmission of filariasis infection was under control in this area. Our study provides insights into the surveillance phase by identifying areas of low transmission and where MDA is not required. Although we have not identified cases of filarial infection, there is a need to provide services that will provide assist those already affected with morbidity and help reduce and prevent disability.
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Affiliation(s)
- Ellyda Silva
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Amanda Xavier
- b Programa de Pós-graduação em Ciências da Saúde , Universidade de Pernambuco (UPE) , Recife , Pernambuco , Brasil
| | - Elis Silva
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Walter Barbosa Júnior
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Abraham Rocha
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil.,d Secretaria de Saúde do Estado de Pernambuco , Laboratório do Hospital Otávio de Freitas , Recife , Pernambuco , Brazil
| | - Vania Freitas
- e Secretária Municipal de Saúde de Jaboatão dos Guararapes , Diretoria de Vigilância em Saúde , Jaboatão dos Guararapes , Pernambuco , Brazil
| | - Paula Oliveira
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Ana Maria Aguiar-Santos
- c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
| | - Cristine Bonfim
- f Diretoria de Pesquisas Sociais, Núcleo de Estudos em Estatísticas Sociais , Fundação Joaquim Nabuco (FUNDAJ) , Recife , Pernambuco , Brasil.,g Programa de Pós-graduação em Saúde Coletiva , Universidade Federal de Pernambuco (UFPE) , Recife , Pernambuco , Brasil
| | - Zulma Medeiros
- a Programa de Pós-graduação em Biociências e Biotecnologia em Saúde , Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil.,b Programa de Pós-graduação em Ciências da Saúde , Universidade de Pernambuco (UPE) , Recife , Pernambuco , Brasil.,c Serviço de Referencia Nacional em Filarioses, Departamento de Parasitologia , Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ) , Recife , Pernambuco , Brasil
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