Abstract
BackgroundBrugia malayi is endemic in several Asian countries with the highest prevalence in Indonesia. Determination of prevalence of lymphatic filariasis by serology has been performed by various investigators using different kinds of antigen (either soluble worm antigen preparations or recombinant antigens). This investigation compared the data obtained from IgG4 assays using two different kinds of antigen in a study on prevalence of antibodies to B. malayi.MethodsSerum samples from a transmigrant population and life long residents previously tested with IgG4 assay using soluble worm antigen (SWA-ELISA), were retested with an IgG4 assay that employs BmR1 recombinant antigen (BmR1 dipstick [Brugia Rapid™]). The results obtained with the two antigens were compared, using Pearson chi-square and McNemar test.ResultsThere were similarities and differences in the results obtained using the two kinds of antigen (SWA and BmR1). Similarities included the observation that assays using both antigens demonstrated an increasing prevalence of IgG4 antibodies in the transmigrant population with increasing exposure to the infection, and by six years living in the area, antibody prevalence was similar to that of life-long residents. With regards to differences, of significance is the demonstration of similar antibody prevalence in adults and children by BmR1 dipstick whereas by SWA-ELISA the antibody prevalence in adults was higher than in children.ConclusionsResults and conclusions made from investigations of prevalence of anti-filarial IgG4 antibody in a population would be affected by the assay employed in the study.
Highlights
Brugia malayi is endemic in several Asian countries with the highest prevalence in Indonesia
The first detection of IgG4 antibody by the BmR1 dipstick was recorded at 3 years post-exposure, the antibody prevalence increased from 0% in the new arrivals (≤ 1 month and 2–4 months) to 7.4%, 11.1%, 39.1% and 42 % in populations exposed to the infection for 3, 4, 5 and 6 years respectively
This study highlights that assays using both BmR1 and soluble adult worm antigen (SWA) antigens demonstrate an increasing prevalence of specific IgG4 antibodies in the transmigrant population with increasing length of residence in an area endemic for brugian filariasis, and, by six years residency that the antibody prevalence was similar to that observed in the life-long residents (LLR) population
Summary
Brugia malayi is endemic in several Asian countries with the highest prevalence in Indonesia. Brugia endemic countries of Malaysia and Indonesia [2,3] This diagnostic method depends on the detection of microfilariae in the peripheral blood, and due to the nocturnal periodicity of microfilaremia in these areas, requires nighttime collection and survey, which is often unpopular with the local population. This method is relatively insensitive [4] and difficult to perform accurately and with consistency in field situations. Serological diagnostic methods exhibit better sensitivity than detection of microfilaria by thick blood smear, allow the detection of amicrofilaraemic infections among "endemic normals" and afford daytime fingerprick blood sampling ( overcoming the inconveniences associated with night blood sampling, thereby encouraging greater cooperation with the local population and facilitate field work) [5]
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