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. 2022 Apr:117:378-386.
doi: 10.1016/j.ijid.2022.02.006. Epub 2022 Feb 9.

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

Angela M Cadavid Restrepo  1 , Katherine Gass  2 , Kimberly Y Won  3 , Meru Sheel  4 , Keri Robinson  3 , Patricia M Graves  5 , Saipale Fuimaono  6 , Colleen L Lau  7
Affiliations

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

Angela M Cadavid Restrepo et al. Int J Infect Dis. 2022 Apr.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: American Samoa; Antifilarial antibodies; Lymphatic filariasis; Lymphatic filariasis resurgence; Post–mass drug administration; Transmission assessments surveys.

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Conflict of interest statement

Declaration of interests The authors declare no competing interests.

Figures

Figure 1
Figure 1
Map of American Samoa.
Figure 2
Figure 2
Locations of the schools (N = 30) included in the surveys and observed number of children who were antigen-positive in TAS-1 (2011), TAS-2 (2015), and TAS-3 (2016) in American Samoa. TAS, transmission assessment survey.
Figure 3
Figure 3
School locations (N = 30) included in surveys and prevalence of antibody responses to Wb123, Bm14, and Bm33 in TAS-1 (2011), TAS-2 (2015), and TAS-3 (2016) in American Samoa. TAS, transmission assessment survey.
Figure 4
Figure 4
Percentage of Ag- and Ab-positive schools (including all combinations of Abs) among (A) all school locations (n = 30) that participated in TAS-1, TAS-2, and TAS-3, and (B) the 25 schools that participated in all 3 TAS. Ab, antibody; Ag, antigen; TAS, transmission assessment survey.
Figure 5
Figure 5
Crude prevalence of Ab-positive responses to single (Bm14, Bm33, Wb123) and combinations of Ab responses (Wb123∪Bm14, Wb123∪Bm33, Bm14∪Bm33, Wb123∪Bm14∪Bm33, Wb123∩Bm14, Wb123∩Bm33, Bm14∩Bm33, and Wb123∩Bm14∩Bm33) in TAS-1, TAS-2, and TAS-3 among children from the 25 schools that participated in all 3 TASs, stratified by school Ag status (presence or absence of children who were Ag-positive) in TAS-3. *p ≤ 0.05; ns indicates p > 0.05. Ab, antibody; Ag, antigen; ns, not significant; TAS, transmission assessment survey.
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