Potential use of antibodies to provide an earlier indication of lymphatic filariasis resurgence in post–mass drug ad ministration surveillance in American Samoa

•The patterns of the antibody (Ab) responses varied across the 3 transmission assessment surveys (TASs).•The overall and school-level prevalence of Bm33 Ab was the highest in all TASs.•Bm14 Ab-positive schools decreased, whereas Wb123 Ab-positive schools increased.•Abs could provide earlier signals...

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Published in:International journal of infectious diseases Vol. 117; pp. 378 - 386
Main Authors: Cadavid Restrepo, Angela M., Gass, Katherine, Won, Kimberly Y., Sheel, Meru, Robinson, Keri, Graves, Patricia M., Fuimaono, Saipale, Lau, Colleen L
Format: Journal Article
Language:English
Published: Canada Elsevier Ltd 01.04.2022
Elsevier
Subjects:
American Samoa
American Samoa - epidemiology
Animals
Antibodies, Helminth
Antifilarial antibodies
Antigens, Helminth
Child
Elephantiasis, Filarial - drug therapy
Elephantiasis, Filarial - epidemiology
Elephantiasis, Filarial - prevention & control
Humans
Lymphatic filariasis
Lymphatic filariasis resurgence
Pharmaceutical Preparations
Post–mass drug administration
Transmission assessments surveys
Wuchereria bancrofti - physiology
American Samoa
American Samoa
Lymphatic filariasis resurgence
Post–mass drug administration
Lymphatic filariasis
Antifilarial antibodies
Transmission assessments surveys
ISSN:1201-9712, 1878-3511, 1878-3511
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Summary:•The patterns of the antibody (Ab) responses varied across the 3 transmission assessment surveys (TASs).•The overall and school-level prevalence of Bm33 Ab was the highest in all TASs.•Bm14 Ab-positive schools decreased, whereas Wb123 Ab-positive schools increased.•Abs could provide earlier signals of resurgence and enable a timelier response.•The role of Abs in post–mass drug administration surveillance should be further investigated. Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted 7 rounds of mass drug administration (MDA) between 2000 and 2006. The territory passed transmission assessment surveys (TASs) in 2011 (TAS-1) and 2015 (TAS-2). In 2016, the territory failed TAS-3, indicating resurgence. This study aims to determine if antibodies (Abs) may have provided a timelier indication of LF resurgence in American Samoa. We examined school-level antigen (Ag) and Ab status (presence/absence of Ag- and Ab-positive children) and prevalence of single and combined Ab responses to Wb123, Bm14, and Bm33 Ags at each TAS. Pearson chi-square test and logistic regression were used to examine associations between school-level Ab prevalence in TAS-1 and TAS-2 and school-level Ag status in TAS-3. Schools with higher prevalence of Wb123 Ab in TAS-2 had higher odds of being Ag-positive in TAS-3 (odds ratio [OR] 24.5, 95% confidence interval [CI] 1.2–512.7). Schools that were Ab-positive for WB123 plus Bm14, Bm33, or both Bm14 and Bm33 in TAS-2 had higher odds of being Ag-positive in TAS-3 (OR 16.0–24.5). Abs could provide earlier signals of resurgence and enable a timelier response. The promising role of Abs in surveillance after MDA and decision making should be further investigated in other settings.
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ISSN:1201-9712
1878-3511
1878-3511
DOI:10.1016/j.ijid.2022.02.006